Infertility

Question 1

Definition of infertility

Answer 1

inability to conceive after 1 yr of regular unprotected intercourse
*>35 inability after 6 months

Question 2

Labs for fertility evaluation

Answer 2

• Anti-mullerian hormone (AMH) –> detects infertility
• semen analysis –> eval vol, sperm count, motility, vitality & morphology
• hysterosalpingogram (HSG) [x ray] –> provides image of uterus, fallopian tubes, ovaries

Question 3

Treatment for infertility d/t ovulation disorders

Answer 3

Ovulation induction
- Letrozole
- Clomiphene
risk of multifetal pregnancy

Question 4

Treatment of infertility d/t insulin resistance

Answer 4

metformin
*most commonly w. PCOS

Question 5

How can fertility be optimized

Answer 5

• avoid smoking
• limit alcohol use
• limit caffeine use (<200 mg/day)
• BMI range 19-25
• prevent STI exposure
• time fertile periods

Question 6

Medical treatment of infertility

Answer 6

1. ART (assisted reproductive tech)
   - IVF
   - GIFT (gamete intrafallopian transfer)
   - ZIFT (zygote intrafallopian transfer)
   - ICSI (intracytoplasmic sperm injection) 1 sperm injected directly into egg; used w/ IVF or ZIFT

Question 7

Other options for infertility

Answer 7

1. surrogate/sperm donor
2. adoption/fostering
3. child free