Infertility

Question 1

Most gonadotoxic chemotherapy

Answer 1

Cyclophosphamide

Question 2

What porportion of infertility is thought to be attributable to male factor

Answer 2

Up to 50%

Question 3

How much of couples investigated for subfrrtility are unexplained

Answer 3

25%

Question 4

When to get pregnant after taking rubella vaccine

Answer 4

At least 1 month

Question 5

When to measure FSH investigating infertility

Answer 5

D2-5

Question 6

Normal AFC- FSH- AMH

Answer 6

AMH: 5-25 pmol/l
FSH: 4-8 IU/l
AFC: 4-16

Question 7

The most used ovarian reserve testing

Answer 7

FSH D2-5

Question 8

Most important factor affecting ovarian reserve

Answer 8

Age

Question 9

The test that most predicts ovarian response

Answer 9

FSH- AMH

Question 10

Difference between premature ovarian failure and aging

Answer 10

If AFC POOR + young age= aging
If associated w/ menopausal symptoms= failure

Question 11

When to repeat abnormal semen analysis

Answer 11

If abnormal: after 3 months
If azoospermia or severe abnormality: ASAP

Question 12

When to test progesterone to confirm ovulation

Answer 12

Midluteal progesterone
(7 days before menses)

Question 13

Do TFTs or prolactin routine testing investigating infertility

Answer 13

Not routine
Prolactin: ovulatory disorder, glactorrhea or pituitary tumor
TFT: sym of thyroid disease

Question 14

People undergoing ivf should be offered testing for

Answer 14

HIV
HEB B AND C

Question 15

Criteria where reduce HIV transmission from +ve male to female

Answer 15

1. the man is compliant with (HAART)
2. the man has had a plasma VL less than 50 copies/ml for more than 6
   months
3. no other infections present
4. UPSI is limited to the time of ovulation

Question 16

Classification of ovualtory disease

Answer 16

Griup 1: ⬇️GN hypogonadotropic hypogonadism( ttt with GN or Pulsatile GNRH)
Group 2: NORMAL GN PCOs 80%
Group 3: ⬆️ GN : POI (ttt w egg donation)

Question 17

Rotterdam PCO CRITERIA

Answer 17

1. Androgenemia
2. 12 or more follicles in 1 ovary
3. Oligomenorrhea (oligoovulation)

Question 18

Testing of tubal patency

Answer 18

Hx of PID or tubal morbidity?
Yes: laparoscopy and dye
No: HSG or Hystersalpingo ultrasonography

Question 19

Which cases of ohss should be reported to the HFEA

Answer 19

Severe and critical OHSS

Question 20

Most common chromosomal abnormality that may cause to azoospermia

Answer 20

Klinfelter

Question 21

Indication to double embryo transfer in the 1st IVF cycle

Answer 21

Age 40-42

Question 22

Portion of patient with pco tagt has metabolic syndrome

Answer 22

1/3
-PCOS
- obesity
- high androgen
- atherosclerosis

Question 23

Risk factor for OHSS

Answer 23

✔️ Previous OHSS,
✔ PCOS
✔ increased (AFC)
✔ high (AMH)

Question 24

When to admit patient with OHSS

Answer 24

unsatisfactory pain control
• unable to maintain adequate fluid intake due to nausea
• worsening OHSS .
• unable to attend for regular outpatient follow-up
• Who have critical OHSS

Question 25

Risk of Ohss on pregnancy

Answer 25

Pre eclampsia Preterm labor

Question 26

Surgical management of OHSS

Answer 26

Only if adnexal torsion Ovarian rupture Ectopic pregnancy

Question 27

What to give women of OHSS goong paracentesis

Answer 27

- IV colloid should be considered for women who have large volumes of fluid removed by paracentesis (e.g Albumin 25% 50–100 g, infused over 4 hours and repeated 4- to 12-hourly + Strict fluid balance recording should be followed for these patients)