Ovulatory dysfunction and infertility Flashcards Preview

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Flashcards in Ovulatory dysfunction and infertility Deck (17):
1

hormonal features of hyothalamic-pituitary failure

 

examples

hyopgonadotropism

low or normal FSH

low estradiol

 

Kallman syndrome, Anorexia, Stress or weight related

2

progestin chellenge test

if estrogen status unclear

medroxyprogesterone acette admin daily for 7-14d

normal should have withdrawal bleeding after

2

like ___ and ___ Climiphene citrate is a SERM and thus can act as ___-

likeDiethylstilbestrol and Tamoxifen,

act as estrogen agonist and antagonist

3

confirm dx of intrauterine adhesions or synechiae

hysterosalpingogram

hysteroscopy

4

hormonal features of ovarian failure

 

examples

hypergonadotropism

high FSH

low estradiol

 

premature ovarian failure, premenopause

5

aromatase inhibtors for ovulation induction

 

specific mechanism

Letrozole

inhibition of E2 production, negative feedback  causes increase in FSH levels

7

GnRH antagonists

 

specific mechanism

Ganirelix and cetroelix

 

prevent LH surge during controlled ovarian hyperstimulation 

8

indications Clomiphene citrate

induce ovulation in infertilty

stiumulation of mutlifollicualr ovulation or enhancing ovulation in ovulatory infertile women

9

gonadotropins indicated for

hypothalamic amenorrhea

anovulatory paatients who do no respond to Clomiphene citrate or aromatase inhibitors

Patients udnergoing hormonal stimulation for in vitro

10

infertility presentating with High FSH - screening protocol and results

confrim FSH one month later, on day three if possible

=Premature ovarian failure

(if

11

dx criteria for PCOS

oligoovulation or anovulation

clinical or biochemical signs of hyperandrogenism

polycystic ovaries in each ovary (2 to mm, and/or ovarian vol

12

hormonal features of secondary HPO dysfunction

 

exaamples

variable, lownormal FSH and estradiol

 

hyperproalctinemia

thyroid disease

congenital adrenal hyperplasia

tumors

12

chromosomal causes 

45X

47XXY

variable mosaicism

Fragile X (FRMR1 triplet repeat within exon 1)

14

serum progesterone levels of ___ indicate presence of ovulation

> 3ng/ml

15

sufficient for Dx of SOI

FSH levels >40 on two ocassions in woman

16

hormonal features of hyopthalamic pituitary dysfunction (not failure)

Normogonadotropism

normal FSH

normal estradiol

with or without Hyperandrogenism

 

PCOS, stress or weight related, iodpathic

17

if presenting infertility with low or normal FSH, testing procedure and results

Acess estrogenization with progestin challenge

 

if progestin withdrawal bleed= hypothalamic amenorrhea