Infertility Flashcards
t or f: infertility increases with age of the male partner
FALSE - increases with age of the FEMALE partner
female factors account for approximately what percent of couple infertility issues? male?
40-50%; 25% ; in approx 40% of infertile couples there are multiple causes
what is the definition of infertility?
inability to conceive after 12 months of unprotected sex
what is the definition of primary infertility?
infertility without any prior pregnancies
what is the definition of secondary infertility?
infertility with a prior pregnancy
what are the main 3 male factors contributing to infertility?
sperm production, function, and obstruction of the ductal system
which anti hypertensive medication is known to contribute to impairment of sperm number and function?
CCBs
what is the procedure for conducting a sperm analysis?
pt must abstain from sex for 48 hours; semen must be analyzed within 2 hours of ejaculation/collection; 2 collections must occur 4 weeks apart
sperm analysis is a reflection of sperm production that has occurred within what time frame?
3 months
what is the normal sperm volume? semen count? normal sperm movement? normal morphology? (%)
2 mL; 20 million PER mL; greater than 50% with fwd movement; greater than 40% w/normal morphology
what is the cause of most male infertility?
IDIOPATHIC
t or f: elevation of basal body temperature is a good indicator that ovulation is taking place
TRUE
what is the expected result of day 3 FSH if the pt is anovulatory?
elevated levels
if the cause of an ovulation is pituitary inefficiency, what is the treatment?
intramuscular LH/FSH
if the cause of infertility is hyperprolactinemia, what is the treatment?
bromocriptine (dopamine agonist) which suppresses prolactin
what is the most common treatment for PCOS?
clomid (ovulation induction agent) mixed with metformin (for weight loss)
what is the next step in infertility investigations if there is a normal semen analysis and ovulation analysis?
analysis of the internal architecture of the uterus and fallopian tubes is indicated
what is asherman’s syndrome? what is the mcc? treatment?
intrauterine adhesions; d&c; lysis of adhesions
what is the procedure that involves radiopaque dye injected into the cervix and uterus?
hysterosalpingram - dye passes through the fallopian tubes to the peritoneal cavity - demonstrates if there is patency; if there is no spillage into the cavity - it indicates that the tubes may be obstructed
when must a hysterosalpinogram be performed?
during the follicular phase (avoid possibility of pregnancy)
what is the risk associated with hysterosalpingoram?
salpingitis
what is the test of choice for a pt unable to get pregnant with a hx of PID?
hysterosalpinogram - will determine tubal blockage due to prior PID
what is the most effective treatment for infertility if the cause is tubal?
in vitro
what is the process of intrauterine insemination?
washed sperm is injected into the uterus NOTE: pts must have patent/normal tubes
t or f: IVF does NOT increase the chance of multiple gestation
FALSE
what is the process of IVF?
egg cells are fertilized OUTSIDE the uterus and implanted into the uterus
what is the process of artificial insemination?
sperm (donor most likely) is inserted into the vagina
t or f: artificial insemination has a higher success rate when compared to IVF
TRUE; 70% vs. 20%
