Flashcards in Infertility Deck (19):
Failure to conceive after 12 months of unprotected sex
What is a normal (lower limit) ejaculate made of?
40% good motility sperm
39 million in ejaculate
4% normal sperm.
What would you look at for women fertility?
Regularity of period.
Progesterone levels at day 21 and estrogen at day 12
FSH at days 2-4
Timing of intercourse
Causes of anovulation and what are some treatments to stimulate ovulation?
Obestiy or annorexia.
Weight gain or loss.
Clomiphene citrate - selective estrogen modulation (makes brain think there is less estrogen)
Letrazole - aromatase inhibitor (prevents the conversion of androgens to estrogen = brain produce more FSH)
What is Polysystic ovarian syndrome and who does it affect?
Has many follicles in the ovary, medium size follicles an large ovaries.
Affects 10% of women.
Infrequent or no periods
Metabolic syndrome - overweight
Increased androgens - alters apearance
What tubual disease can cause infertility?
Cyst, tumour, adhesions that block the fallopian tube.
Treat: IVF, surgery to fix the tube
What is the treatment for infertility caused by cervical problems?
Treatment: Intrauterine insemination
Treatment and symptoms of edometriosis
10% affected (30% infertile)
Treatment: hormonal contraceptives, ablation surgery
How would you makes someone with premature menopause or rising FSH and decreasing AMH pregnant?
Treat with donor egg (IVF)
Time lapse photography?
Takes a photo every 10 minutes of the embryo. Can follow development to determine if it is normal.
What is oligospermia and how do you treat?
Low sperm count
Treat by taking a single sperm and inseminating an egg (intracytoplasmic sperm injection [ICSI]) or donor sperm
What is Oligoasthenoteratosperima (OATS)?
Low concentran, slow moving, abnormal form (3 defect)
Treat with intracytoplasmic sperm injection (ICSI) or donor sperm
What is azoospermiaand how do you treat?
No GnRH - no FSH/LH.
Obstructive - vasectomy
Congenital vas deferens absence.
Testicle aspiration of sperm then intracytoplasmic sperm injection [ICSI]
Surgical removal of sperm
Fine needle taking fluid from the epididymis (1st try) or tissue from testis (2nd attempt).
Take a larger chunk if that doesn't work.
Milk the seminephrous tubules.
What are the steps involved in intracytoplasmic sperm injection?
Select sperm with normal motility and morphology
Aspirate sperm tail first
Position sperm in needle.
Insert needle into egg
Rupture egg cytoplasm by aspiration
Expel the sperm
What are some treatments for unexplained infertility?
Usually associated with age or a problem at the sperm and ovary level.
Mild ovarian stimulation and intrauterine insemination
What can you check to see implatation rate for IVF?
AMH - high means polysystic ovaries and high ovarian reserve
Preimplantation genetic screen analysis of embryos at day 3. Cut hole in zona and allow the cells to herniate out the hole. Take 4-5 cells and do gen seq.
Why is age associated with infertility?
Eggs age. Associated with an increased aneuploidy (number of eggs with chromosomal abnormalities) and the implantation rates decrease.