OB 1 > Chapter 37: Assisted Reproductive Technologies > Flashcards

Chapter 37: Assisted Reproductive Technologies Flashcards

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1
Q

the number of follicles measuring 2 to 10 mm early in the ovarian cycle. This count helps assess a woman’s potential for success with fertility treatments. It varies according to a woman’s age and is used to obtain an overall sense of a woman’s reserve relative to her age-matched peers

A

antral follicle count (AFC)

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2
Q

Clinical treatments and laboratory procedures used to establish a pregnancy. This includes treatments in which both eggs and sperm are handled but in general would exclude the treatment if eggs are only stimulated and not retrieved; or if only the sperm are handled.

A

assisted reproductive technologies

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3
Q

Transfer of embryo 5 to 6 days after egg retrieval, 4 to 5 days after fertilization

A

blastocyst (embryo)

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4
Q

transfer of embryo 3 days after egg retrieval, 2 days after fertilization

A

cleavage-stage (embryo) transfer

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5
Q

fertility medication used for controlled ovarian hyperstimulation of a single or multiple follicles

A

clomiphene citrate

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6
Q

process that promotes the development of multiple follicles in the ovary using clomiphene citrate, letrozole, or injectable gonadotropins

A

controlled ovarian hyperstimulation

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7
Q

process, usually using liquid nitrogen, to free embryos or gametes

A

cryopresevation

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8
Q

in vitro fertilized embryo transfer into the uterine cavity at the cleavage or blastocyst stage

A

embryo transfer

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9
Q

primary hormone produced by ovarian follicles in women of childbearing age

A

estradiol

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10
Q

the ability to conceive, have ongoing pregnancy, and produce offspring

A

fecundity

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11
Q

period during which the viability and survivability of both oocytes and sperm are maximum, refers to the 4 to 5 day interval ending on the day after ovulation

A

fertile window

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12
Q

capacity to produce offspring

A

fertility

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13
Q

first half of the ovarian cycle characterized by high levels of circulating follicle-stimulating hormone (FSH), which result in ovarian follicle maturation

A

follicular phase

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14
Q

An ART option rarely used, where the sperm and ova are placed directly in the ampullary portion of the fallopian tube for in vivo fertilization

A

gamete intrafallopian transfer

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15
Q

hormone produced by the trophoblastic cells of the normal developing placenta or by abnormal germ cell tumors, molar pregnancies, and choriocarcinoma

A

Human chorionic gonadotropins

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16
Q

an endovaginal sonogram which allows for the evaluation of the fallopian tubes, uterus, and ovaries by following the course of a saline being instilled from the cervix to the ends of the fallopian tubes. No x-ray is needed

A

Hysterosalpingo contrast sonography

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17
Q

process whereby ova and sperm come into contract outside the body and fuse to form a zygote from extracted ova and sperm in a laboratory setting

A

in vitro fertilization

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18
Q

failure to achieve a pregnancy after 12 months or more of regular, unprotected intercourse. If the woman is under the age of 35. For those women over the age of 35, diagnosed if there is a failure to achieve a pregnancy after 6 months or more, of regular, unprotected intercourse

A

infertility

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19
Q

injection of a single sperm into an ovum

A

intracytoplasmic sperm injectionj

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20
Q

placement of seminal fluid-free sperm through the cervix directly into the uterine cavity

A

intrauterine insemination

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21
Q

fertility medication used for controlled ovarian hyperstimulation of a single or multiple follicle, used instead of clomiphene citrate

A

letrozole

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22
Q

second half of the ovarian phase, when the corpus luteum secretes high levels of progesterone that act on the endometrium

A

luteal phase

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23
Q

first 5 days of the menstrual cycle, characterized by endometrial shedding

A

menstrual phase

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24
Q

excessive response to ovulation induction therapy with some severe cases requiring hospitalization

A

ovarian hyperstimulation syndrome

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25
estimation of a woman's remaining follicles
ovarian reserve
26
begins with the administration of fertility medications that induce the development of one or more multiple follicles
ovulation induction
27
time just before and after mid cycle during which the endometrium may demonstrate a range of appearances spanning both the proliferative and secretory phases
periovulatory period
28
portion of the menstrual cycle during which endometrial tissue proliferates. It overlaps the menstrual phase and extends through mid-cycle.
proliferative phase
29
portion of the menstrual cycle characterized by an increase in circulating progesterone and during which endometrial tissue is thickest and prepared for embryo implantation
secretory phase
30
less than normal fertility through still capable of achieving pregnancy
subfertile
31
enlarged ovaries with multiple cysts due to abnormally high levels of hcG
theca lutein cysts
32
female factors cause ___ of infertility issues
1/3
33
male factors cause ____ of infertility issues
1/3
34
unexplained infertility issues or a combo between male and female
1/3
35
unknown etiology; hyperechoic/ hypoechoic lesions with shadowing
subserosal, intramural, submucosal myoma
36
congenital anomaly; septum visualized on coronal plane with 3D sonography
septate uterus
37
unknown etiolgy; hyperechoic lesion indenting into endometrial cavity; feeding vessel seen with Doppler; best characterized with saline infusion sonohysterography
endometrial polyp
38
unknown etiology; almost always follows pregnancy loss; absence or discontinuation or endometrial stripe
Asherman disease, uterine scarring
39
blocked or scarred tubes
hydrosalpinx or pyosalpinx
40
scarring around the tubes/ ovaries; infection; prior surgery; echogenic fluid areas surrounding ovary, tubes
adhesions
41
ectopic endometrial tissue; unknown etiology; lesions with low-level internal echoes
endometriosis
42
ovarian hyperandrogenism; unknown etiology; cysts arranged like a string of pearls
PCOS
43
assisted reproductive technology
ART
44
controlled ovarian hyperstimulation
COH
45
embryo transfer
ET
46
gamete intrafallopian transfer
GIFT
47
intracytoplasmic sperm injection
ICSI
48
intrauterine insemination
IUC
49
in vitro fertilization
IVF
50
ovulation induction
OI
51
zygote intrafallopian transfer
ZIFT
52
Gonadotropin-stimulated cycles mean diameter of mature follicles at ovulation
16-18 mm
53
Clomiphene or letrazole stimuated cycles mean diameter of mature follicles at ovulation
20-24 mm
54
Natural cycle mean diameter of mature follicles at ovulation
15-25 mm
55
Infertility impacts ___ in ___ couples.
1 8
56
diagnosis is made when a couple fails to conceive naturally despite 1 year of unprotected intercourse, or in a woman 35 or older that fails to conceive naturally despite 6 months of unprotected intercourse
infertility
57
Most central role of sonography in treatment of infertility
monitoring of follicular growth
58
Zygote develops of __-__ days into a blastocyst that must travel down length of fallopian tube and arrive in uterine cavity __-__ days after fertilization
4-5 4-5
59
The average menstrual cycle is __ days
28
60
produce by hypothalamus; acts on anterior pituitary gland to release FSH; primary follices in ovary begin to grow and mature
GnRh
61
fluid filled cavity that forms within each of a select few primary follicles
antrum
62
Mature follicle turns in ____ follicle
Graafian
63
1st half of menstrual cycle
follicular phase
64
Granulosa cells of the growing ovarian follicle produce the hormone ____
estradiol
65
___ hours after LH and FSH surge, the dominant follicle ruptures and the ovum is expelled from ovarian follicle
36
66
occurs 14 days before beginning of next cycle
ovulation
67
second half of ovarian cycle
luteal phase
68
The ruptured follicle becomes the ______
corpus luteum
69
If implantation does not occur, the corpus luteum begins to regress __-__ days after ovulation
8-10
70
only structure within the human body that shifts from producing one hormone to another within such a short period of time
corpus luteum
71
occurs in endometrial lining of uterus
menstrual cycle
72
The menstrual cycle being with :
shedding of the old endometrium from previous cycle
73
The endometrium is the thinnest during the ____ phase.
menstrual
74
What phase does the endometrium have a triple layer
proliferative
75
Sonography appearance of the endometrium during the secretory phase
thick and homogenous hyperechoic double-layered appearance
76
3 stages of follicle development
primordial early growing antral
77
4-5 days preceding ovulation the dominant follicle grows __-__ mm daily
1-2
78
The rise in serum estradiol is directly proportional to growth in diameter of ______
single dominant follicle
79
mean diameter of dominant follicle during natural cycle
15-25 mm
80
81
quantity of eggs that a female has
ovarian reserve
82
What is considered a low AFC count?
3-4
83
The AFC is most predictive if measured during the _______
early follicular phase
84
common etiology of anovulation
PCOS
85
86
most commonly used diagnostic procedure for evaluating intracavitary lesions
saline infusion sonogram
87
physiologic at mid-cycle, extending from cervical os to uterine cavity produced in response to elevated periovulatory level of estradiol
cervical mucus
88
_______ can prevent sperm from ascending into uterus
cervical factor infertility
89
two layers of endometrium
basal functional
90
Normal reproductive years thickness of endometrium
3-16 mm
91
shedding of uterine lining; thin, echogenic interface with myometrium
menstrual phase
92
endometrium thickens and fertile window occurs
proliferative phase
93
echogenicity and thickness of endometrium increase; homoegenous, hyperechoic, thick, double layer
secretory phase
94
What does an endometrial thickness of less than 7 mm indicative of?
poor implantation rates in in vitro fertilization
95
allows characterization of intracavitary abnormalities, helps distinguish endometrial lesions from myometrial lesions
SIS
96
appear as hyperechoic filling defects; emanated from endometrial layer of uterus
polyps
97
arise from myometrial layer, often round in shape
myomas
98
2 types of myomas
intracavitary submucosal
99
pillars of linear filling defects within cavity, often connect anterior and posterior aspects of cavity
intrauterine synechaie
100
structural mullerian anomaly
septate uterus
101
presence of endometrial tissue within myometrium; diffuse or focal form
adenomyosis
102
preferred imaging procedure to evaluate tubal patency
hysterosalpingogram
103
most common abnormality associated with male infertility
varicoceles
104
reduced testicular volume
12 mL or less
105
Normal testicular volume
15-25 mL
106
classic "bag of worms" appearance of multiple tubular veins superior to testes
varicoceles
107
Varicocele diagnosis
3 or more veins 3 mm or greater in diameter
108
prewashed sperm placed directly in woman's uterus at time of ovulation
intrauterine insemination
109
preceded by COH and retrieval of ova from mature follicles
in vitro fertilization
110
fertilization takes place outside of the body
in vitro
111
involves injection of one sperm into cytoplasm of egg
intracytoplasmic sperm injection
112
performed within first few days of menstrual flow, determine appearance of uterus and ovaries prior to initiation of stimulation
baseline sonogram
113
____ plays central role in process of ART
COH
114
use of clomiphene citrate or letrozole
ovulation induction
115
goal is to develop a single mature follicle that will ovulate
ovulation induction
116
Mean OI mature follicle
20-24 mm
117
mean diameter gonadotropin cycle follicles
16-18 mm
118
mean diameter CC or L-stimulated cycle follicles
20-24 mm
119
Natural ovarian mean diameter cycle follicles
15- 25 mm
120
occurs when a sufficient number of follicles reach an optimum size in the hyperstimulated ovaries
follicle aspiration
121
transferred either as cleavage-stage embryos 3 days after egg retrieval or as blastocysts 5 or 6 days after egg retrieval
embryo transfer
122
visualized by 5 weeks after LMP
gestational sac
123
visualized by 5.5 weeks after LMP
yolk sac
124
Fetus visualized with heartbeat
by 6.5 weeks
125
Fertility patients are usually referred to OB at __-__ weeks
10-12
126
Ovaries markedly enlarged ( greater than 10 cm diameter)
severe OHSS
127
Infertility is the failure to produce a pregnancy with unprotected intercourse after:
12 months
128
Sonographic assessment of the male ____ may help to assess and diagnose infertility in a couple.
scrotal anatomy
129
Clomiphene citrate and letrozole are known as:
ovulation induction agents
130
Fertilization of one egg by one sperm creates a:
zygote
131
What is the fluid-filled cavity that develops within primary follicles and is sonographically visible?
antrum
132
The second half of the ovarian cycle is the:
luteal phase
133
The endometrium is thinnest during the:
menstrual phase
134
The dominant follicle grows approximately ____ daily, in the 4 to 5 days preceding ovulation.
1 to 2 mm
135
When determining the antral follicle count (AFC) for an infertility patient, only follicles between ____ are tallied.
2 and 10 mm
136
The syndrome associated with irregularly timed menstrual cycles, elevated androgen levels often manifested by increased hair growth, hair loss, and acne is:
polycystic ovarian syndrome
137
Normal endometrial thickness varies from ____ through the menstrual cycle during the reproductive years.
3 to 16 mm
138
Polyps, myomas, synechaie, retained products of conception, endometrial hyperplasia, and carcinoma can best by viewed by using:
SIS
139
Distortion of the uterine cavity, interference of uterine/ endometrial blood flow, and tubal ostia occlusion are mostly related to:
submucosal fibroids
140
The preferred imaging method to ensure fallopian tube patency is:
HSG
141
The prevailing reason for male infertility is:
varicoceles
142
A baseline scan is performed when:
within the first few days of menstrual flow
143
Intracytoplasmic sperm injection (ICSI) is:
the injection of one sperm into the cytoplasm of one egg
144
For many etiologies of infertility, the first step in treatment is:
OI
145
In an embryo transfer procedure, the embryo along with its surrounding culture media appears:
echogenic once released from the catheter
146
The stage of an embryo at 2 or 3 days after fertilization is known as:
zygote
147
Am embryologist uses a container responsible for moving embryos into the uterine cavity. The container is a:
transfer catheter
148
EV sonography is utilized to detect a gestational sac;
by 5 weeks after a woman's last menstrual period
149
Most fertility centers will follow patients through their first trimester with the first sonogram often being scheduled at approximately ___ weeks EGA..
6
150
Serious complications of ovarian stimulation techniques used in assisted reproduction are ___ and ____.
OHSS multifetal gestations
151
____ is frequently linked with timed intercourse, intrauterine insemination, or in vitro fertilization embryo transfer
COH
152
The normal ovarian/menstrual cycle last ___ days, beginning on the first day of a woman's menses, and extending to the ___ day of her next menses/
28 first
153
Day 14 of the menstrual cycle is usually when _____ occurs.
ovulation
154
The corpus luteum begins to degenerate about ____ days after ovulation if fertilization does not occur.
8-10
155
A surge in ____ causes the dominant follicle to rupture, at which time the ______ will erupt from the ovary.
LH Graafian follicle
156
The mean diameter of a dominant follicle, at the time of ovulation, is ____ mm.
15-25
157
_____ acquisition can provide automated counting of follicles.
3D volume
158
A "string of pearls" is associated with ____ and increased ovarian surface area/
PCOS
159
The endometrium consists of a _____ layer and a _____ layer.
functional basal
160
IUI is _______
intrauterine insemination
161
A cause of female infertility known for uterine scarring and usually related to pregnancy loss showing absence or discontinuation of endometrial stripe is ______
Asherman syndrom
162
Sonography of the endometrium is able to assess _____, ____ flow, ______ movements, presence of intracavitary lesions, and the presence of intracavitary fluid.
thickness blood perstaltic
163
Adenomyosis is the presence of endometrial tissue within the _____.
myometrium
164
Semen analysis includes sperm _____, ______, and ______.
density motility morphology/shape
165
The classic appearance of mutliple tubular veins superior to the testes which can contribute to infertility is described as _____.
varicoceles
166
Once follicles are considered to be mature, _____ or ______ is administered to induce ovulation.
clomiphene citrate letrozole
167
An endometrial thickness of less than ___ mm is useful in predicting poor implantation rates in in vitro fertilization cycles.
7
168
Varicocele is determined by ___ or more veins measuring ___ mm or greater with or without the Valsalva technique
3 3
169
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