Recalls-Subfertility

1. May 2013: role player 37 yr old lady coming to enquire about options to preserve her
fertility.
2. May 2011: Viva- Infertility and PCOS ( Day2 Hirsutism).
3. Nov 2016: SD -subfertility PCO
4. Nov 2016: 3 yrs31 year oldinfert. All inv normal. Hsgbil blocked tube ,had lot of pain
during hsg n only 10 ml dye was injected.Discuss management options .(Simulated pt)
 Other version: Infertility for 3 yrs. Partner semen normal. Hsg done... tubal
blockage but procedure stopped because of pain. Asking for other options.
Willing for lap and dye. Refused Ivf at the moment
5. Rcog course Nov 2016: subfertility ,explain tubal patency tests role player
6. 2012: 2 women with same sex relation wants to have a baby counseling (my first station
) options, counselling and address concerns.
I. You should not show any sign of surprise when you know they are same sex
couple (and so on for all same cases): the examiner will look at your face
and body language when the role player is in same sex relationship
II. Think out side the box: so do not forget to ask about her partner in this
case, how is it going with her, and since when they are together
III. In that station the main Q was about to:
 Are they in a civil relationship or not [important for legal
responsibilities]
 Explain the options: IVF/IUI with sperm donor, adoption
 Explain the rules and law with sperm donor
 Explain who will give the egg( the partner who is younger, and
healthier: so ask about their full Hx and ages ) and the one who will
carry the pregnancy : if the older, explain the risks and how you will
minimize it
 Explain the NHS rules with regard to same sex IVF (Specially funding)
 Then general advice about pregnancy and IVF complications.
IV. Encourage questions
7. 2008, role play: Your patient is a political refugee from the Congo who is HIV+ve as
aresult of having been raped whilst a political prisoner. Her husband is HIV-ve. They
have an 8-year-old daughter who is lost in the Congo, they don't know what her fate is.
She was found whilst being investigated for abdo pain in Hull to have bilateral
hydrosalpinges. She feels her only way of moving on is by starting a new family and
wants IVF. Counsel her. [Shocked]

MHD