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Flashcards in investigation and treatment of infertility Deck (31)
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1

for the best chance of making a baby when should sexual intercourse occur

frequently or appropriately timed. in stressed couples frequent sex is better less forced

2

what three things do you need to make a baby

sperm egg and a pathway

3

what are the six physiological events required for conception

spermatogenesis, ovulation, intercourse, ejaculation, fertilistation, implantation

4

define infertility by nice guidelines

a woman of reproductive age who has not conceived after one year of unprotected sexual intercourse

5

considering a holistic approach what do healthcare professional have to bear in mind aiding couples with infertility

that not being successful in having children is causing psychological distress to couples

6

what is the most significant factor in ability to have a child assuming sperm is fine

woman age for normal birth or ivf live birth

7

what causes sub fertility

male factor, anovulation, tubal factor, unexplained ( not dectactable)

8

how does smoke and alcohol effect fertility

alcohol effects sperm quality and smoking reduces sperm quality and woman fertility

9

how does a bmi of 26 affect pregnancy

greater than 25 so reduced fertility in men and women

10

when you take history of couple together what should you aim to find out (investigating infertility)

how long they are together, how long they been trying to conceive, smoking and alcohol, coital frequency(means how often you kweng)

11

what do you find out specifically from a female when investigating infertility

occupation, sti ectopic pregnancy or surgery, period cycles, drugs, endometriosis??

12

what do you find out specifically from a male when investigating infertility

occupation • testicular maldescent • trauma • infections – STI – mumps orchitis • surgery • drugs – therapeutic – recreational

13

what are the basic investigations for infertility

ovulation, ovarian reserve, tubal patency and pelvic anatomy, semen fluid analysis

14

how do you assess ovulation

ask about periods if they are regular then over 95% of women will have fine ovulation. also assess midluteal progesterone, urinary lh too

15

what do you look for in semen analysis

concentration, motility, morphology

16

what should the volume of semen be

1.5ml

17

what proportion of sperm should be progressively motile

more than 40 per cent

18

how do you assess tubal patency and pelvic anatomy 3 ways

laparoscopy and dye(GOLD STANDARD), hysterosalpingogram HSG, hysteron contrast sonogram (hycosy)

19

what happens to ovarian reserve as woman ages

decline

20

how can you tests ovarian reserve

early follicular fsh, antral follicle count afc, amh, not

21

An elevated early follicular FSH level can suggest what in woman

depleted ovarian follicular pool

22

what is a drawback of AFC

looks at an image for follicles so inter observer variability, not good for pregnancy prediction

23

list some of the other investigation you would do into infertility aside from the main basic ones

Day 2-4 hormone profile – FSH, LH, prolactin, TSH, testosterone • Rubella • cervical smear • Chlamydia swabs • Viral serology (Hep B, Hep C, HIV)

24

Infertility clinics often have long waiting lists, when can you get early refferal

• female age 35 years or above
• Low ovarian reserve
• amenorrhoea / oligomenorrhoea
• suspected tubal factor
• suspected male factor

25

What can cause tubal damage

sti, ectopic pregnancy, endometriosis, surgery

26

how is anovulation classified

three groups, group one hypothalamus pituitary failure, group two hypothalamic pituitary ovarian dysfunction, ovarian failiure

27

what is a gonadotroph

hormone that acts on gonads

28

what causes male subfertility

sti, trauma , drugs,

29

what are the two processes called in which sperm can be stored

percutaneous epididymal sperm aspiration, testicular sperm extraction

30

what is HFEA and why are they needed

HUMAN FERTILISATION AND EMBRYOLOGY AUTHORITY (HFEA).
• The regulation of infertility treatment in the UK is undertaken by the HFEA, which was established following the Human Fertilisation and Embryology Act 1990.

Reflects public and professional concern about the implications assisted reproduction on human life and family relationships