Infertility: The Daily PANCE Blueprint

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Infertility: The Daily PANCE Blueprint

A 36-year-old female presents to your office with her 38-year-old male partner. They have been trying to conceive for the past 8 months without success. Both partners are healthy with no significant medical history. The woman has regular menstrual cycles and denies pelvic pain or abnormal bleeding. What is the most appropriate next step in management?

A. Reassure them and recommend they continue trying for 4 more months
B. Begin infertility evaluation now
C. Prescribe clomiphene citrate to improve ovulation
D. Order karyotype testing for both partners
E. None of the above

Answer and topic summary

The answer is B. Begin infertility evaluation now

Infertility is the inability to become pregnant despite regular, unprotected sex (after at least >1 year in women under 35 years old or >6 months in women over 35 years old). Infertility impacts 10-15% of couples. The most common cause of male infertility is idiopathic sperm disorders. The most common cause of female infertility is anovulation. Workup may include semen analysis, mid-luteal serum progesterone levels, ovulation prediction test, androgen levels, early FSH and estradiol levels, TSH, prolactin levels, endometrial biopsy, and imaging of the uterus/Fallopian tubes. Treatment depends on the cause. Many times assisted reproductive technology is used (e.g., IVF).

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Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint Reproductive System ⇒ Infertility

Also covered as part of the Women's Health EOR topic list

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