Infertility: lasku

Question 1

what is estrogen fraction used to evaluate

Answer 1

sexual maturity, menstrual problems, fertility, fetal-placental health, estronge-producing tumors in females

Question 2

when does E2 peak?

Answer 2

peaks during the ovulatory phase

Question 3

estrodil E3

Answer 3

produced in placenta

major in pregnancy

Question 4

estrone E1

Answer 4

from androstenedione peripheral tissues

Question 5

drugs that elevate and decrease estrogen

Answer 5

increase: steroids, ampicillin, estrogen containing drugs

decrease: clomiphene (used to treat infertility)

Question 6

Clinical sig of increased estrogen levels

Answer 6

feminization syndrome, precocious puberty
ovarian, testicular adrenal tumors
normal preg
hepatic cirrhosis
hyperthyroidism

Question 7

clinical sig od decreased estrogen levels

Answer 7

failing pregnanxy
turners
hypopituitarism
primary and secondary hypogonadism
menopause: low estrogen/progesterone: high LH/FSH
anorexia nervosa

Question 8

what is progesterone assay used for

Answer 8

infertility
problems maintaining the pregnancy

Question 9

when should progesterone assay be done

Answer 9

check day 21 bc its at its highest levels

Question 10

where is progesterone secreated

Answer 10

secreted by corpus luteum after ovulation

initiates the secretory phase of endometrium

Question 11

clinical sign of increased progesterone levels

Answer 11

ovulation, pregnancy, luteal cysts of ovary, adrenocortical hyperplasia, choriocarcinoma (releases HCG which stimulate the corpus luteum to continue to make progesterone to support preg)

Question 12

clinical sig of decreased progesterone levels

Answer 12

amenorrhea, ovarian hypofunction, preeclampsia, eclampsia, threatened abortion, placental failure, fetal death, ovarian neoplasm

Question 13

complications during pregnancy of low progesterone:

Answer 13

preclampsia: high BP and protein in urine

eclampsia: develops seizures

Question 14

what is serum testosterone used to evaluate

Answer 14

ambiguous sex characteristics
precocious puberty
virilizing syndromes in females
infertility in males

Question 15

where is testosterone secreted?

Answer 15

leydig cells of the testicles

Question 16

where are DHEA and androstenedione produced

Answer 16

in the adrenals

Question 17

what does LH stimulate in males
FSH?

Answer 17

LH: stimulates the production of testosterone
FSH: stimulates spermatogenesis

Question 18

clinical sig of increased testosterone levels males vs females

Answer 18

males: sexual precocity, congenital adrenal hyperplasia, leydig cell tumors, hyperthyroidism, adrenocortical tumor

females: pcos, congenital adrenal hyperplasia, trophoblastic tumor (during pregnancy)

Question 19

what is LH/FSH assay used to evaluate

Answer 19

infertility, menopause, gonadal failure

Question 24

interfering factors in LH/FSH assay

Answer 24

drugs that increase: cimetidine, digitalis, levodopa, clomiphene

drugs that decrease: estrogen, progesterone, testosterone, steroids

Question 24

clinical sig of increased LH/FSH

Answer 24

gonadal failure precocious puberty pituitary adenoma PCOS

Question 24

clinical sig of decreased LH/FSH

Answer 24

pituitary failure hypothalamic failure stress anorexia nervosa, malnutrition

Question 25

what is semen evaluation used to evaluate

Answer 25

quality of sperm, infertile couple, to document the adequacy of operative vasectomy performed 2-3 days of sexual abstinence

Question 26

sperm count

Answer 26

50-200 millin/ml

Question 27

anti spermatozoal antibody

Answer 27

in an infertility screening to detect the presence of sperm antibodies

Question 28

IgA anti-sperm antibodies

Answer 28

decrease sperm mobility

Question 29

igG anti-sperm antibodies

Answer 29

decrease their ability to penetrate the ovum

Question 30

when are antispermatozoal antibodies present in men

Answer 30

positive in men with blocked efferent ducts of testes and in 30-70% of them who have had a vasectomy

Question 31

postcoital test (sims-huhner test)

Answer 31

from cervical mucus measures the ability of sperm to penetrate the mucus and maintain motitlity

Question 32

when is the postcoital test (sims-huhner test) performed

Answer 32

done midcycle when estradiol levels are highest a specimen of endocervical mucus is obtained between 2-8 hours after intercourse

Question 33

normal postcoital test (sims-huhner test) findings

Answer 33

mucus is clear stretchable for more than 4cm (spinnbarkeit) exhibits a ferning pattern contains more than 5 motile spem

Question 34

abnormal postcoital test (sims-huhner test) findings

Answer 34

increased viscosity absence of sperm more than 3 WBC suggest antisperm antibodies and cervicitis or prostatitis