Infertility

Question 1

Clinical definition of Infertility

Answer 1

inability to achieve a pregnancy after 1 year of normal relations.

Question 2

sperm problems

Answer 2

low sperm count, Poor sperm movement, odd sperm shape

Question 3

Low sperm count causes

Answer 3

Decreased since 1930s due to environmental estrogens.

Question 4

Blockage of ducts (Male)

Answer 4

Prevent sperm transport and addition of seminal fluid

Question 5

Hormonal disorders

Answer 5

Low hormonal levels, high levels of fertility suppressing hormones

Question 6

Reproductive blockages (Female)

Answer 6

thick cervical mucus, scarring in uterine tubes

Question 7

Seminal evaluation

Answer 7

testing qualities of semen to evaluate number/mobility/morphology of sperm

Question 8

Ovulation induction

Answer 8

A chemical is used to stimulate ovulation

Question 9

Intrauterine insemination (IUI)

Answer 9

introduction of semen into female’s uterus.

Question 10

Success of IUI

Answer 10

Twice as successful as normal intercourse, has impregnated single women and lesbians

Question 11

In vitro fertilization (IVF) steps

Answer 11

• Stimulation of oocyte production
• Removal of multiple oocytes
• Collection of sperm
• Combining sperm and oocytes
• Embryo preservation
• Embryo transfer

Question 12

Stimulation of oocyte production

Answer 12

multiple oocytes are stimulated to develop

Question 13

removal of multiple oocytes

Answer 13

ovulation is suppressed, oocytes are removed

Question 14

collection of sperm

Answer 14

usually occurs through masturbation. Sperm (and oocytes) can be stored and frozen for multiple years. Sperm are “washed” and capacitated.

Question 15

Washing of sperm

Answer 15

seminal fluid, abnormal sperm, pathogens removed

Question 16

combining sperm and oocytes

Answer 16

sperm deposited in general area of oocytes. Sometimes injected with ICSI. Many oocytes are fertilized.

Question 17

Intracytoplasmic sperm injection (ICSI)

Answer 17

injection of sperm into cytoplasm of oocyte.

Question 18

Embryo preservation

Answer 18

Embryos develop until 8-cell stage, best are used, excess are frozen :(

Question 19

Preimplantation Genetic Diagnosis (PGD)

Answer 19

removal of blastomere for genetic testing, Increases embryo death risk.

Question 20

Embryo transfer

Answer 20

Movement of embryos to the uterine cavity. If one implants, IVF is successful

Question 21

Surrogacy

Answer 21

transfer to a woman who did not contribute gametes

Question 22

Gamete intrafallopian transfer (GIFT)

Answer 22

introduction of sperm and oocyte into fallopian tubes

Question 23

Zygote intrafallopian transfer

Answer 23

introduction of a zygote in to the fallopian tube. Zygote is created using IVF. Transferred without testing

Question 24

ART success rates

Answer 24

implantation is ~35% successful, so 3 deaths for each life. Not more successful than 30 year old surgery treatments.

Question 25

ART Risks and limitations

Answer 25

multiple babies, premature birth, low birth weight, selective reduction, OHSS, preeclampsia, birth defects, ectopic pregnancy, does not reveal underlying reason for infertility.

Question 26

selective reduction

Answer 26

abortion of conceptuses when multiples result from IVF

Question 27

Ovarian Hyperstimulation Syndrome (OHSS)

Answer 27

Ovary is hyper stimulated. occurs due the ovulation drugs used.

Question 28

Preeclampsia

Answer 28

high blood pressure in a pregnancy