7.2 Contraception Flashcards Preview

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Flashcards in 7.2 Contraception Deck (18):
1

Give the main methods to contraceptions

Natural
- Abstinence, coitus interuption, rhythm

Vasectomy

Barrier methods

Spermicide

Hormonal

Inhibition of transport along uterine tubes
Sterilisation

Inhibition of implantation:
IUCD

2

Give 3 methods of natural contraception.

Abstinence
Coitus interruptus
Rhythm method.

3

What is the problem with coitus interrupts?

Stop sex before ejaculation
Sperm in pre-ejaculate

4

What is the rhythm method? Disadvantage?

Have sex only in non-fertile period
7-16 days

Requires regular cycle.

5

What is a vasectomy?

Prevent sperm from entering ejactulate by dividing cad deferens bilaterally.

6

Give 3 barrier methods of contraception. Prupose?

Condoms
Diaphragm
Cap

Prevent sperm from reaching cervix

7

Advantages of condoms?
Disadvantages of diaphragm

Condoms:
Readily available
Protect against STIs

Diaphragm
Requires correct fitting
Does not completely occlude passage
Holds sperm in acid environment of vagina, reducing survival time.

8

How does progesterone act as contraception? Oestrogen?

Thick hostile cervical mucus plug
Prevents sperm from entering uterus
Negative feedback to hypothalamus/pituitary
Decrease frequency of GnRH pulses, inhibiting follicular development.

Oestrogen negatively feeds back on ant pit
Loss of positive feedback - no LH surge - inhibits ovulation

9

Giv the types of hormonal contraception.

Combined OCP

POP

Depot progesterone:
3 monthly injections
Negative feedback to inhibit ovulation

Progesterone implants

10

What is sterilisation?

Occlusion of Fallopian tubes:
Clips, rings, ligatino.

11

Give some IUCDs

Inert copper
Interferes with endometrial enzymes
Interferes with implantation

Progesterone impregnated

12

Describe post-coital contraception

• Combined Oestrogen / Progesterone High Dose
o Or Progesterone only
• Up to 72 hours after intercourse
• May disrupt ovulation
• Blocks implantation
• May also impair luteal function

13

What is infertility? What can it be due to?

• Failure to conceive within 1 year
• Primary (no previous pregnancy) or secondary (previous pregnancy)
• Due to:
o Coital problems
o Anovulation
• Occasionally anovulatory cycles are normal at extremes of reproductive life

14

Describe polycystic ovarian syndrome.

• Uncertain pathogenesis
• Increased androgen secretion
• Raised LH/FSH ratio
o Lack of pulsatile GnRH release
o Many follicles begin to develop but dominant follicle is not selected to mature.
• Insulin resistance
• Multiple small ovarian cysts
• Anovulation, amenorrhoea/oligomenorrhoea


• LH dependent excess androgen production from both ovaries and adrenals
o Androgens may suppress LH surge
o Hirsutism
• Abnormal hair growth
o Oily skin/acne
• Abnormal oestrogen secretion put women at risk of endometrial malignancy
o Sustained oestrogen stimulation of endometrium

15

How can ovulation be induced?

• Anti-oestrogen
o Reduce negative feedback to hypothalamus/pituitary.
o Increase GnRH/FSH
• Gonadotrophins
o FSH administration
• GnRH agonists
o Pulsatile to mimic normal secretion

16

How is infertility due to tubal occlusion caused, diagnosed and treated?

• Caused by:
o Sterilisation
o Scarring from infection/endometriosis
• Diagnosed by:
o Laparoscopy and dye
o Hysterosalpingogram
• Treatment:
o Tubal surgery
o Assisted conception

17

How is infertility due to abnormal sperm caused, diagnosed and treated?

• Abnormal production
o Testicular disease
• Obstruction of ducts
o Infection
o Vasectomy
• Hypothalamic/pituitary dysfunction

18

Normal values for semen analysis?


Volume > 2ml
Sperm count > 20 million per ml
Motility > 50%
Morphology > 50%