Cedrick
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A married couple in their mid 20's comes to the physician for evaluation of infertility
they say they have had sexual relations 2 to 3 times per week for the past year
Which of the following is the most appropiate next step for the physician ?
a.-ask the couple what they mean by "sexual relations"
b.-perform a gynecologic examination on the wife
c.-perform a testicular examination on the husband
d.-refer the couple for marital counseling
e.-suggest that the husband indergo fertility evaluation
f.-suggest that the wife undergo fertility evaluation
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| caza
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Right answer is E
Generall, we perform postcoital test.
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| Cedrick
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| Cedrick
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Choice A
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| nadiabarati
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A
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| robin082006
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A is the best
Other choices show discrimination because both couple should need to have medical check, not only wife or husband.
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| leen
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A..
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| sridevibandaru24
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yeah it is A
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| vamsi2004
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the correct ans is E. the reason given by caza is absolutely right.
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| jedw
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Why do you think E? When we evaluate infertility we have to check both partners,
in general causes of infertility can be divided as follows:
- 40% male
- 40% female
- 10% both
- 10% idiopathic
so why evaluate the guy first? no reason..
the ans is A
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| vamsi2004
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bcos testing a male is a very cheap and easy procedure. so we will rule him out first.
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| jedw
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but asking whether they had an intercourse is relevant, isn't it?
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| eaguin
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come on people, who doesn´t know how to do SEX?, and in the other hand male is the easyiest way to start the study of the couple..
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| tolito
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hey remember clinton's definition of sex with monica???
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| mjl1717
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tolito wrote:
hey remember clinton's definition of sex with monica???
Tolito, I never got the details of this but I think she performed "oral" {speaking objectively, not like a teenager} although I heard it was on the internet.
But for the OTHERS answer is- a- what do they mean by sexual relations. Because you cant assume both ends of the spectrum from I.Q. of 0 to I.Q. of 250 to ACTUALLY know what copulation or procreation is!! [Not that sex is dependent of I.Q.]/ could be cultural and personal influences also. {Once again it comes down to a doc knowing how to communicate clearly and properly, putting ego and pride aside. And getting off a "high" horse and communicating "even steven" with the common man. Most feel they can do this. I find its takes experience and breaking down language barriers, cultural barriers, women dealing with there feminity, being open minded about enrichment, etc.
By the way: for those who are calloused and unconscientious [*Not tolito!]--this is very sensitive communication with the patient- "IF THE PATIENT TRUST YOU ENOUGH TO ATTAIN THIS LEVEL OF COMMUNICATION WITH THE PATIENT!!!!!!"
Edited by mjl1717 on 07/23/06 - 01:20 PM
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| tolito
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yes. clinton said he did not have sex with her. when further questioned he defined sex as penetration of the vulva by penis. but we know about oral sex too. so he had oral sex with her but not 'sex'. so with a couple that comes in and say htey have 'sexual relations', we need to understand what they mean by that. i ahve had girls come crying to me that they were pregnant cos they did 'heavy petting'. this is my two cents.
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| mjl1717
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tolito wrote:yes. clinton said he did not have sex with her. when further questioned he defined sex as penetration of the vulva by penis. but we know about oral sex too. so he had oral sex with her but not 'sex'. so with a couple that comes in and say htey have 'sexual relations', we need to understand what they mean by that. i ahve had girls come crying to me that they were pregnant cos they did 'heavy petting'. this is my two cents. 
that's unique and interesting. {you never know what layman are thinking and doing}
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| eaguin
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I'm starting to like behavioral...
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| mjl1717
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yes its human nature oriented
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| pallav
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guys lets end the discussion
because not having a child for one year cant be labelled as infertility
and im sure regarding this...cutting across cultures
and eaguin doing sex has not to be taught
but some 50% couples dont know about the right positions and the technicalities associated with it
so indeed the answer is (a
and of course the rule of thumb is
when in doubt agree to what cedrick has to say
i love u cedrick
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| alpha12
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c'mon, guys...this is one of the easiest Behavioral science questions. Before starting any investigation, you need to be on the same level of understanding. If a patient told you he's feeling funny, don't you try to understand what they mean? If they say they have fever, don't try to know how much, when, at what intervals? when they say they've been having sex, don't you want to know how, how much and when? (of course there are still lots of cultural barriers about the last one).
Final answer: A
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| eytanraz
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Moreover, you have to begin with the cheapest procedure. What is cheaper than a question?!?!
A, all my life
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| eaguin
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thanks alpha 12, I like your response I'm starting to see it more clearly.
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| dr_bilalahmad
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the answer is E.
After one year of unprotected intercourse if a women is not able to conceive then infertility test is started with MALE .
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| Ivil
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hi dr_bilalahmad, in the question they never said they had unprotected intercourse...and as alpha said you should be at the same level of understanding. so the ans is A.
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