Episode 179

Fertility Management: Common Issues and Advice for GPs with Dr Jana Combrinck

In this episode of The Good GP, host Dr Karin Sekhon is joined by Dr Jana Combrinck, an experienced women's health GP working in Perth and the current GP lead of Oasis Fertility Centre. They delve into the GP's role in fertility management.

Dr Combrinck discusses the prevalence of fertility issues, noting that one in six couples of reproductive age in Australia are affected by subfertility. Identifying advanced maternal age as a common cause, along with conditions such as polycystic ovarian syndrome (PCOS), ovulation disorders, and endometriosis. She emphasises the importance of considering male factors, which are responsible in at least 50% of cases.


Giving insights on the process for couples experiencing infertility. Dr Combrinck outlines a systematic approach, which includes taking a thorough history, conducting necessary blood tests, and performing imaging investigations. For male patients, a semen analysis is recommended as the first step.


Dr Combrinck also discusses the medications and supplements that GPs can prescribe to aid in fertility. For PCOS patients, metformin and myoinositol are suggested as first-line treatments. She provides a comprehensive guide on the use of letrozole for ovulation induction, emphasising the need for close monitoring. Supplements like CoQ10 and melatonin are recommended for women with reduced ovarian reserve, and Menivit is suggested for male patients with suboptimal semen analysis.


They also touched on when to refer patients to a fertility specialist. Referral timelines vary based on the age of the female partner and any known fertility-impacting conditions.


The Good GP Podcast is a proud member of the Talking HealthTech Podcast Network - the premier audio destination for cutting-edge insights and thought leadership in healthcare delivery, innovation, digital health, healthcare ICT, and commercialisation. Learn more at www.talkinghealthtech.com/podcast/network.


If you have any questions or would like to contact The Good GP, send an email to thegoodgp@gmail.com.

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About your hosts

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Tim Koh

Dr. Tim Koh is a General Practitioner and practice owner based in Perth, Australia, with over 20 years of experience. Throughout his career, Tim has been continuously involved in GP education and teaching GP registrars. As the host of The Good GP podcast, Tim provides expert insights and practical advice for GPs and other health professionals. Passionate about evidence-based medicine and teaching in general practice, Tim addresses a wide range of topics relevant to primary care, keeping listeners informed about the latest issues affecting the field.
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Krystyna de Lange

Dr Krystyna de Lange is co-host of The Good GP and dedicated General Practitioner with nine years of experience in primary care in Australia. Passionate about the full spectrum of medicine, she thrives on the opportunity to support her patients’ diverse health needs. She has a specific interest in the areas of Aboriginal and Torres Strait Islander health, womens health and chronic disease management.

Since joining The Good GP podcast team in 2019, her goal has been to empower fellow practitioners with the latest insights, best practices, and valuable discussions on essential health topics. With her approachable style and deep commitment to community health, she fosters an engaging environment that encourages learning and collaboration.
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Sean Stevens

Dr Sean Stevens, a seasoned General Practitioner with 27 years of experience, is a pioneer in medical education and podcasting. As one of the founding voices of The Good GP Podcast since 2016, he has personally contributed to over 60 episodes of their 170+ episode catalogue, sharing invaluable insights with the medical community. Recognised as Australian GP Supervisor of the Year, Sean combines his passion for education with a commitment to embracing new technologies. He is dedicated to empowering fellow GPs and promoting quality care in general practice.