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Flashcards in Assessment of infertility Deck (19):
1

Chocolate cysts

Endometriosis

2

dysmenorrhoea (classically before menstruation), dysparenuia, menorrhagia, painful defaecation, chronic pelvic pain, uterus may be fixed and retroverted, scan may show characteristic ‘chocolate’ cysts on ovary, infertility, asymptomatic

Endomertriosis

3

Tubal disease (infective causes)

Pelvic inflammatory disease (chlamydia, gonorrhoea, other: anaerobes, syphilis, TB)
transperitoneal spread: appendicitis, intra-abdominal abscess
following procedure: IUCD insertion, hysteroscopy, HSG

4

Tubal disease (non-infective)

endometriosis
surgical (sterilisation, ectopic pregnancies)
fibroids
polyps
congenital
salpingitis isthmica nodosa

5

45X

Turner's

6

hot flushes, night sweats, atrophic vaginitis

Endocrine Feature: high FSH, high LH, low oestradiol

Premature ovarian failure

7

high free androgens, high LH, impaired glucose tolerance

PCOS

8

obesity, hirsutism or acne, cycle abnormalities and infertility

PCOS

9

FSH, LH and oestradiol levels in anorexia?

Low

10

Endocrine conditions which could cause MALE infertility

Acromegaly, cushings disease, hyperprolactinemia
Anorexia
Hyper/hypothyroidism

11

Globospermia

Could cause male infertility

12

Kartagner's syndrome

Causes male inferility

13

Clinical Features:
normal testicular volume
normal secondary sexual characteristics
vas deferens may be absent
Endocrine features:
Normal LH, FSH and testosterone

Obstructive

14

Clinical Features:
low testicular volume
reduced secondary sexual characteristics
vas deferens present
Endocrine features:
High LH, FSH and low testosterone

Non-obstructive

15

When would you do midluteal progesterone level

Day 21/28 (or week before period is due)
Normal levels >30 suggest ovulation

16

Hysterosalpingiogram

Test of tubal patency
(if you have any indication that there is problem, just do laparoscopy. Laparoscopy is gold standard)

17

When would you do hysteroscopy?

Performed in cases where suspected or KNOWN endometrial pathology (e/g/ adhesions, polyp)

18

How much semen is normal?

>1.5ml

19

Normal semen motility?

>50%