Reproductive Disorders

Question 1

What is the definition of infertility?

Answer 1

No pregnancy after 12 months of unprotected sex in a couple with no children

Question 2

What is primary and secondary infertility?

Answer 2

Primary = no pregnancy
Secondary = pregnant but ectopic/miscarriage

Question 3

Name 5 risk factors for infertility?

Answer 3

Older age
Chlamydia
Obesity
Caffeine
Drugs

Question 4

What is anovulatory disease?

Answer 4

No ovulations

Question 5

Name 5 causes of an anovulation disorder .

Answer 5

Anorexia
Tumours
Hyperprolactinemia
Ovulation disorder
Endometriosis

Question 6

What are group 1 ovulation disorders caused by + name 3 causes?

Answer 6

H-P axis failure
No GnRH/LH or FSH
Hypogonadotrophic hypogonadism 
Kallman's syndrome
Anorexia

Question 7

Treatment for group 1 ovulation disorders?

Answer 7

Pulsatile GnRH

Question 8

What are group 2 ovulation disorders caused by + an example?

Answer 8

H-P-O axis failure

PCOS

Question 9

What is the definition of PCOS?

Answer 9

12 or more 2-9 mm follicles and increased ovarian volume

Question 10

What is the diagnostic criteria for PCOS?

Answer 10

2 out of:
Chronic anolvulation
Polycystic ovaires
Hyperandrogenism

Question 11

Treatment for group 2 ovulation disorders?

Answer 11

Clomifene citrate

FSH/LH injections

Question 12

What is the profile of PCOS in terms of LH/FSH and BG?

Answer 12

High LH/FSH

High BG

Question 13

What is the cause of group 3 ovulation disorders + 2 examples?

Answer 13

High gonadotrophin causing low oestrogen
Ovarian failure
Hypergonoadotrophic hypogonadism

Question 14

What 3 conditions are associated with ovarian failure?

Answer 14

Turner’s syndrome
XX gonadal agenesis
Fragile X syndrome

Question 15

What is the diagnostic criteria for ovarian failure?

Answer 15

3x FSH > 30

Low oestrogen

Question 16

Treatment for ovarian failure?

Answer 16

HRT

OCT

Question 17

What is the definition of oligomenorrhea?

Answer 17

Less than 9 periods/year

Question 18

What is the definition of primary and secondary amenorrhea?

Answer 18

Primary = no periods before 16
Secondary = cessation of periods > 6 months

Question 19

What is the main cause of primary amenorrhea + name two examples.

Answer 19

Congenital disease
Turner’s syndrome
Kallman’s syndrome

Question 20

What is Turner’s syndrome + inheritance + karyotype + does it affects men/women more?

Answer 20

Missing X chromosome
Sporadic mutation
45 X
Only women affected

Question 21

What is Kallman’s syndrome and example of + inheritance + mutation + does it affect men/women more?

Answer 21

idiopathic hypogonadotrophic hypogonadism
X-linked recessive
ANOS1
Men

Question 22

High prolactin or hypopituitarism can both cause amenorrhea. True or False?

Answer 22

True

Question 23

Triad of amenorrhea and oestrogen deficiency?

Answer 23

Flushing
Decreased libido
Painful sex

Question 24

Name 5 tests for ovulatory disorders.

Answer 24

LH/FSH/oestrogen
TFT
PFT
Prolactin
Ovarian US

Question 25

Where is the origin of the problem in primary (hypergonadotrophic) vs. secondary (hypogonadotrophic) hypogonadism in females + males?

Answer 25

``` Primary = ovaries or testes Secondary = hypothalamus/pituitary ```

Question 26

How does ovarian failure work?

Answer 26

Ovarian dysfunction Low oestrogen High gonadotrophins

Question 27

What is the key symptoms of Kallman's syndrome?

Answer 27

Inability to smell

Question 28

What is the identified defect in idiopathic hypogonadotrophic hypogonadism?

Answer 28

Mutation of GnRH receptor

Question 29

What is kisspeptin and what does it do?

Answer 29

GPCR ligand | Controls release of GnRH

Question 30

What is the profile of primary and secondary hypogonadism in males in terms of LH/FSH and testosterone?

Answer 30

``` Primary = high FSH/LH, low testosterone Secondary = low FSH/LH, low testosterone ```

Question 31

What is the profile of primary and secondary hypogonadism in females in terms of LH/FSH and oestrogen?

Answer 31

``` Primary = high FSH/LH, low oestrogen Secondary = low FSH/LH, low oestrogen ```

Question 32

What are the main congenital causes of primary hypogonadism in males + females?

Answer 32

``` Males = Klinefelter's syndrome Females = Turner's or Kallman's syndrome ```

Question 33

What is Klinefelter's + inheritance + karyotype + does it affect men/women more?

Answer 33

Extra X chromosome Sporadic mutation 47 XXY Only men affected

Question 34

What is the main cause of female + male infertility?

Answer 34

``` Female = ovarian failure Male = varicocele ```

Question 35

What is hydrosalpinx?

Answer 35

Blockage casing fluid overload in fallopian tube

Question 36

What is endometriosis + key US sign?

Answer 36

Endometrium growing outside uterus | Chocolate cysts

Question 37

What is varicocele?

Answer 37

Testicular varicose veins

Question 38

Name 2 infections which can cause female infertility?

Answer 38

Chlamydia | Rubella