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Infertility Flashcards

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1
Q

Define infertility.

A

Failure to conceive after 1 yr of unprotected sex

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2
Q

What questions do you ask yourself about infertility?

A

is it the man?
is it the ovulation?
is it the tubes?
is it something else?

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3
Q

What percent of infertility is down to the man?

A

30%

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4
Q

What percent of infertility is down to the ovulation?

A

25% (anovulatory)

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5
Q

Tell me about how sperm is made.

A

FSH/LH — leydig — testosterone – sertoli — sperm

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6
Q

Idiopathic male infertility is common. True or false?

A

true

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7
Q

Name 4 drugs that can cause male infertility.

A

alcohol, smoking, steroids, industrial chemicals

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8
Q

Name 5 causes of male infertility other than idiopathic or drugs.

A
  • CF
  • Klinefelter’s
  • Kallmans
  • epididymitis
  • retrograde ejaculation
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9
Q

What do you find out about sperm in semen analysis? (x3)

A

sperm count
mobility
morphology

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10
Q

If semen analysis abnormal, what do you do?

A

examine testes

repeat 3 months later

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11
Q

If semen analysis shows azoospermia, what three further tests would you do?

A

KARYOTYPE
CF SCREEN
HORMONE PROFILE

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12
Q

What’s tested in a hormone profile?

A

FSH, LH, TSH, testosterone, prolactin

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13
Q

What is the difference between primary and secondary infertility?

A

primary - has never conceived before

secondary - has conceived before

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14
Q

What % of infertility is down to the tubes?

A

20%

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15
Q

What % of infertility is down to something else?

A

25% unexplained

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16
Q

Give me two examples of conditions that would cause anovulatory infertility.

A

PCOS

premature ovarian failure

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17
Q

If a woman is ovulating, her mid luteal progesterone should be above what??

A

above 30

if it’s below it makes you think anovulatory

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18
Q

To investigate anovulatory infertility, what three investigations?

A

MID LUTEAL PROGESTERONE
HORMONE PROFILE
OVARIAN RESERVE TESTING (day 2 FSH, AMH)

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19
Q

If a woman has low ovarian reserve, what would you expect from ovarian reserve testing?

A

Day 2 FSH low

AMH high

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20
Q

Low AMH =

A 
low eggs
(in premature ovarian failure)
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21
Q

What three things could cause ISHEWS with the tubes causing infertility?

A

PID
endometriosis!!!!
adhesions

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22
Q

What investigations for tubes infertility?

A

HyCoSy
or hysterosalpingogram
or laparoscopy + dye test

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23
Q

What is HyCoSy?

Study These Flashcards
A

hystero salpingo contrast sonography (US)

best option for investigating tubes infertility

24
Q

Why would day 2 FSH be high in anovulatory fertility?

Study These Flashcards
A

the FSH is having to push hard for follicles to make oestrogen but not getting anywhere

25
Name 4 tips and tricks for maximising chances of conceiving.
intercourse 3x a week no smoking / alcohol healthy BMI + controlled comorbidities folic acid + vit supplements
26
In what scenario could you get referral for assisted conception before a yr of trying?
>35, Hx pelvic surgery | risk factors basically
27
What is intra-uterine insemination?
sperm injected into uterine cavity
28
What is half the price of IVF and half the success rate?
intra-uterine insemination
29
sperm injected into cavity. What's this?
intra-uterine insemination.
30
What is success rate of IVF?
30-35%
31
How long does one cycle of IVF take?
one month
32
Do you need patent tubes for IVF?
no
33
Do you need normal ovarian reserve for IVF?
yes (for egg collection)
34
Give me the five stages of IVF.
1. stimulate ovaries 2. egg collection 3. fertilisation and culture 4. embryo transfer 5. luteal phase support.
35
FSH/LH injections in IVF. What stage is this?
1. stimulate ovaries
36
transvaginal needle in IVF... what stage is this?
2. egg collection
37
Growing a blastocyst in IVF... what stage is this?
3. fertilisation and culture
38
Catheter through cervix. What stage of IVF is this?
4. embryo transfer
39
Progesterone until 4-8wks. What stage of IVF is this?
5. luteal phase support
40
After stimulating the ovaries, what is the next step in IVF?
2. egg collection
41
After egg collection, what is the next step in IVF?
3. fertilisation and culture
42
After fertilisation and culture, what is the next step in IVF?
4. embryo transfer
43
After embryo transfer, what is the next step in IVF?
5. luteal phase support
44
Give me three RISKS of IVF.
multiple pregnancy ectopic pregnancy ovarian hyperstimulation syndrome.
45
multiple pregnancy ectopic pregnancy and ovarian hyperstimulation syndrome are all risks of what?
IVF
46
What process is an adjunct to IVF?
intra-cytoplasmic sperm injection (ICSI)
47
Intra-cytoplasmic sperm injection is on about which cytoplasm?
the cytoplasm of the oocyte | injecting sperm right into the egg rather than just mixing them
48
explain what intra-cytoplasmic sperm inject is please.
injecting sperm right into the egg rather than just mixing them an adjunct to IVF
49
Which method of assisted conception is particularly good for male infertility with IMMOTILE sperm?
intra-cytoplasmic sperm injection they can't swim there themselves
50
Give me 5 indications for Assisted Conception
``` unexplained infertility male subfertility endometriosis genetic disorders other methods failed. ```
51
For those with low ovarian reserve, IVF isn't suitable. What is?
egg donation
52
What happens in egg donation?
the donor goes through the stimulation bit of IVF | then the recipient gets the embryo transfer bit!
53
What is straight surrogacy?
surrogate's eggs
54
What is host surrogacy?
her eggs
55
What conditions might be candidates for surrogacy?
can't carry in womb: congenital uterine abnormalities hysterectomy chronic disease needing teratogenic drugs!
56
If you're having chemo which threatens your fertility, and you're in a relationship, what assisted conception could you consider?
embryo freezing | needs partner's consent to be thawed

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