Infertility physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2] Associate Editor(s)-in-Chief:  Sanjana Nethagani, M.B.B.S.[3]

## Overview

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Physical examination plays an important role in detecting infertility. A detailed history and physical, along with imaging and blood tests can identify the cause of infertility in most cases

## Physical Examination

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* Infertility testing involves a complete medical history and physical examination of both partners.

* Blood and imaging tests will be done[1]

* In women, this may include:

* Blood tests to check hormone levels, including progesterone and follicle stimulating hormone[2]
* Checking body temperature first thing in the morning to check if the ovaries are releasing eggs
* FSH and clomid challenge test
* Hysterosalpingography (HSG)
* Pelvic ultrasound
* Laparoscopy
* Luteinizing hormone urine test (ovulation prediction)
* Thyroid function tests

* Tests in men may include:

* Sperm testing
* Testicular biopsy (rarely done)

Some important findings in physical exam might be

#### Head and neck exam

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* Exophthalmos might indicate hyperthyroidism
* Webbed neck is seen in Turner's syndrome
* Epicanthal folds in eyes and low set ears are seen in Down's syndrome
* Neck swellings in thyroid pathology

#### Chest and abdomen exam

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* Thorough breast exam might reveal swellings or nipple discharge
* Any palpable swellings in the abdomen

#### Gynecological exam

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* Pattern of distribution of pelvic hair
* If there is presence of any clitoral enlargement
* Any external signs of sexually transmitted infections
* Cervical motion tenderness
* Presence of fibroids
* Septate vagina

## References

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1. ↑ Hwang K, Lipshultz LI, Lamb DJ (2011). "Use of diagnostic testing to detect infertility". Curr Urol Rep. 12 (1): 68–76. doi:10.1007/s11934-010-0154-0. PMC 3079371. PMID 21088937.CS1 maint: Multiple names: authors list (link)
2. ↑ Sigman M, Jarow JP (1997). "Endocrine evaluation of infertile men". Urology. 50 (5): 659–64. doi:10.1016/S0090-4295(97)00340-3. PMID 9372871.

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