Lindsay Harnish
Based on the history, what are the top three things on your differential diagnosis as a cause for her difficulty conceiving?
- polycystic ovarian syndrome
- pelvic inflammatory disease
- stress
Other considerations:
- hypothalamic dysfunction
- pituitary dysfunction - prolactinoma, hypopituitarism
- ovarian dysfunction - premature ovarian failure, luteal phase defect
- tubal dysfunction - adhesions, scarring from prior ectopic
- uterine dysfunction - congenital anomalies, bicornuate uterus, uterine septum, intrauterine adhesions, infection, fibroids/polyps, endometrial ablation
- cervical factors - acidic mucous, anti-sperm antibodies, structural defects
- systemic diseases- thyroid, Cushing’s, renal failure, hepatic failure
- congenital - Turner’s, gonadal dysgenesis, gonadotropin deficiency
- lifestyle - poor nutrition, over exercise