Table 4.
Minimum Data Set and Classifications
| Data Elements in the General Information Class | |
| Record number | |
| National identifier | |
| Age | |
| Education | |
| Occupation | |
| Phone number | |
| Husband age | |
| Husband occupation | |
| Husband phone number | |
| Data Elements in the Patient History Class | |
| Female | Male |
| General | Addiction (smoking, addictive drugs, alcohol) |
| Height | Any medical problem |
| Weight | Name of problem |
| Duration of marriage | Previous operations Name of operations |
| Previous marriage | Previous marriage |
| Number of children in previous marriage | Number of children in previous marriage |
| Addiction (smoking, addictive drugs, alcohol) | Diseases in family |
| Any medical problem | Infertility problems |
| Name of problem | Recurrent miscarriage |
| Previous operations | Difficulties with ejaculation |
| Name of operation | Difficulties with erection |
| Medication allergies | Exposure of genitals to excessive heat |
| Name of medications | Injury to genitals |
| Diseases in family | Infection of prostate glands, penis, or testicles |
| Cancer | |
| Premature menopause | |
| Birth defects | |
| Hormonal disorders | |
| Infertility problems | |
| Recurrent miscarriage | |
| Blood clots | |
| Family relationship | |
| Menstrual | |
| Duration of bleeding | |
| Usual menstrual interval | |
| Spotting between menses | |
| Premenstrual syndrome (PMS) | |
| Dyspareunia | |
| Galactorrhea | |
| Hirsutism | |
| Dysmenorrhea | |
| Number of intercourses per week | |
| Normal | |
| Lower than normal | |
| No intercourse | |
| Pregnancy | |
| Duration of infertility | |
| Form of contraception used | |
| Period of time of contraception used | |
| Number of previous pregnancies | |
| Number of children | |
| Previous treatment of infertility | |
| In vitro fertilization (IVF)/ intracytoplasmic sperm injection (ICSI) | |
| Intrauterine insemination (IUI) | |
| Induction of ovulation (IO) | |
| Drugs for IUI/IO | |
| Number of treatment cycles received | |
| Outcome of previous treatment | |
| Complications during or after pregnancy | |
| Number of preterm births | |
| Number of miscarriages | |
| Number of ectopic pregnancies | |
| Data Elements in the Paraclinical Reports Class | |
| Female | Male |
| Laboratory tests | Sperm motility |
| Thyroid-stimulating hormone (TSH) | Sperm count |
| Follicle-stimulating hormone (FSH) | Morphology |
| Prolactin | Venereal disease research laboratory (VDRL) |
| Luteinizing hormone (LH) | Human immunodeficiency virus (HIV) 1, 2 |
| Anti-Mullerian hormone (AMH) | Hepatitis B surface antigen (HBsAg) |
| Fasting blood sugar (FBS) | Hepatitis C virus (HCV) |
| Complete blood count (CBC) | Human T-lymphotropic virus (HTLV) 1, 2 |
| Pap smear | |
| Venereal disease research laboratory (VDRL) | |
| Human immunodeficiency virus (HIV) 1, 2 | |
| Hepatitis B surface antigen (HBsAg) | |
| Hepatitis C virus (HCV) | |
| Human T-lymphotropic virus (HTLV) 1, 2 | |
| Ultrasound | |
| Antral follicle count (AFC) | |
| Number of mature follicles | |
| Uterine | |
| Right ovary (RO) | |
| Left ovary (LO) | |
| Endometrial thickness | |
| Laparoscopy, Hysteroscopy | |
| Uterine cavity | |
| Right tube (RT) | |
| Left tube (LT) | |
| Right ovary (RO) | |
| Left ovary (LO) | |
| Data Elements of Treatment Plan (IVF/ICSI, IUI, IO) Class | |
| Cause of infertility | |
| Male factor | |
| Endometriosis | |
| Ovarian factors | |
| Hormonal problems | |
| Male severe (ICSI) | |
| Tubal pathology ovary | |
| Unexplained | |
| Mix | |
| Type of infertility (primary or secondary) | |
| Number of IUI/IO cycle | |
| Number of IVF/ICSI cycle | |
| Drugs for stimulation | |
| Gonadotropin dose | |
| Sperm catch | |
| Type of cycle | |
| Antagonist protocol | |
| Agonist protocol | |
| Long | |
| Poor | |
| Shanghai protocol | |
| Donor (embryo, oocytes, surrogate's uterus) | |
| Heterologous oocytes | |
| Autologous oocytes | |
| Number of oocytes | |
| Quality of oocytes | |
| Number of transferred embryos | |
| Quality of transferred embryos | |
| Stage of embryos (cells) | |
| Embryo transfer (easy, difficult) | |
| Number of frozen embryos | |
| Thawed embryos for frozen embryo transfer | |
| Data Elements of Treatment Outcome Class | |
| Lost to follow-up of pregnancy | |
| Clinical pregnancy | |
| Intrauterine live pregnancy at week 7 or later | |
| Gestational sacs | |
| Fetal reductions | |
| Miscarriage | |
| Ectopic pregnancy | |