Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Endocrinology > Infertility > Flashcards

Infertility Flashcards

(62 cards)

Start Studying
1
Q

What is infertility?

A

disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months of regular unprotected sexual intercourse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is primary infertility?

A

when have not had a live birth previously

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is secondary infertility?

A

when have had a live birth >12 months previously

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Infertility affects how many couples?

A

1 in 7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What impact does infertility have on the couple?

A

psychological distress, no biological child, impact on larger family, investigation, treatments often fail

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What impact does infertility have on society?

A

less births, less tax income, investigation costs, treatment costs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Causes of infertility in males can be grouped into?

A

pre-testicular
testicular
post-testicular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

List examples of pre-testicular causes of male infertility.

A

congenital/acquired endocrinopathies: Klinfelter’s 47XXY, Y chromosome deletion HPG, T, PRL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

List examples of testicular causes of male infertility.

A

STDs, cryptorchidism, antisperm antibodies, varicocele, trauma/surgery, chemo/drugs/DXT/smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

List examples of post-testicular causes of male infertility.

A

CF absence of vas deferens, obstructive azoospermia, erectile dysfunction (retrograde ejaculation, mechanical impairment, psychological), latrogenic (surgery)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Define cryptorchidism.

A

undescended testes from the abdomen to the scrotum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Define variocele.

A

mass of varicosed blood vessels in the testes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Causes of infertility in females can be grouped into?

A 
pelvic
tubal
ovarian
uterine
cervical
unexplained
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

List pelvic causes of infertility.

A

endometriosis

adhesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

List tubal causes of infertility.

A

tubopathy: infection, trauma, endometriosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

List ovarian causes of infertility.

A

anovulation

corpus luteum insufficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

List uterine causes of infertility.

A

chronic endometritis (TB)
fibroid
adhesions
congenital malformation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

List cervical causes of infertility.

A

antisperm antibodies

chronic cervicitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is endometriosis?

A

presence of functioning endometrial tissue outside the uterus (5% of women, responds to oestrogen)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Symptoms of endometriosis

A

more severe menstrual pain
menstrual irregularities
deep dyspareunia
infertility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Define dyspareunia.

A

painful intercourse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Treatments of endometriosis

A

hormonal (continuous OCP, prog)
laparoscopic ablation
hysterectomy
bilateral salpingo-oophorectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is bilateral salpingo-oophorectomy?

A

removal of fallopian tubes and ovaries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are fibroids?

A

benign tumours of the myometrium (1-20% of premenopausal women, ^ with age, responds to oestrogen)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What are symptoms of fibroids?
``` usually asymptomatic more severe menstrual pain Menstrual irregularities Deep dyspareunia Infertility ```
26
Treatment of fibroids
Hormonal (eg continuous OCP, prog, continuous GnRH agonists) | Hysterectomy
27
In hyperprolactinaemia, Kallman syndrome, what are the levels of gonadal axis hormones in males?
low GnRH low LH low FSH low testosterone
28
In hypopituitarism, what are the levels of gonadal axis hormones in males?
low LH low FSH low testosterone
29
In congenital/acquired hypogonadism, what are the levels of gonadal axis hormones in males?
high LH high FSH low testosterone
30
What is Kallmann syndrome?
condition characterized by delayed or absent puberty and an impaired sense of smell (form of hypogonadotropic hypogonadism)
31
List reproductive features of Kallman syndrome.
Cryptorchidism Failure of puberty: Lack of testicle dvlpt, micropenis, primary amenorrhoea Infertility
32
Hyperprolactinaemia inhibits what neurons?
kisspeptin
33
List causes of hyperprolactinaemia.
``` Prolactinoma (micro/macro) Pituitary stalk compression Pregnancy & Breastfeeding Medications (Dop antagonists eg anti-emetics and antipsychotics) (Oestrogens eg OCP) PCOS Hypothyroidism ```
34
List examples of sex chromosome disorders.
Klinefelter syndrome XXY Triple X syndrome XXX Turner syndrome X0 Fragile X syndrome
35
List clinical features of Klinefelters syndrome.
tall stature, less facial/chest hair, mildly impaired IQ, narrow shoulder, gynecomastia, wide hips, low bone density, female type pubic hair pattern, small penis/testes, infertility
36
What information should you look for in initial history of a patient with potential male infertility?
``` duration previous children pubertal milestones associated symptoms medical/surgical/family/social history ```
37
What examinations should you carry out for a patient with potential male infertility?
``` BMI sexual characteristics testicular volume epididymal hardness presence of vas deferens other endocrine signs syndromic features anosmia ```
38
What main investigations should you carry out for a patient with potential male infertility?
semen analysis: vol, conc, motility blood tests: LH/FSH/PRL, SHBG, albumin, karyotyping, morning fasting testosterone microbiology: urine, chlamydia imaging: MRI pituitary, scrotal US
39
What general lifestyle treatments are there for male infertility?
optimise BMI smoking cessation alcohol reduction/cessation
40
What specific treatments are there for male infertility?
dopamine agonist for hyperPRL gonadotrophin for fertility testosterone (for symptoms) surgery (eg micro TESE)
41
In congenital/acquired hypogonadotrophic hypogonadism + hyperPRL, what are the levels of gonadal axis hormones in females?
low GnRH low LH low FSH low E2
42
In hypopituitarism, what are the levels of gonadal axis hormones in females?
low LH low FSH low E2
43
In PCOS, what are the levels of gonadal axis hormones in females?
increased LH:FSH | normal/low E2
44
In hypergonadotrophic hypogonadism, what are the levels of gonadal axis hormones in females?
high LH high FSH low E2
45
What is the most common endocrine disorder and cause of infertility in women?
polycystic ovarian syndrome
46
What is the strategy for diagnosing PCOS?
exclude other reproductive disorders | 2 out of 3 of Rotterdam Diagnostic Criteria
47
What are the Rotterdam PCOS diagnostic criteria?
oligo or anovulation clinical/biochemical hyperandrogenism polycystic ovaries (US)
48
How is oligo/anovulation usually assessed?
oligomenorrhoea <21d or >35, <8-9 cycles/y, > 90d for any cycle anovulation can be proven by lack of progesterone rise or US
49
How is clinical hyperandrogenism usually assessed?
acne hirsutism (Ferriman-Gallwey score) alopecia (Ludwig score)
50
How is biochemical hyperandrogenism usually assessed?
raised androgens (eg testosterone)
51
How is polycystic ovaries assessed?
≥20 follicles OR ≥10ml either ovary on TVUS (8 MHz) | do not use US until 8 years post menarche
52
What are treatments for irregular menses/amenorrhea (PCOS)?
oral contraceptive pill | metformin
53
What are treatments for infertility (PCOS)?
clomiphene letrozole IVF
54
What are treatments for insulin resistance (PCOS)?
metformin
55
What are treatments for hirsutism (PCOS)?
antiandrogens | creams/waxing/laser
56
What are treatments for increased endometrial cancer risk (PCOS)?
progesterone courses
57
What are clinical features of Turner's syndrome?
``` short stature low hairline webbed neck shield chest coarctation of aorta poor breast development/wide spaced nipples short 4th metacarpal elbow deformity underdeveloped reproductive tract amenorrhea brown nevi ```
58
What initial history should you get when investigating a patient with potential female infertility?
``` duration previous children pubertal milestones breastfeeding menstrual history medical/surgery/family/social history ```
59
What examinations should you carry out when investigating a patient with potential female infertility?
``` BMI sexual characteristics hyperandrogenism signs pelvic exam anosmia endocrine signs syndromic features ```
60
What main investigations should you carry out for a patient with potential female infertility?
blood test pregnancy test microbiology imaging
61
What blood test should be carried out for a patient with potential female infertility?
``` LH FSH PRL oestradiol, androgens Foli phase 17OHP luteal prog SHBG albumin pituitary/thyroid profile karyotyping ```
62
What imaging should be carried out for a patient with potential female infertility?
US (transvaginal) hysterosalpingogram MRI pituitary (if low LH/FSH or high PRL)

Endocrinology (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions