Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Reproductive > Infertility > Flashcards

Infertility Flashcards

1
Q

Definition of infertility?

A

Inability of a couple to conceive after 12 months of regular intercourse without use of contraception

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How many couples report infertility issues?

A

1 in 7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the chances of conception?

A

80% of couples in the general population will conceive within 1 year if: the woman is aged under 40 years and

they do not use contraception and have regular sexual intercourse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the main queries as to why they cannot concieve?

A

Are eggs available?

Are sperm available?

Can they meet?

Can embryo implant?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What questions should the woman be asked during the history?

A
  • Duration of infertility
  • Previous contraception
  • Fertility in previous relationships
  • Previous pregnancies and complications
  • Menstrual history
  • Medical and surgical history
  • Sexual history
  • Previous investigations
  • • Psychological assessment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What should be examined of the female?

A
  • Weight
  • Height
  • BMI (kg/m2)
  • Fat and hair distribution
  • Galactorrhoea
  • Abdominal examination
  • Pelvic examination
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What baseline investigations should be carried out?

A
  • Rubella Immunity
  • Chlamydia
  • TSH
    • sub-clinical hypothyroidism can cause issues with implantation
  • Testing for Ovulation
    • Regular Period: Mid-luteal phase progesterone 7 days prior to expected period
    • Irregular Period: Day 1-5 FSH, LH, PRL, TSH & testosterone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What investigations should be carried out at the fertility clinic?

A
  • Pelvic US
  • Physical Exams
  • Tubal Patency Test
    • Hysterosalpingo-Contrast-Sonography (HyCoSy)
    • Laparoscopy
  • Test for ovulation
    • mid luteal phase progesterone
    • Irregular periods require FSH & LH testing to assess
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What male investigations should be carried out? And what are the normal reference values for said test?

A
  • Computerised Semen Analysis
    • Reference values15-200 million/ml
      • <15 million is oligospermia
      • <5 million is severe oligospermia
      • 0 is azoospermia
      • Total sperm count: <39 million= low
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are group 1 ovulatory disorders? + treatment?

A
  • Hypo-gonatrophic hypo-gonadial anovulation
  • Treatment: Optimise BMI and reduce exercise levels if very high
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are group 2 ovulatory disorders?

A
  • Normo-gonadotrophic, normo-oestrogenic anovulation
  • Polycystic Ovary Syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How can we diagnose polycystic ovary syndrome?

A

Need 2 of the following:

  • Androgen Excess
    • Hirsutism
    • Moderately raised Testosterone
    • acanthosis nigricans
  • Infrequent periods
    • due to Anovulation
  • US
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the treatment for polycystic ovary syndrome?

A
  • Optimise BMI (18-30)
  • Clomifene (selective oestrogen receptor modulator, Inhibits oestrogen receptos in hypothalamus, preventing negative feedback, leading to up-regulation of gonadotrophin release, causing ovulation)
  • Gonadotrophins
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the required dose of Clomifene for Polycystic ovarian disease? + side effects?

A
  • Start at 50mg per day
  • Follicle scanning to monitor and adjust dose up to 150mg as necessary
  • 6 cycles
  • Ovarian hyperstimulation
  • Multiple pregnancy
  • Visual alterations
  • Vasomotor “flushes”
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the indications of use for gonadotrophins for polycystic ovarian disease?

A
  • No ovulation on Clomifene
  • Ovulated but still not pregnant after 6 cycles
  • Up to 3-6 cycles
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are group 3 ovulatory disorders?

A

Hyper-gonadotrophic hypo-oestrogenic

17
Q

What are some other infertility causing female pathologies that are not ovulatory?

A
  • Androgen secreting adrenal tumour
    • Signs and symptoms
      • Hirsutism
      • acanthosis nigricans
  • Prolactinoma
  • Fibroids:
    • Signs and symptoms
      • Pressure Symptoms
      • Period problems
    • Submucosal
      • Affect fertility the most as alter implantation
  • Endometriosis
  • Tumours
  • Sterilised
    • Reversal not offered on NHS
  • Unexplained
18
Q

What is Hirsutism? Common causes? Why is it clinically important to identify?

A

[condition of unwanted, male-pattern hair growth in women]

Nonclassic congenital adrenal hyperplasia (NCCAH) is a common cause of hirsutism.

Androgen-secreting tumors are rare, particularly in premenopausal women (0.2 percent of women with hirsutism) [13], but 50 percent are malignant at the time of diagnosis.

19
Q

What should we look for on pelvic examination?

A
  • Masses
  • Pelvic distortion
  • Tenderness
  • Vaginal septum
  • Cervical abnormalities
20
Q

How would fibroids present?

A
  • Period problems
  • Pressure symptoms
  • Infertility
21
Q

What issues cause male infertility in relation to epididymus?

A

STIs: Chlamydia, Gonorrhoea

22
Q

What causes male infertility in relation to vas deferens?

A
  • Cystic Fibrosis mutations of Vas Deferens
  • Congenital Bilateral Absence of Vas Deferens
23
Q

What causes male infertility in relation to testes?

A
  • Testicular Maldescent
  • Varicocele
    • Dilatation of pampiniform plexus of veins
24
Q

What causes male infertility in relation to hypospadias?

A

Urethral opening not in usual place

25
Q

What causes male infertility in relation to azoospermia (semen contains no sperm)?

A
  • Aetiology
    • Testicular
      • Normogonadotrophic
      • Hypogonadism
        • Klinefelter Syndrome: Commonest cause of primary hypogonadism – 10-15% of infertile men with azoospermia
      • Hypergonadotrophic
    • Post-testicular
      • Iatrogenic
      • Congenital
      • Infective
26
Q

What should be carried out when investigating male infertility?

A
  • History & Exam
  • FSH, LH. testosterone and prolactin
  • Karyotype
  • CF screen
27
Q

What management is available for male infertility?

A
  • Micro-epididymal sperm aspiration
  • Testicular Sperm Extraction
28
Q

What is the general management for female infertility?

A
  • Ovulation Induction
  • IVF
  • ICSI
29
Q

What is the general management for male infertility?

A
  • Urologist Appointment if relevant
  • IVF/ICSI
  • Intra-uterine Insemination
  • Surgical Sperm Retrieval
  • Donor Insemination

Reproductive (34 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions