A 34-year-old female patient complains of lack of conception after unprotected sexual intercourse for 1 year. The patient has been keeping track of basal body temperature to plot ovulation. Pelvic examination is normal
The clinician should ask the patient if which of the following laboratory test(s) have been done:
A. TSH
B. FSH
C. LH
D. All of the above
ANS: D
The work-up for infertility is complex and will need to be referred to a gynecologist specializing in infertility. The causes are numerous but generally fall into the categories of anovulation, implantation failure, hormonal failure, chromosomal abnormalities, or low sperm count in the male partner. Preliminary tests that can be initiated by the nurse practitioner include the following: pelvic examination to ensure that the cervix is open and that there are no uterine abnormalities, basal body temperature charts to plot monthly ovulation and menstrual patterns, and laboratory testing that includes TSH, FSH, LH, and estradiol.
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