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Infertility Issues Flashcards

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1
Q

definition of infertility

A

inability to conceive after 12 months of frequent, unprotected intercourse

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2
Q

what can cause infertility?

A
  • female factor (40%) or male factor (20%)
  • combo/unexplained
  • delayed childbearing (inc. age)
  • weight
  • STI
  • stress
  • smoking
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3
Q

how long should couples who are trying to conceive participate in intercourse?

A

every other day

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4
Q

what cycle days are most fertile?

A

7-17

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5
Q

what hormones may be tested for in women

A

gonadotropin, FSH, LH, progesterone, prolactin, TSH, androgen levels

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6
Q

when is FSH tested?

A

day 3

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7
Q

when is LH tested?

A

mid cycle, indicated ovulation

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8
Q

when is progesterone tested?

A

day 21

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9
Q

what are cervical mucus changes caused by

A

estrogen as ovulation approaches

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10
Q

what is spinbarkheit

A

mucus elasticity, indicating ovulaton

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11
Q

what is the crystallization of dried mucus under a microscope

A

ferning

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12
Q

what are anti sperm antibodies

A

made my cervix to immobilize sperm

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13
Q

describe ideal cervical mucus

A

thin, clear, watery, profuse, alkaline

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14
Q

what provides information about the receptivity of the endometrial lining and the effects of progesterone after ovulation

A

endometrial biopsy

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15
Q

what is used to assess development of follicles, endometrial development. it is indicated during ovulation induction, timing for insemination and intercourse, invitro fertilization, and early pregnancy

A

transvaginal ultrasound

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16
Q

what is when dye is placed and the uterine structure and patency of fallopian tubes are assessed?

A

hysterosalpingogram

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17
Q

what assesses uterine structire and allows for further uterine assessment of size, shape, and location of uterine cavity

A

hysteroscopy

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18
Q

what procedure is visualization of pelvic organs

A

laparoscopy

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19
Q

what does a laparoscopy look for?

A

endometriosis, adhesions, adhesions, pelvic inflammatory

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20
Q

what is dilation of scrotal veins (big cause of male infertility)

A

varicocele

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21
Q

what are causes of male infertility

A
  • varicocele
  • testicular atrophy
  • absence of vas deferens (congenital)
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22
Q

what is the normal sperm volume

A

greater than 2 ml

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23
Q

what is the normal sperm pH

A

7 to 8

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24
Q

what is the normal sperm count

A

greater than 20 million / ml

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25
what is the normal sperm liquefaction?
complete in 1 hour
26
what is the normal sperm motility
50% or more move forward
27
what are the normal forms of sperm
30% or greater
28
what is involved in semen analysis?
* oligospermia * azoospermia * antisperm antibodies
29
what is semen with low concentration of sperm?
oligospermia
30
what is imparied or nonexistant sperm production
azoospermia
31
what may be present d/t impairment in blood/testes barrier
antisperm antibodies
32
what med induces ovulation through stimulation of the hypothalamus to produce more FSH and LH
clomid
33
what is the route of administration for gonadotropins (repronex, menopur, follistim, gonal-f)
IM/SQ
34
what do gonadotropins contain?
FSH&LH
35
what are gonadotropins used for?
* anovulatory women with low/normal levels * pts who can't conceive with clomid * pts undergoing assisted reproduction
36
what needs to be monitored while on gonadotropins
* hyoerstimulation, multiple pregnancy * follicle development
37
when is hCG administered to stimulate ovulation?
when follicles are mature
38
when should patients who receive gonadotropins and hCG have intercourse
24-46 later and for the next 2 days
39
what is luteal phase defect caused by?
* poor follicle maturation * premature demise of corpus luteum * lack of endometrial response to progesterone * low progesterone levels are associated with FSH in the proliferation phase
40
what pharm agent is used for luteal phase defect?
progesterone
41
when is progesterone administered for luteal phase defect and what does it do
* it is administered after cHG in ovulation induction cycle * it increases endometrial receptivity to implantation
42
which infertility med inhibits the pituitary's secretion of prolactin and is used for anovulatory patients who have high levels of prolactin (dec. FSH&LH)
parlodel
43
what are side effects of parodel
teratogenic!!! * nausea, diarrhea, dizziness, HA, fatigue
44
anovulatory women with PCOS have what realtion with insulin?
hyperinsulinemia
45
what med is used for anovulatory women with PCOS?
insulin sensitizing agents (metformin)
46
what is the presence of endometrial tissue outside of the uterus
endometriosis
47
what med suppresses ovulation and menstruation to allow atrophy of endometrial tissue (endometriosis)
danazol
48
what 2 meds are used for treatment of endometriosis?
danazol and oral contraceptives
49
what med stimulates and releases eggs through stimulating hypothalamus, produces FSH&LH
clomid
50
what med directly stimulates follicle development
gonadotropins
51
what med triggers ovulation
hCG
52
what med prepares endometrial lining and maintains pregnancy
progesterone
53
what med inhibits secretion of prolactin, allowing production of FSH and LH
parlodel
54
what med settles endometriosis
danazol
55
what med controls hyperinsulinemia in women with PCOS
metformin
56
what is placement of sperm at the cervical opening
therapeutic insemination
57
why would donor sperm be used in therapeutic insemination
* sperm quality * single woman * lesbian couple
58
how lon gis donor sperm frozen and quarantined for?
6 months
59
what is IVF
after trying infertility meds, eggs are extracted from ovaries and fertilized with sperm in a lab. embryos are transferred to uterus 1-5 days later
60
is IVF expensive?
yes
61
what is storage of extra embryos, may be thawed in future
embryo cryopreservation
62
how many embryos are placed in IVF for greatest chance of pregnancy?
3-4
63
what is when eggs are collected with ultrasound guidance. eggs and sperm are transferred separately into fallopian tube
gamete intrafallopian transfer (GIFT)
64
what is the rationale for GIFT?
may be more accepted in religions
65
what is when eggs are collected with ultrasound guidance, fertilized with sperm in a lab, then placed in fallopian
ZIFT
66
how does ZIFT differ from IVF?
ZIFT = fallopian IVF = uterus
67
is GIFT or ZIFT more effective?
ZIFT
68
what is when sperm are sorted and desired sex is used in insemination or IVF
sperm sorting
69
what is rationale for sperm sorting?
* chromosomal abnormalities associated with sex * 2 or more children of same sex and want diff
70
what is when a woman is contracted to carry the pregnancy for a couple that is not genetically their own
gestational carrier
71
what is a gestational carrier and oocyte (egg) donor?
surrogate
72
what is a specialized procedure where sperm quality or morphology is of concern, genetic conditions, or prior IVF was unsuccessful?
intracytoplasmic sperm injection (ICSI)

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