3. CASE HISTORY
26 years old Nulligravida
Wife of Serving Soldier
Hindu
Graduate
Homemaker
3
4. MENSTRUAL HISTORY
Menarche- 14 years of age
Previous Menstrual Cycles-
Irregular
3-5 days bleeding/ 60-90 days cycles
No dysmenorrhea
No passage of clots PV
4
5. OBSTETRIC HISTORY - Nulligravida
FAMILY HISTORY – Not significant
PAST HISTORY- Not significant
5
11. SYSTEMIC EXAMINATION
Respiratory System:
Bilaterally equal breath sounds, No adventitious sounds
Cardiovascular System:
S1 & S2 Normal, No diastolic murmurs heard
Central Nervous System:
HMF – Normal
Per Abdomen:
Soft ,non tender , no organomegaly
11
12. LOCAL GENITAL EXAMINATION
External Genitalia- Vulva normal, No clitoromegaly seen
Per Speculum– Vagina and Cervix Healthy
Per Vaginum – Cervix is Firm, Posterior, Mobile
Uterus Normal Size & Anteverted
Bilateral Adnexa Free
12
20. CASE HISTORY
No History Of-
Coital Difficulty
Premature Ejaculation
Erectile Dysfunction
Penile Discharge/Ulcerations
STD/ Infections of Genital Tract 20
24. GENERAL PHYSICAL EXAMINATION
Average built & nourished
Height- 172 cm Wt- 70 kg BMI-23.8kg/m2
Male pattern hair distribution
No gynaecomastia/ No Thyromegaly
No pallor/ icterus/ edema/ cyanosis/ clubbing/
lymphadenopathy
PR: 80bpm BP: 126/80 mm Hg RR- 20 bpm
24
25. SYSTEMIC EXAMINATION
Respiratory System:
Bilaterally equal breath sounds, No adventitious sounds
Cardiovascular System:
S1 & S2 Normal, No diastolic murmurs heard
Central Nervous System:
HMF – Normal
Per Abdomen:
Soft ,non tender , no organomegaly , Bilateral hernia sites normal
25
26. LOCAL GENITAL EXAMINATION
Penis and bilateral scrotal sacs
normal
Testis palpable in both
scrotum ,Normal volume
No
varicocele/Hydrocele
26
Transvagical ultrasound is considered the gold standard in the diagnosis of polycystic ovaries. Features can affect either one (unilateral polycystic ovary) or both ovaries.
Features include presence of 10-12 or more follicles 3,5 individual follicles are generally similar in size and measure 2-9 mm in diameter 7
peripheral distribution of follicles - this can give a "string of pearls" appearance background ovarian enlargement (volume greater than 10 cc 7)
central stromal brightness +/- prominance General imaging differential considerations include
multi-follicular ovaries (MFO) 2 - fewer cysts ( ~ 6 or more per ovary), which tend to be larger (up to 10 mm in diameter) and distributed throughout the ovary with no stromal hypertrophy
AMH is expressed by granulosa cells of the ovary . it is a measure of certain aspects of ovarian function,[19] useful in assessing conditions such as polycystic ovary syndrome and premature ovarian failure
patient is truly azoospermic is confirmed by centrifugation of the semen sample with meticulous microscopic examination of the pellet on two different occasions.
- The presence of any sperm in the pellet rules out bilateral ductal obstruction, and the patient should be evaluated for oligospermia and not azoospermia.
