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Reproductive Medicine Exam 2 > Infertility > Flashcards

Flashcards in Infertility Deck (22)
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1

How is infertility defined?

Failure to achieve pregnancy after 1 year of regular, unprotected intercourse (2x/week)

2

In women being worked up for infertility.....

What should the be supplemented with?

Folic Acid

3

Other than folic acid......

What Interventions should women take to increase chance of pregnancy?

1. Glycemic Control (especially in DM)
2. Abstience from alcohol
3. Weight Reduction
4. Smoking Cessation
5. Avoid teratogens

4

What is the cornerstone of infertility work up in males?

Semen Analysis

***Abstinence for 2-7 days

5

How soon after collection does a semen analysis need to be evaluated?

Within 1 hour

6

What is a normal sperm count?

> 15 million per mL

7

If a male has a low sperm count.....

What should be included in their lab work up?

FSH
Total Testosterone
Free Testosterone
LH
Prolactin

8

Less than __% of male factor infertility can be overcome with management?

Less than 10%

9

T/F: Infertility due to varicocele typically responds to surgical management

True

10

A 31 year old infertile woman has menses every 45-120 days and reports excessive facial hair and acne. Her husband has a normal semen analysis.

What is her most likely diagnosis?

PCOS

11

A 31 year old infertile woman has menses every 45-120 days and reports excessive facial hair and acne. Her husband has a normal semen analysis.

What 'factor' is the likely cause of her infertility?

Ovarian Factor --> Ovulatory Dysfunction

12

A 31 year old infertile woman has menses every 45-120 days and reports excessive facial hair and acne. Her husband has a normal semen analysis. She is eventually diagnosed with PCOS.

What medication would most likely lead to pregnancy in this patient?

Clomiphene citrate—E antagonist

(Increases the secretion of FSH and LH by the pituitary leading to the development of one or more dominant follicles)



BONUS: Metformin is second line to decrease insulin levels which has been shown to promote ovulation and contraception

13

Ovarian factor is responsible for __% of infertility in women

40%

14

What is the first step in managing ovarian factor infertility in females?

Manage Com-morbidities first

15

What are some adverse effects of Clomiphene Citrate?

Vasomotor Symptoms (due to being estrogen antagonist)
Visual Changes

16

T/F: There is an associated risk of ovarian cancer with Clomiphene Citrate

False

There is not a risk of ovarian cancer

17

What are the most common side effects of metformin?

GI Upest (N/V/D)

***Monitor for hepatotoxicity

18

What is the name of the aromatase inhibitor used in infertility?

Letrozole

19

What are the most common side effects of Letrozole?

Fatigue
Dizziness

20

T/F: Letrozole is potentially teratogenic

True

21

What are concerning 'side effect' of giving exogenous gonadotropins (FSH +/- LH) for infertility?

Ovarian Hyperstimulation Syndrome
Multifetal Gestation

22

What is the surgical approach to pituitary adenoma removal?

Transphenoidal

***This is commonly done when a women is pregnant to d/c dopamine agonist medication