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BMSC > IVF treatment > Flashcards

IVF treatment Flashcards

1
Q

What drug is used first line for ovulation induction in women with PCOS?

A

Clomiphene Citrate

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2
Q

What is the ideal amount of eggs you want to get at collection?

A

8 - 15

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3
Q

What would be the first line test to confirm ovulation?

A

Mid luteal progesterone

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4
Q

What would be the first line test to assess tubal patency?

A

HSG

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5
Q

Describe the classifications of sperm motility?

A

Grade A: Progressively motile
Grade B: Slow/Sluggish but progressive motility
Grade C: Minimal progression
Grade D: No motility

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6
Q

Aspermia?

A

No ejaculate

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7
Q

Azoospermia?

A

No sperm in ejaculate

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8
Q

Hypospermia?

A

Low semen volume

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9
Q

Oligozoospermia?

A

Low sperm count

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10
Q

Asthenozoospermia?

A

Poor motility

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11
Q

Teratozoospermia?

A

Abnormal morphology

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12
Q

Necrozoospermia?

A

Dead sperm

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13
Q

Globozoospermia?

A

Round head, no axonne

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14
Q

Oligoteratoasthenoozoospermia?

A

Low count, poor motility, poor morphology

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15
Q

What are the current WHO semen analysis limits?

A

Volume: 1.5ml
Concentration: 15 million/ml
Progressive motility: 32%
Normal forms: 4%

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16
Q

What is the normal range of testicle size?

A

12 - 30 ml

17
Q

What are the testis like in klinfelters syndrome?

A

Small and firm

18
Q

What condition has the genetic profile 47 XXY?

A

Klienfelters

19
Q

What value of mid luteal progesterone is considered normal?

A

Over 25mnol/L

20
Q

How many peptides does endogenous GnRH contain? How long is its half life?

A
  1. Half life is a few minutes
21
Q

Is the half life of exogenous GnRh longer or shorter that endogenous?

A

Longer

22
Q

Describe the flare protocol

A
  • GnRH agonist started on day 1 of the cycle. This causes flare of exogenous gonadotrophins.
  • Exogenous gonadotrophins started on day 2
  • Agonist continued until day of HCG
23
Q

Who is given the flare protocol in general?

A

Women with poor ovarian reserve

24
Q

What happens when you give someone a GnRH agonist?

A

Initial hypersecretion of LH and FSH. This is followed, after around 10 days, by desensitisation of the pituitary and profound suppression of LH and FSH. This results in inhibition of sterioidogenesis and follicular growth.

25
Q

Describe the long protocol

A
  • GnRH agonists are given either on day 21 or day 1 by depot injection, daily SC or daily nasal spray.
  • Suppression generally achieved between 14 - 21 days and this is confirmed by the presence of a withdrawal bleed.
26
Q

Discuss the normal and abnormal values for antral follicle count

A

Less than/Equal to 4 = Likely to be a low response to stimulation
Greater than/Equal to 16 = Likely to have a high response

27
Q

Discuss the normal and abnormal values for AMH

A

Less than/Equal to 5.4pmol/l = Low response

Greater than/Equal to 25 = High response

28
Q

Discuss the normal and abnormal values for FSH

A

Greater that 8.9IU/l = Low response

Less than 4IU/l = High response

29
Q

What three measurements are used to assess ovarian reserve?

A

AFC
AMH
FSH

30
Q

What test is done to confirm ovulation?

A

Mid luteal progesterone

31
Q

Below what viral load is the risk of HIV transmission thought to be negligable?

A

Less than 50 copies/ml for more than 6 months

32
Q

What treatment can be offered to an HIV positive male to reduce chances of transmission during fertility treatment?

A

Sperm washing

33
Q

If a women has to have a rubella vaccine how long should she wait before attempting to conceive?

A

1 month

34
Q

Above what thickness should the endometrium be for there to be a chance of implantation?

A

5mm

35
Q

Why is the luteal phase deficient in ART cycles?

A

LH levels are lowered by the high steroid levels (produced by multiple corpus lutea)
This causes a negative feedback on the pituitary gland that lowers the LH levels. This causes the length of the luteal phase to be shortened and the chances of a pregnancy are reduced

36
Q

How is luteal phase support given?

A
  • Progesterone given either IM, oral, vaginal or rectal
    -hCG given IM or SC
    GnRH agonists given nasally, I or SC
37
Q

What is the current recommended practice for luteal phase support?

A

Progesterone for 8 weeks

BMSC (17 decks)

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