B8-065 Assisted Reproductive Treatments

Question 1

if FSH is greater than […], recommend donor eggs or embryos

Answer 1

40

(probably WHO 3)

Question 2

E2 is given to patients to thicken their endometrial lining, but can slow […] growth

Answer 2

follicular

Question 3

E2 concentration peaks in the […] phase

Answer 3

late follicular

Question 4

used as an LH analog
has a longer half life and less expensive

Answer 4

hCG

Question 5

the oocyte is released about […] hours after onset of LH surge

Answer 5

34-36

Question 6

following ovulation, the oocyte is arrested in what state of meiosis?

Answer 6

metaphase II

Question 7

when does the placenta take over progesterone production?

Answer 7

8-10 weeks gestation

Question 8

if a pregnant patient comes in with a ruptured luteal cyst and they are in early pregnancy, what needs to be given in order to maintain the pregnancy?

Answer 8

progesterone

(also in IVF, they give exogenous progesterone until 10 weeks because there is not corpus luteum)

Question 9

why is the embryo transferred at day 6-7 in IVF?

Answer 9

that is when it would normally be in the uterus.

used to be transferred day 3-4, but physiologically the embryo would still be in the tube, a very different environment

Question 10

fertilization occurs in the […]

Answer 10

ampulla

(why its a common location for ectopic)

Question 11

inner cell mass of the blastocyst
becomes the

Answer 11

fetus

Question 12

outer cell mass of the blastocyst becomes the

Answer 12

placenta/fetal membranes

Question 13

IVF has a higher success rate with […] transfer due to stage matching

Answer 13

blastocyst

(vs. used to be day 3-4 cleavage stage; also lower twin rate)

Question 14

blastocyst approaches uterine wall is called […]
blastocyst attaches to uterine wall is called […]

Answer 14

adplantation
adhesion

then, invasion/embedding

Question 15

less than […] sperm is considered indication for ICSI

Answer 15

5 million

Question 16

in Controlled Ovarian Hyperstimulation,
[…] antagonists are used daily to prevent ovulation
followed by […] agonist to trigger oocyte maturation

Answer 16

GnRH
hCG or GnRH

(retrieval is 34-36 hours after trigger)

Question 17

injection of sperm directly into mature oocyte (metaphase II)

Answer 17

ICSI

Question 18

most important predictory of IVF success at time of egg retrieval

Answer 18

advanced oocyte age (>35 years)

(more granular)

Question 19

most errors in meiosis resulting in aneuploid occur during what phase?

Answer 19

meiosis 1

(defects in spindle assembly)

Question 20

as oocyte age increases, rates of […] increase and rates of successful […] decrease

Answer 20

as oocyte age increases, rates of [aneuploidy] increase and rates of successful [implantation] decrease

Question 21

there is no evidence to support a […] cutoff for offering infertility treatment

Answer 21

BMI

Question 22

salpingitis due to untreated, asymptomatic […] is a primary cause of tubal infertility

Answer 22

chlamydia/gonorrhea

Question 23

if you have a communicating hydrosalpinx, […] is recommended before embryo transfer to prevent cytotoxic fluid reflux

Answer 23

salpingectomy

Question 24

direct testing of IVF embryo for single inherited disease

Answer 24

preimplantation genetic testing- monogenic (PGT-M)

(ex. CF)

Question 25

direct testing of IVF embryo for large scale chromosomal abnormalities

Answer 25

preimplantation genetic testing- aneuploidy (PGT-A) (decreases chance of miscarriage and time to ART in women of AMA)

Question 26

insemination should be done between [...] hours after oocyte retrieval for the best chance of fertilziation

Answer 26

3-5

Question 27

fully mature oocytes have [..]N number of chromosomes

Answer 27

1N each with two chromatids

Question 28

when should oocyte retrieval be scheduled in relation to the hormonal injection give to mature oocytes?

Answer 28

34-36 hrs

Question 29

[...] is used to trigger oocyte maturation with an IVF cycle

Answer 29

hCG

Question 30

why is hCG used instead of LH to stimulate oocyte development?

Answer 30

less expensive longer half life

Question 31

high levels of [...] suppress ovulation

Answer 31

estradiol

Question 32

what is the order of event for standard fertilization

Answer 32

sperm preparation sperm incubation for capacitation activation of acrosomal digestion cortical reaction

Question 33

prepared sperm for standard insemination are incubated in protein rich medium to achieve [...]

Answer 33

capacitation

Question 34

the process by which spermatozoa become capable of going through the acrosomal reaction and fertilizing an oocyte

Answer 34

capacitation

Question 35

after sperm membrane fuses with the oocyte membrane, microvilli on the oocyte surround the sperm head and the oocyte releases [...]

Answer 35

cortical granules

Question 36

the presence of hydrosalpinx with communication to the uterine cavity decreases rate of [...] by about 50%

Answer 36

implantation