Fertility

Question 1

What is subfertility?

Answer 1

Infertility
a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse.”

Question 2

What is Primary Infertility

Answer 2

When woman is unable to ever bear a child

Question 3

What is secondary infertility?

Answer 3

When woman is unable to bear child, possibly due to previous pregnancy

Question 4

What are reasons for subfertility?

Answer 4

Ovulatory disorders
Tubal damage
Uterine/peritoneal disorders
Male factors

Question 5

What general conception advice can be given?

Answer 5

Intercourse throughout the cycle
Smoking
Alcohol
Folic acid
Weight
Stress
Caffeine
Drugs
Occupation

Question 6

What are the 3 classificiations of ovulatory causes?

Answer 6

Type 1: Hypopituitary Failure
Type 2: Hypopituitary Dysfunction
Type 3: Ovarian Failure

Question 7

What causes hypopituitary failure?

Answer 7

Anorexia nervosa

Question 8

What causes hypopituitary dysfunction?

Answer 8

PCOS

Hyperprolactinaemia

Question 9

What is the Rotterdam criteria for Polycystic Ovarian Syndrome?

Answer 9

i) Clinical hyperandrogenaemia
ii) Oligomenorrhoea
iii) Polycystic ovaries on ultrasound

Question 10

What are symptoms of PCOS?

Answer 10

Raised LH with normal FSH
Raised testosterone
Ovarian cysts

Question 11

What are Tubal and Uterine causes of infertility?

Answer 11

Pelvic inflammatory disease
Previous tubal surgery
Endometrioses
Fibroids
Cervical mucous defect

Question 12

What is pelvis inflammatory disease?

Answer 12

Upper reproductive system infection which may be asymptomatic

Question 13

What are main causes of PID?

Answer 13

Chlamydia trachomatis

Neisseria gonorrhoeae

Question 14

What are S+S of PID?

Answer 14

Pelvis pain
Vaginal discharge
Cervical tenderness

Question 15

What is endometriosis?

Answer 15

Endometrium (uterine tissues) growing in the wrong place

Question 16

What are symptoms of endometriosis?

Answer 16

Pain

Infertility

Question 17

Is there a genetic link for endometriosis?

Answer 17

Yes

Question 18

What are fibroids?

Answer 18

Benign, smooth muscle tumours of the uterus

Question 19

What do fibroids do?

Answer 19

Cause regular, heavy periods

Question 20

How to treat fibroids?

Answer 20

Tranexamic acid
COCP/LARCs
Surgery

Question 21

How are fibroids named?

Answer 21

Due to their location

Question 22

What are male causes of infertility?

Answer 22

Testicular
Azoospermia w or w/o sperm antibodies
Reversal of vasectomy
Ejaculatory problems
Hypogonadism

Question 23

How do you treat hypopituitary failure?

Answer 23

Increase weight

Decrease exercise or pulsatile GnRH release

Question 24

How do you treat PCOS?

Answer 24

Weight loss so BMI <30
Metformin
Clomiphene

Question 25

How do you treat ovarian failure?

Answer 25

Donor eggs

Question 26

What is intrauterine insemination?

Answer 26

Sperm is separated in lab and slower samples are removed

Sperm is then inseminated into partner

Question 27

How many cycles of intrauterine insemination occur before IVF?

Answer 27

12 cycles

Question 28

Who do you offer intrauterine insemination to?

Answer 28

Unable to have vaginal intercourse
Sperm wash for HIV-positive men
Same sex relationships

Question 29

What is IVF?

Answer 29

Fertilisation of an egg outside the body

Question 30

What is intracytoplasmic sperm injection?

Answer 30

ICSI, sperm directly injected into egg rather than rely on natural fertilisation

Question 31

When is intracytoplasmic sperm injection used?

Answer 31

Semen quality defects
Obstructive azoospermia
Previous IVF failure