A 38-year-old female complains of having trouble with conception. It is important to ask the patient to:
A. Schedule a date for pelvic exam and Pap smear
B. Chart at least three menstrual cycles
C. Take basal body temperature for 3 cycles
D. B and C
ANS: D
Infertility may be caused by anovulation, decreased function of the corpus luteum, or blocked or scarred fallopian tubes. Any of these can occur despite the fact that the patient may be having menstrual cycles. A history of menstrual irregularities may suggest anovulation or thyroid disease, either of which can cause infertility. A history of STDs could lead to scarring of the tubes. If the patient has not already done so, ask her to chart her menstrual cycles and basal body temperatures for 3 months to determine if and when ovulation is occurring.
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