Infertility and Sexuality

Question 1

What measures are used to assess for mid cycle ovulation?

Answer 1

Progesterone levels (day 21, mid-luteal)
Cervical mucus monitoring

Question 2

What are markers of ovarian reserve?

Answer 2

Antimullerian hormone
Day 3 FSH and estradiol
Clomiphene citrate challenge
Antral follicle count

Question 3

How does quetiapine cause infertility?

Answer 3

Antidopaminergic effect –> increased prolactin –> suppresses ovulation

Question 4

What is flibanserin?

Answer 4

5-HT1A receptor agonist used for hypoactive sexual desire disorder

Question 4

When should intercourse occur for best success at pregnancy?

Answer 4

Middle of cycle (Day 14) - since sperm can survive up to 5 days, intercourse up to 3 days before ovulation can still result in pregnancy

Question 4

What is first-line for PCOS? Second-line?

Answer 4

Ovulation induction agents are first-line
Laparoscopic ovarian drilling is second-line for those who have failed conservative measures

Question 5

What causes deep dyspareunia?

Answer 5

Conditions that cause pelvic inflammation:
Endometriosis
Prior pelvic surgery

Question 6

What is first-line for postmenopausal insertional dyspareunia?

Answer 6

Water-based lubricants and frequent vaginal intercourse

Question 7

What provides natural vaginal lubrication during arousal phase of intercourse?

Answer 7

Transudate across vaginal mucosa from increased engorgement with blood

Question 8

What do the terms sexual orientation, identity, and expression refer to?

Answer 8

Orientation: Who a person is attracted to
Identity: What gender the person identifies with
Expression: How a person publicly expresses or presents their gender

Question 10

Pathophysiology of idiopathic hirsutism

Answer 10

Excessive conversion of testosterone to dihydrotesterone in hair follicles
Usually positive family history