Infertility

Question 1

What can cause infertility?

Answer 1

Coital issues
Anovulation (15 -> 40%)
Tubal occlusion
Abnormal/Absent sperm production (20 -> 25%)

Question 2

What Coital issues can cause infertility?

Answer 2

Vaginosis

Ejaculatory issues

Question 3

What can cause Anovulation?

Answer 3

Ovarian failure - Polycycstic Ovarian syndrome, Chemotherapy, Radiotherapy
Stress
Pituitary tumours
Pituitary necrosis (Post partum, Sheehan’s syndrome)

Question 4

How can stress cause Anovulation?

Answer 4

Disrupts the hypothalamic pituitary axis

Question 5

What is Polycycstic Ovarian syndrome?

Answer 5

Increased Androgen secretion
Increased LH/FSH ratio
Insulin resistance
Multiple ovarian cysts

Question 6

How can you treat Anovulation?

Answer 6

Induce ovulation via;

• Antioestrogens (Negative feedback to hypothalamus/pituitary. Increased GnRH. Increased FSH)
• Gonadotrophins - can administer FSH, GnRH agonists in a pulsatile way to mimic normal body

Question 7

What can cause Tubal occlusion?

Answer 7

Scarring due to infection, endometriosis or Fitz-Hugh curtis syndrome

Question 8

How can you diagnose Tubal occlusion?

Answer 8

Laproscopy

Hysterosalpingogram

Question 9

How can you treat Tubal occlusion?

Answer 9

Tubal surgery

Assisted conception

Question 10

What can cause Abnormal/Absent sperm production?

Answer 10

Hypothalmic/pituitary dysfunction
Testicular disease
Obstruction of ducts (Infection, Vasectomy)