Flashcards in L74 Deck (21)
Def of infertility
1 year with unprotected intercourse
Normal: talk through the hormonal axis to getting a dominant follicle
1. GnRH from hypothalamus -> ant pit released FH
2. FH acts at ovary to move multiple follicles into development
3. Surge in E form these = -FB onto ant pit = ↓FSH
4. Dominant follicle chosen = E spike = +FB = ↑LH to stimulate OVULATION
Normal: describe the hormones involved after ovulation
CL makes P = -FB on ant pit + hypothalamus
No pregnancy = progresterone drops = period
Hormones you want to check if a woman is ovulation
Day 3 FSH - elevated concerned for early menopause
Day 21 progesterone- ovulate around day 14, should be elevated at 21
Prolactin - ↑ed means you won't ovulate
How does body temp predict fertility
Progesterone ↑body temp
You can have sex during this period aka you've already ovulated
What is the fertility window?
3-5 days before ovulation - sperm can remain in repro tract
24 hrs after ovulation
Meds to make a woman ovulate
Menopausal gonadotropin - make you think you're menopausal = overproduced FSH
Mechanism of clomiphene citrate
Lose the -FB to hypothalamus from the ↑P from dominant follicle
↑FSH to overstim ovaries
What is a hysterosalpingogram? Who do you do it for?
Check uterus and tubes for scarring
+ Contrast, take XR
Do it after menstruation before ovulation (not to disrupt an existing pregnancy)
What is a sonohytserogram? What is the main cons?
US after injecting saline into the tubes
Good for tubes, bad for uterus eval
What does PID put you at risk for?
How would you use laperoscopy to eval patency of tubes?
Retrograde fill tubes with dye
Should spill into abdomen if patent
What is a hysteroscopy?
Camera in through cervix
Doesn't help you eval the tubes
Treat tubal cause of infertility if both tubes effected
Take eggs out - fertilize out of body - implant into uterus
Why is there a delay in male fertility?
Takes 3 months to produce viable sperm
Overturn sperm every 3 months anyways
Describe the -FB in male fertility
1. Hypothalamus - GnRH
2. Anti pit - LH + FSH
3. Make sperm via leydig (LH) and sertoli cells (FSH)
4. Testosterone shuts off the hypothalamus one the sperm are make
What is the male workup for fertility?
Sperm analysis - count, motility, morphology
Where does fertilization happen?
In the tubes - why most common site of ectopic
Treat male infertility
↑# via multiple ejaculation + cryopreseration
Steroids if Abs vs sperm
Surg if obstruction
+Hormones if defiicient
How test cervical mucus problem?
After sex - see how long takes sperm to get through