Infertility Flashcards
(40 cards)
a disease characterized by failure to achieve successful pregnancy after 12 months of attempting or due to an impaired capacity to reproduce with one’s partner
infertility
in absence of known etiology, and presence of regular, unprotected intercourse, evaluation should be initiated at ____ months when the female is under 35 years old
12
in absence of known etiology, and presence of regular, unprotected intercourse, evaluation should be initiated at ____ months when the female is 35 years or older
6
what are the 2 most common causes of infertility in couples?
tubal/pelvic pathology
male
what is the greatest non-modifiable factor for fertility?
female age
maternal age over _____ is associated with placental abruption, pre-term delivery, low birth weight, intrauterine growth restriction, stillbirth, and perinatal mortality
40
what are the 3 tests used to evaluate ovulatory function?
ovulation predictor kits
basal body temp
mid-luteal serum progesterone level
tests for LH rise in urine to evaluate ovulatory function
ovulation predictor kits
what causes the change in body temperature during ovulation?
progesterone rise
what is the most common etiology of infertilify?
PCOS
what is the criteria for PCOS?
2/3:
< 9 menses/year
OR
> 35 day cycle intervals
+
Polycystic appearing ovaries on US
Hyperandrogenism
assesses reproductive potential as a function of the number of oocytes
ovarian reserve
what is the most predictive of live birth rates?
female age
what are the 3 tests used for ovarian reserve?
AMG
FSH/estradiol levels on day 3
antral follicle count
what are 3 tests to assess fallopian tube patency?
hysterosalpingogram (HSG)
hysterosallpingo-contrast sonogram
laparoscopy with chromopertubation
at what point in the cycle should a hysterosalpingogram be done?
follicular phase (days 5-12)
when should prophylactic antibiotics be considered for a hysterosalpingogram? (2)
history of STI/PID
known tubal abnormality
what are 2 contraindications for a hysterosalpingogram?
pregnancy
purulent cervical discharge
allergy to iodine contrast
large fibroids > 4-5cm and those that are close to or inside the endometrial cavity are most concerning
uterine leiomyoma
patient presents with abnormal bleeding, menorrhagia, and pelvic pressure/pain. Dx?
uterine leiomyoma
intrauterine adhesions that present with light/absent menses
asherman’s syndrome
used to evaluate myometrial defects, intracavity defects like polyps, ovarian cysts, antral follicle count, follicular development, and pathology.
pelvic sonogram
what are the 2 peritoneal factors that cause infertility?
endometriosis
pelvic/adnexal adhesions
what should be considered to diagnose and treat peritoneal factors leading to infertility?
laparoscopy
