S7 L2 Intro to Contraception and Infertility Flashcards
Contraception
- Definition
- Categories (6 types)
Definition - Any method to prevent pregnancy.
Natural
- List them
Abstinence
Withdrawal
Lactational Amenorrhoea Method
Natural, explain advantage and disadvantages of the following method
- Abstinence
- Withdrawal
- What can be monitored and recorded fertility indicator throughout menstrual cycle
FERTILITY AWARENESS METHODS
Monitoring and recording fertility indicators throughout menstrual cycle:
• Cervical secretions + Changes in Cervix
• Basal body temperature
• Length of menstrual cycle “Calendar Method”
Advantages: No hormonal/contraindications
Disadvantages:
• Periods of abstinence when highly fertile
• Time-consuming, Unreliable, no STI protection
• Not suitable for all
Lactational Amenorrhoea method
- What is this, advantages and disadvantages
Barrier
- What is this method?
- Give examples
- Advantages and Disadvantages
Hormonal control
- How does this work
- Types of homronal control methods
To interrupt HPG axis, and prevent ovulation. May have effects on endometrial lining.
Short-Acting or Long-Acting Reversible Contraception (LARC)
Types:
Combined Oestrogen and Progestogen (this is recombinant artifical progesterone) – COCP, Patch, Ring
Progestogen-only Pill (POP)
LARC – Progestogen Depot and Implant
Combined Oral Contraceptive Pill (COCP)
- What is this?
- How does it work?
- How is it taken?
Combined Oral Contraceptive Pill (COCP)
- Advantages and Disadvantage
Progestogen-Only Pill (POP) - Mini pill
- What is it?
- Actions of it?
- What does this effect
- Advantages
- Disadvantages
Progesterone Implant
- How does this work
- Main actions
- Advantages
- Disadvantages
Inhibit Implantation
- Progesterogen-releasing coil
- Copper-containing coil
Main actions
Advantages and Disadvantages
Advantages:
• Convenient
• Effective up to 99%
• LARC – from 3 to 10 years
• IUS for treatment of menorrhagia
Disadvantages:
• No STI protection
• Complications with insertion - perforation
• Menstrual irregularities
• Displacement/expulsion may occur
• PID
Sterilisation
- Vasectomy
- Tubal ligation/Clipping
How it works?
Advantages and disadvantages?
Failure rate?
Emergency Contraception
- 3 types
- Explain them
- What to think about with emergency contraception?
Infertility:
Subfertility - Define
2 types of infertility:
- Primry infertility
- Secondary infertility
Prevalance of infertility
Causes of infertility
- Subfertility = a couple who are having regular (every 2-3 days), unprotected coitus, who have failed to conceive within 1 year
- Primary Infertility – never been pregnant
- Secondary Infertility – previous pregnancy (including ectopic and terminations) but struggling to conceive again
Prevalence:
- Approx. 1 in 7 UK couples 84% of couples will conceive naturally within 1 year with regular unprotected intercourse.
- 92% after 2 years and 93% after 3 years.
- After 3 years – chance of spontaneous pregnancy ≤ 25%
Male Causes
- 3 main groups
Ovulatory Disorders
- 3 groups
Uterine and Peritoneal Disorders
- Physical reasons why implantation fails…
Tubular Damage
- Causes of tubal damage
Questions to ask on Presentation - of fertility problems
Examinations to do - if patient comes in with infertility
Advice to Patients
Advice to Patients:
Smoking cessation
Reduce Alcohol intake
Lifestyle changes – stress mx
Regular intercourse (2-3 times a week)
Weight loss
REASSURANCE!
Investigations - if infertility
Referral to Secondary Care
Management Options (specialist)
