RISK FACTORS, INVESTIGATIONS & DIAGNOSIS & TREATMENT PLAN
RISK FACTORS
- Advanced age
- Smoking
- Obesity
- Alcohol
- Recreational drugs (cocaine)
- Medications: NSAIDs, methyldopa, metoclopramide, citalopram, fluoxetine, antipsychotics (prolactin elevation), androgenic steroids and finasteride
- Occupational: pesticides, metals, nitric oxide exposure
- STIs
- Low birth weight
- Tight underwear
INVESTIGATIONS & DIAGNOSIS
Male:
- Semen analysis
- Chlamydia screen
- Examination: genitalia, secondary sexual characteristics, gynaecomastia Female:
- Mid-luteal progesterone (day 21 of a 28-day cycle) – in women w/ confirmed cycles
- Serum gonadotropins (irregular cycles) – in women w/ irregular cycles
- TFTs
- Prolactin
- Chlamydia screen
- BMI
- Examination: acne, hirsutism, galactorrhoea
- Abdominal examination: ovarian cysts
- Bimanual examination: fibroids/cysts
- Pelvic/vaginal examination
TREATMENT PLAN
Medical:
- Clomiphene (ovulation induction)
- Gonadotropins
Surgical:
- Endometriosis ablation
Correction of obstructive azoospermia Assisted reproduction:
- IVF
- Intrauterine insemination
- Intracytoplasmic sperm injection