Infertility Investigations (NICE) Flashcards
What hormone should be tested in all women undergoing investigations for infertility even if periods are regular?
21 day progesterone (mid-luteal phase)
What does 21 day progesterone test for?
Ovulation
When do you do a hysterosalpingogram vs a diagnostic laparoscopy to look for tubal occlusion?
Hysterosalpingogram - women who are not known to have comorbidities (PID, previous ectopic, endometriosis)
Diagnostic larparoscopy - women who do have known co-morbidities
What virus should women who are trying to become pregnant be tested for susceptibility to?
Rubella
How long after getting rubella vaccine should patients avoid getting pregnant for?
One month
What can women who have hypothalamic infertility do to increase chances of pregnancy?
Raise BMI if less than 19
Stop doing excessive exercise if exercising excessively
What management is available for hypothalamic causes of infertility (in women)?
GnRH (leucoprelin) or gonadotrophins with LH activity
What management is available for people with PCOS (e.g. not ovulating)?
Clomifene Citrate
AND/OR
Metformin
What is the maximum length of time someone can take clomifene citrate?
6 months
Second line management available for people with PCOS (e.g. not ovulating)?
Metformin and clomifene citrate
Gonadotrophins
Laparoscopic ovarian drilling
What medications should be given for infertility due to hyperprolactinaemia?
Dopamine agonists e.g. bromocriptine, cabergoline
What should be done for hydrosalpinx before IVF and why?
Salpingectomy
Improves chances of pregnancy
What is the management for women with intrauterine adhesions?
Hysteroscopic adhesiolysis
Can surgery for endometriosis improve fertility?
Yes
