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Flashcards in Infertility Deck (32)
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1

What ares some examples of conditions which may be indicators for ACT?

Endometriosis

Tubal disease

Ovulatory disorders

Male factor infertility

2

Give some examples of important criteria which must e met before ACT can be started?

Alcohol: females <4 units, men <14 units

Weight BMI 18.5-30

Abstinence from drugs

Smoking cessation

3

What are the treatment options available of assisted conception?

Donor insemination

In vitro fertilisation (IVF)

Intra-uterine insemination (IUI)

Intra cytoplasmic sperm injection (ICSI)

Fertility preservation

Surrogacy

4

What are some of the possible complications of assisted conception?

Ovarian hyper-stimulation syndrome

Multiple pregnancy

Ectopic pregnancy

5

How does ovarian hyper-stimulation syndrome present?

Abdominal bloating

Abdominal pain

N&V

US evidence of ascites

6

What is a heterotrophic pregnancy?

Both intrauterine (normal) and extrauterine (ectopic) pregnancy occur simultaneously

7

How is intra uterine insemination (IUI) performed?

Prepared semen is inserted into the uterine cavity around the time of ovulation

8

How is in vitro fertilisation (IVF) performed?

Egg and sperm are combined outwith the body

(egg is collected form the female and sperm form the male)

9

For how long must a male abstain before producing sperm for IVF?

72 hours

10

How is intra cytoplasmic sperm injection (ICSI) performed?

Sperm may need to be surgically aspirated

Egg is stripped, sperm is immobilised then injected

11

What are the two primitive genital ducts?

Wolffian and Mullerian ducts

12

Describe the development of the reproductive tracts from the primitive genital ducts in males and females

MALE
Wolffian duct forms the reproductive tract
Mullerian duct degenerates

FEMALE
Wolffian duct degenerates
Mullerian duct forms the reproductive tract

13

How does androgen insensitivity syndrome present?

Phenotypically female
- Female external genitalia but absence of the uterus and ovaries and have a short vagina

present at puberty with amenorrhoea

14

What is androgen insensitivity syndrome?

Congenital insensitivity to androgens

X-linked recessive

Male karyotype (46 XY) but phenotypically female

15

What is the normal testicular volume pre-pubertal and in adults?

1-3mls pre-pubertal

12-25mls in adults

16

What is used to measure testicular volume?

An orchidometer

17

What is the medical term for undescended testes?

Cryptorchidism

18

What cells does LH act on and what effect does this have?

LH acts on Leydig cells to stimulate testosterone secretion

19

What cells does FSH act on and what effect does this have?

FSH acts on sertoli cells to enhance spermatogenesis

20

Inhibin and activin are important for feedback to the pituitary gland. They are produced from which cells?

Sertoli cells

21

What effects does testosterone have throughout life?

Descent of the testes

Puberty and secondary sexual characteristics

Spermatogenesis

22

What are some of the causes of obstructive male infertility?

Cystic fibrosis

Vasectomy

Infection

23

What are some of the non-obstructive causes of male infertility?

Cryptochordism

Klinefelter's

Endocrine disorders

Systemic disorders e.t.c

24

What are the hallmarks of Kallman's syndrome?

Don't produce LH and FSH

Poor sense of smell

25

What factors should be examined in semen analysis?

Volume

Density

Motility

Progression

26

What factors can falsely result in poor semen analysis?

Illness

Temperature

Failure to abstain for 3 days before giving a sample

Too long between production and assessment

27

What are some of the possible treatment options for male infertility?

Intracytoplasmic sperm injection

Surgical sperm aspiration

Donor insemination

28

What things are recommended to help with male infertility?

Frequent sexual intercourse 2-3x per week with avoidance of lubricants which are toxic to sperm

Avoid tight fitting underwear and prolonged hot baths and saunas

<4 units of alcohol per day

Smoking cessation

BMI<30

29

What does oligoasthenospermia mean?

Low count and low motility

30

What does teratoasthenospermia mean?

Low motility and abnormal forms