Infertility: Hormonal methods of contraception & causes of infertility

Question 1

Which 2 hormones are in an oral contraceptive?

Answer 1

Oestrogen & Progesterone

Question 2

Fill in the blanks: Oestrogen at low levels ___. However, at high doses, oestrogen
____.

Answer 2

Oestrogen at low levels stimulates the release of eggs. However, at high doses, oestrogen
will inhibit FSH production.

Question 3

What are the side effects and final result of taking the pill?

Answer 3

Egg development and release will stop completely. If there is no egg available, there can be no baby.

Question 4

List 2 benefits and 2 risks of taking oral contraceptives

Answer 4

+ Oral contraceptives are more than 99% effective if taken correctly.
+ Reduced the risk of certain cancers
+ Contraceptive injections, implants or skin patches contain slow release progesterone to inhibit the maturation and release of eggs.

• side effects are changes in weight, mood and blood pressure due to high
  levels of oestrogen.
• Irregular vaginal bleeding

Question 5

Name 6 causes of infertility

Answer 5

• Advancing maternal age
• Ovulation disorders
• Tubal occlusion (blockage)
• Uterine fibroids
• Male factors affecting sperm function
• Endometriosis

Question 6

Explain what happens with the quality of eggs in the advancing of maternal age

Answer 6

• egg numbers decrease at a rapid rate.
• egg quality, or the likelihood of an egg being genetically normal, decreases.

Question 7

What 2 methods can you use to keep track of ovulation?

Answer 7

Menstrual calendar or an ovulation predictor kit

Question 8

What is tubal occlusion?

Answer 8

Blockage of the fallopian tubes

Question 9

What factors can predispose a woman of having blocked fallopian tubes?

Answer 9

A history of sexually transmitted infections including chlamydia, gonorrhea, or pelvic
inflammatory disease

Question 10

How does tubal occlusion cause infertility?

Answer 10

The ovulated egg is unable to be fertilized by sperm or to reach the endometrial cavity.

Question 11

What are uterine fibroids?

Answer 11

Abnormal growths/ solid tumors that develop in the uterus lining

Question 12

What are the effects of fibroids on pregnancy rate?

Answer 12

They can reduce pregnancy rate, roughly by 50%, and
removal of which will double pregnancy rate.

Question 13

What are the effects of fibroids?

Answer 13

Often, but not always, submucosal fibroids can cause heavy periods, or bleeding
between periods.

Question 14

What percentage does male infertility contribute?

Answer 14

40-50%

Question 15

Define Endometriosis

Answer 15

Endometriosis is a condition whereby cells very similar to the ones lining the uterine cavity, or endometrium, are found outside the uterine cavity.

Question 16

How does endometriosis cause infertility?

Answer 16

Produces inflammation and scarring, which has
detrimental effects on egg, sperm or embryo.

Question 17

What 4 methods are used to identify causes of infertility?

Answer 17

• Egg production
• Sperm Production
• Fallopian Tubes
• Uterus

Question 18

What is used to measure whether ovulation is occurring and what is the indication?

Answer 18

Basal Body Temperature

A slight, sustained rise indicates that ovulation has occurred

Question 19

What factors will be analysed about a semen specimen?

Answer 19

A semen specimen will be analyzed for the number of sperm, their shape and movement.

Question 20

What tests are taken to shown whether the fallopian tubes are open?

Answer 20

hysterosalpingogram (HSG)
or sonohysterogram (ultrasound)

Question 21

How is the uterine lining checked for implantation?

Answer 21

• The shape of the uterus is shown in an HSG/hysteroscope inserted through the vagina and cervix
• endometrial biopsy
  samples the uterine lining in the last half of the cycle to see if it is prepared for an embryo to implant. The thickness of the lining can also be measured using ultrasound.