Lec 8: Infertility Drugs Flashcards
(29 cards)
Infertility: Inability to conceive after ….. months of ……. intercourse
12
Fecundability
Likelihood of conception per month of exposure
The most prevalent cause of infertility in female is…
Amenorrhea/ovulatory dysfunction due to hypothalamic/pituitary causes (51%) or PCOS (30%)
The most prevalent cause of infertility in men is…
Primary hypogonadism (high FSH) 30% but really 50% is unknown
Female infertility causes (conditions)
PCOS, endometriosis
Therapy for females
Anovulatory: …..
Tubal occlusion: …..
A: ovulation inducers
B: corrective surgery/ IVF
Does mild endometriosis impair fertility?
No, only moderate to severe do.
What can endometriosis impair
Folliculogenesis, fertilization, implantation, adhesion
Treatment of endometriosis depends on ….. and …..
A: severity
B: need to become pregnant
Pain medication for endometriosis?
Ibuprofen, naproxen
NSAIDs
Why and when does endometriosis cause pain?
Thickening and expulsion of ectopic endometrial implants causes pain.
When it is time for menstruation(?)
If endometriosis patient does not want to have a child, taking only ……. will suffice.
Hormonal contraceptives (birth control pills, patches, rings)
Only mild to moderate endometriosis
GnRH agonist and antagonist treat endometriosis by …
You take low doses of …..and …. with this because it helps……
Can you get pregnant again after stopping meds?
Blocks prod. of FSH LH, lowers estrogen, thus prevents menstruation
Take low doses of estrogen and progesterone with it to help prevent symptoms of artificial menopause
Yes!
Medroxyprogesterone (depo-provera)
Long-acting progestin
(Antiestrogenic and androgenic activities)
Halt menstruation and growth of endometrial implants in endometriosis
Treat endometriosis
AE: weight gain, decrease bone prod., depressed
Danazol
Androgen derivatives
Inhibit FSH, LH prod. —> prevent menstruation
Major use: treat endometriosis **
Can cause serious SE to mum and baby thus not first choice
SE: F turns into M, liver enz. increase
Is conservative surgery a sure fire way of treating severe endometriosis?
No, it can come back but the benefit is your reproductive organs are still intact
Symptoms of PCOS
- High insulin levels (resistance)
- excessive male hormones —> secondary male characteristics
- fertility issues
- anxiety/depression
How is PCOS commonly treated?
By symptoms
High fat cell amount but low leptin —> excess feeding and obesity
Antiandrogenic agents for PCOS treatment
Spironolactone - diuretic, block effect of androgen
Low ….. levels in the blood maybe effective in restoring menstruation and reduce PCOS health risks. Also reduces prod of T, thus help diminish symptoms such as acne and alopecia.
What drugs are needed for this?
Levels of insulin
- glitazones (TZD- thiazolpdinediones)
- metformin
Treatment of infertility for patients with hyperprolactinemia (ovulatory dysfunction)
Dopamine agonists such as bromocriptine
Ovulation induction?
Clomiphene citrate
-increae FSH through mod of negative fb
Gonadotropins
Pulsatile GnRH
Gonadotropins are highly effective for patients with ….
Used to induce multiple follicles development in ….. and ….
Risk of hyperstimulation in ….. patients
Hypogonadotropic hypogonadism
Unexplained infertility and older reprod age women
PCOS patients
Currently available gonadotropins…
Urinary prep. of LH and FSH —> HMG
Highly purified FSH + recombinant FSH —> metrodin
