Repro 7.2 Contraception and Infertility Flashcards Preview

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Flashcards in Repro 7.2 Contraception and Infertility Deck (60)
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1

What are the natural forms of contraception?

Abstinence
Coitus interuputus
Rhythm method

2

Why is coitus interruptus not 100% effective?

There is some sperm in pre-ejaculate

3

Why is the rhythm method not 100% effective?

Requires a regular cycle and no woman can be 100% certain when ovulation will occur.

4

In the rhythm method, what assumptions are made?

Sperm 7 days, ova 1 therefore with a regular 28 day cycle ovulation day will be day 14/15 and the fertile period is days 17-16 so sexual intercourse is avoided at these times

5

What are the barrier methods of contraception?

Condoms
Diaphragm
Cap

6

What are the benefits of condoms as a form of contraception?

Readily available
Protect against STI
Effective if used correctly

7

How does a diaphragm work and what are the disadvantages?

Lies diagonally across the cervix
Needs correct fitting
Does not completely occlude sperm passage but holds sperm in acidic vagina and reduces survival time

8

How does the cap work as a method of contraception?

Fits across cervix

9

What is commonly used in conjunction with barrier methods of contraception?

Spermicide

10

What forms of contraception prevent ovulation?

Combined oral contraceptive pill
Depot progesterone (3 monthly injections)
Progesterone only pill (maybe)
Progesterone implant (maybe)

11

How can ovulation be prevented?

Inhibit follicular development and by negative feedback to the hypothalamus and pituitary

12

What forms of contraception inhibit sperm transport?

Female sterilisation
Vasectomy
Progesterone mediated contraception:
Progesterone implant
POP
Depot progesterone
COCP

13

How do progesterone contraceptives inhibit sperm transport?

Affect cervical mucous -> thick, hostile mucus

14

Can female sterilisation be reversed?

Yes - 50% success

15

How is female sterilisation achieved?

Occlude fallopian tubes by clips, rings or ligation

16

How common is recanalisation following a vasectomy?

rare - 1:300/500

17

What is a vasectomy?

Vas deferens are divided bilaterally. Ensure ejaculate is free of sperm before relying on it (usually takes approx 20 ejaculations)

18

What forms of contraception inhibit implantation?

Hormonal (COCP, POP, implant, depot)
Post-coital contraception
IUCD

19

How do hormonal contraceptives inhibit implantation?

Affect receptivity of the endometrium directly
Absence of corpus luteum further prevents preparation of the endometrium for implantation

20

What is in post-coital contraception and how does it work?

High dose of combined oestrogen/progesterone or progesterone only
May disrupt ovulation
Blocks implantation

21

In what time frame is post-coital contraception effective?

Up to 72 hrs after intercourse
(IUCD may also be used post-coital)

22

What is IUCD?

Inert or copper containing or progesterone impregnated (mirena coil)
Copper interferes with endometrial enzymes and may also interfere with sperm transport into fallopian tubes
Interferes with implantation

23

What are the risks of IUCD?

Perforation
Mood swings
Infection (higher risk with copper)

24

Define infertility.

Failure to conceive within 1 year

25

How many couples suffer from infertility?

15%

26

What is the difference between primary and secondary infertility?

Primary - no previous pregnancies
Secondary - previous pregnancies, successful or not

27

What % of infertility is due to problems in the male, female and unexplained?

Male: 20-25%
Female: 45-60%
Unexplained: 20-30%

28

What are the potential causes of infertility?

Coital problems
Anovulation
Tubal occlusion
Abnormal/absent sperm production

29

How common is anovulation and when is it most common?

Cause of 15-20% of fertility problems
Most common at extremes of reproductive life

30

Where can problems cause anovulation?

Problems in the hypothalamus, pituitary or ovary