Fertility and contraception

Question 1

Symptoms of PCOS

Answer 1

Acne, Hirsuitism, Obesity, Amenorrhoea, Infertility, DM, Hypertension

Question 2

Investigations for PCOS

Answer 2

Bloods (day 5 LH:FSH), USS pelvis, Laproscopy

Question 3

Management of PCOS

Answer 3

Weight loss, Smoking cessation, Metformin
Anti-androgens (Spironolactone, Finasteride)
Endometrium control (COCP, Dydrogesterone)

Question 4

Sequelae of PCOS

Answer 4

Infertility, Endometrial hyperplasia, CVS disease

Question 5

Causes of infertility

Answer 5

Ovulatory - PCOS, Turner’s, Low BMI, Hyperprolactinaemia
Tubal - PID, Congenital, Adhesions
Male factors, Unexplained

Question 6

Questions to ask with female infertility

Answer 6

Menorrhagia, Pain, Dysmenorrhoea, PID, Abdominal surgery, Cycle

Question 7

Questions to ask with male infertility

Answer 7

Injury, Infection, Surgery

Question 8

Female examination for infertility

Answer 8

Hirsuitism, Galactorrhoea, Secondary sexual characteristics, BMI, Speculum

Question 9

Investigations for female infertility

Answer 9

Bloods (day 2 LH+FSH, day 21 progesterone, Prolactin, TFTs, Testosterone, Rubella), Pelvic USS, Hysteroscopy, Hysterosalpingogram

Question 10

Investigations for male infertility

Answer 10

Semen analysis (Count, Morphology, Motility)

Question 11

Management options to induce ovulation

Answer 11

Clomifene, Gonadotrophin injection

Question 12

Assisted fertilisation options

Answer 12

IVF, Artificial insemination

Question 13

Failure rate with barrier contraception

Answer 13

5%

Question 14

Failure rate of COCP

Answer 14

1%

Question 15

Contraindications to COCP

Answer 15

BMI > 40, BP >160/100, Smoking >40, Migraine with aura, Past VTE, Past breast cancer, Past hydatidiform mole

Question 16

Side effects of COCP

Answer 16

VTE, Breast cancer, Mood changes

Question 17

When should the COCP be started

Answer 17

Day 1 of cycle

Question 18

What to do if missed COCP

Answer 18

Take in 24hr, condoms for 7/7 if missed

Question 19

Failure rate of POP

Answer 19

1%

Question 20

Side effects of POP

Answer 20

Acne, Headaches, Weight gain, Mood changes, Irregular bleeding

Question 21

What to do if missed a POP

Answer 21

Take within 12hr, Condoms 7/7 if missed

Question 22

Failure rate of implant

Answer 22

0.5%

Question 23

Side effects of implant

Answer 23

Acne, Headaches, Weight gain, Mood changes, Irregular bleeding

Question 24

Failure rate of an inert IUD

Answer 24

2%

Question 25

Contraindications for IUD

Answer 25

STIs, Cancer of cerix+Ovary+Endometrium

Question 26

Side effects of inert IUD

Answer 26

Infection Lost threads, Irregular bleeding

Question 27

Failure rate of IUS

Answer 27

0.5%

Question 28

Risks with inserting IUD

Answer 28

Cervical shock, Perforation

Question 29

When to remove IUD

Answer 29

During period

Question 30

Failure rate of female sterilisation

Answer 30

0.5%

Question 31

Failure rate of male sterilisation

Answer 31

0.05%