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Infertility Flashcards

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1
Q

No previous pregnancies occured

A

Primary infertility

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2
Q

Prior pregnancy although not necessarily a live birth has occurred

A

Secondary infertility

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3
Q

Probability of a pregnancy within a single menstrual cycle

A

Fecundability

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4
Q

Probability of achieving a live birth within a single cycle

A

Fecundity

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5
Q

Relative prevalence of the etiologies of infertility

A

Male factor - 25-40%
Both male and female factor - 10%
Female factor - 40-55%
Unexplained infertility - 10%

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6
Q

Getting sample in the endo cervical canal

A

Post coital test

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7
Q

Post coital test

A

To check if there is problem with cervical mucus and sperm

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8
Q

Male factor

Developmental defects

A

Undescended testis

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9
Q

Male factor

Infections

A

Mumps orchitis

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10
Q

Male factor

Medication

A

Exposure to diethylstilbestrol

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11
Q

Cause significant testicular atrophy

A

STI
Systemic febrile illness
Mumps
Chickenpox

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12
Q

Can cause retrograde ejaculation

A

Inguinal herniorhapy

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13
Q

Assess any gynecomastia or anosmia ( kallmanns syndrome with hypohonadotropic hypogonadism

A

Exclude klinefelters syndrome

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14
Q

Associated with diminished semen quality or fecundity

A

Caffeine
Alcohol
Smoking

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15
Q

It is likely to detect one out of ten men who have “true” semen abnormality

A

A sensitive test

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16
Q

An abnormal test result does not always mean there is a true semen abnormality

A

Has poor specificity

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17
Q

Basic semen analysis measures

A

Semen volume
Sperm concentration
Super motility
Sperm morphology

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18
Q

Semen analysis

Taken to the lab within

A

1-2 hours of collection

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19
Q

Semen analysis

The initial fraction contains the

A

Greatest sperm density

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20
Q

Semen analysis

Liquefaction occurs

A

15-20 minutes after ejaculation

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21
Q

Semen analysis

Sperm motility decline

A

2 hours after ejaculation

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22
Q

Semen analysis

If abnormal

A

Ulitin ulet para ma compare

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23
Q

Semen analysis

Must be done in

A

3 days abstinence

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24
Q

Semen analysis

Development from spermatogonia to mature sperm

A

75 days

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25
Sperm volume Normal value
1.5-5ml
26
Sperm volume Low volume
Possibility of retrograde ejaculation
27
Sperm volume High volume
Relatively long periods of abstinence or inflammation of the accessory glands
28
Sperm concentration/density Cut off
60M/ml
29
Sperm concentration/density Lower limit
20M/ml
30
Sperm concentration/density How many motile sperm is needed to fertilize egg
500,000
31
Cut off sperm motility
50%
32
Reduction of sperm motility
Asthenozoospermia
33
Abnormality of sperm morphology
Teratozoospermia
34
Tygerberg classification
>14% normal rate | 4-14 % normal morphology
35
Measures the ability of patients sperm to undergo capacitation to fuse with and penetrate
Sperm penetration assay
36
If the result of first semen analysis is abnormal,
A repeat confirmatory test should be offered. Ideally be undertaken 3 moths after the initial analysis. Allow time for spermatozoa
37
Spermatogonia undergo mitotic division to give rise to
Spermatocytes
38
Spermatocytes undergo meiosis to produce
Spermatids
39
Spermatids contain
23 rather than 46 chromosomes
40
Upon maturation spermatids become
Spermatozoa
41
Line the seminiferous tubules, the site of spermatogonia is
Sertoli cells
42
Site of androgen synthesis
Leydig cells
43
Stimulate the synthesis and secretion of testosterone by the leydig cells
LH
44
Stimulates the Sertoli cells to secretes inhibin
FSH
45
Acts on seminiferous tubules to stimulate spermatogenesis
FSH and testosterone
46
16 days maturation
Spermatogenesis
47
Spermatids
Spermatozoa testicle
48
To transverse epididymis
12-21 days
49
Biochemical and electrical events which takes place within the sperms outer surface membrane before fertilization can occu in cervical mucus
Capacitation
50
Release of enzyme of the inner acrosomal membrane results in the breakdown of outer plasma membrane and its fusion with the outer acrosomal membrane
Acrosome reaction
51
As the sperm penetrates the egg, it initiates hardening of zonapellucida, which prevents penetration by additional sperm
Cortical reaction
52
Mature spermatozoa from vas deferents along with the fluid from
Prostate Seminal vesicles Bulbourethral glands
53
Ejaculation
Liquefaction
54
The semen released isa gelatinous mixture of
Spermatozoa and seminal plasma
55
Liquefaction occurs secondary to the presence of
Proteolytic enzyme within the prostatic fluid
56
All semen parameters normal
Normozoospermia
57
Reduced spree numbers
Ologozoospermia
58
5-20 million /ml of semen
Mild to moderate
59
Severe
60
Reduced sperm motility
Asthenozoospermia
61
Increased abnormal forms of sperm
Teratozoospermia
62
Sperm variables all subnormal
Oligoasthenoteratozoospermia
63
No sperm in semen
Azoospermia
64
No ejaculation (ejaculation failure)
Aspermia
65
Increase white cell in semen
Leucocytospermia
66
All sperm are non viable or non motile
Necrozoospermia
67
Volume
>2ml
68
Sperm concentration
>20 M/ml
69
Sperm motility
>50% progressive or > 25 % rapidly progressive
70
Morphology (strict criteria)
>15% normal forms
71
White blood cells
>1 million/ml
72
Immuno beda or mixed anti globulin reaction test
73
Causes of semen abnormalities
Nasa trans So need mo tlagang basahin ang trans. Hwag kang tamarin 3rd year kna
74
Drugs that can impair male fertility Impaired spermatogenesis
``` Sulfasalazine Methotrexate Nitrofurantoin Colchicine Chemotherapy ```
75
Drugs that can impair male fertility Pituitary suppression
Testosterone injections | Gnrh analogue
76
Drugs that can impair male fertility Antiandrogenic effects
Cimetidine | Spironolactone
77
Drugs that can impair male fertility Ejaculation failure
Alpha blockers Antidepressants Phenothiazines
78
Drugs that can impair male fertility Erectile dysfunction
Beta blockers Thiazide Metoclopramide
79
Drug of misuse
Beta anabolic steroids Cannabis Heroin Cocaine
80
Abnormal dilation of veins (most common left) within the spermatic cord
Varicocele
81
Treatment of varicocel
Cut the are of the blood vessel
82
Definition of infertility
1 year of unprotected intercourse without pregnancy

Gyne (2 decks)

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