History and Examination of the Couple

Abstract

Because the initial interview sets the tone for the whole course of treatment, it is especially important that this first encounter should be with the couple. This immediately imparts both to the husband and wife not only the importance of the couple as a unit, but also the relative nature of infertility. Meeting with the couple creates the environment for a more complete and honest discussion of sexual and emotional factors; if necessary, it lays the groundwork for future counseling. It is also a time to banish fears and dispel general misconceptions about infertility and reproduction. So important is sensitive history taking that it should never be delegated to an aide, and, least of all, to a stereotyped questionnaire. With the physician’s reassurance, the feeling of fault resting with one partner or the other is diminished. With the proper explanation, even if the sperm count later proves to be adequate, the maintenance of a supportive role by the husband is exceedingly helpful.