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Are you looking for a free second opinion???

Please answer the following questions and we will be happy to help you out.

Name of Wife Age
Name of Husband Age
eMail ID
Place of Living
Married Life
How long have you been trying to get pregnant?
Have you been using any contraceptives?
Are seeking any doctor's advice?
Are you going to a gynaecologist or a family physician?
Do you know the cause/s for your infertilty?
Yes No
Do you have regular menses?
Yes No
Do you suffer from endometriosis?
Yes No
Do you or anyone in your family suffer from tuberculosis?
Yes No
Have you undergone any previous surgeries?
Yes No
Any previous pregnancies ending in abortion?
Yes No
Semen analysis report of male partner?
Sexual history? Does any of the partner have any dificulty during sexual intercourse?
Previous investigations?
HSG?
Laproscopy?
Hysteroscopy?
F.S.H.levels?
I.I.H. levels?
Prolactin levels?
T.S.H. levels?
Others?
Ultrasound?
Have you used tablets for ovulation induction? Do you know the names?
Any gonadotropin injections? Do you know the names?
Any previous cycles of IVF/ICSI in the past?
Number of eggs retrieved?
Number of embryos transferred?
 
       
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