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Reproductive Medicine Exam 2 > Infertility > Flashcards

Flashcards in Infertility Deck (22)
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1
Q

How is infertility defined?

A

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

2
Q

In women being worked up for infertility…..

What should the be supplemented with?

A

Folic Acid

3
Q

Other than folic acid……

What Interventions should women take to increase chance of pregnancy?

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

What is the cornerstone of infertility work up in males?

A

Semen Analysis

***Abstinence for 2-7 days

5
Q

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

A

Within 1 hour

6
Q

What is a normal sperm count?

A

> 15 million per mL

7
Q

If a male has a low sperm count…..

What should be included in their lab work up?

A
FSH
Total Testosterone
Free Testosterone
LH
Prolactin
8
Q

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

A

Less than 10%

9
Q

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

A

True

10
Q

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?

A

PCOS

11
Q

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?

A

Ovarian Factor –> Ovulatory Dysfunction

12
Q

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?

A

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
Q

Ovarian factor is responsible for __% of infertility in women

A

40%

14
Q

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

A

Manage Com-morbidities first

15
Q

What are some adverse effects of Clomiphene Citrate?

A
Vasomotor Symptoms (due to being estrogen antagonist) 
Visual Changes
16
Q

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

A

False

There is not a risk of ovarian cancer

17
Q

What are the most common side effects of metformin?

A

GI Upest (N/V/D)

***Monitor for hepatotoxicity

18
Q

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

A

Letrozole

19
Q

What are the most common side effects of Letrozole?

A

Fatigue

Dizziness

20
Q

T/F: Letrozole is potentially teratogenic

A

True

21
Q

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

A

Ovarian Hyperstimulation Syndrome

Multifetal Gestation

22
Q

What is the surgical approach to pituitary adenoma removal?

A

Transphenoidal

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