Reproductive - Subfertility & Assisted Conception Flashcards Preview

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Flashcards in Reproductive - Subfertility & Assisted Conception Deck (66)
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1

What is the most common cause of subfertility?

Male factor subfertility

2

What are the three groups of female factors causing subfertility?

Anovulation, tubal disease, uterine/peritoneal disease

3

What are some examples of commonly used 'drugs' which can cause semen abnormalities?

Alcohol and nicotine

4

When should subfertility be investigated?

When couples have not conceived after one year of regular unprotected sex

5

In a couple with subfertility, investigations are carried out in the female to establish what two things?

Is she ovulating, and are the Fallopian tubes patent

6

In a couple with subfertility, investigations are carried out in the male to establish what?

That the semen is of sufficient quality

7

A mid-luteal phase progesterone concentration of greater than what confirms that a woman is ovulating?

30nmol/L

8

When should a progesterone measurement be taken in order to confirm that a woman is ovulating?

7 days before the next expected period

9

Measurements of gonadotrophins and sex hormones should be taken at what stage in the menstrual cycle when investigating subfertility in a female?

Days 2-5

10

In addition to gonadotrophins and sex hormones, what other hormones should be measured when investigating both males and females for subfertility?

TFTs and prolactin

11

High testosterone and a high LH: FSH ratio in a woman with subfertility suggests what underlying diagnosis?

PCOS

12

High FSH and low anti-Mullerian hormone in a woman with subfertility suggests what problem?

Low ovarian reserve

13

When investigating for subfertility, what infection should a woman's immunity status be checked for, and she should be vaccinated against if not immune?

Rubella

14

What infection should always be tested for when investigating both males and females for subfertility?

Chlamydia

15

What imaging investigation is used to diagnose abnormalities of the ovaries and uterus in women with subfertility?

Transvaginal US

16

When investigating a woman for subfertility, if uterine abnormalities are suspected or found on ultrasound imaging, what investigation should be done next?

Hysteroscopy

17

How should tubal patency be confirmed in low risk women (i.e. those with no history of pelvic infection/disease or abdominal surgery)?

Hysterosalpingography (HSG)

18

What side effect do many women experience after an HSG investigation?

Period like cramps

19

How should tubal patency be confirmed in high risk women (i.e. those with a history of pelvic infection/disease or abdominal surgery)?

Laparoscopy and dye

20

What investigation is the gold standard test for confirming tubal patency in women with subfertility?

Laparoscopy and dye

21

How long should a male abstain from ejaculation from before providing a semen sample?

3-4 days

22

If there is a reduction in any variable tested in a semen sample, what is the next step?

Repeat the sample in 3 months time

23

Couples with subfertility are advised to have sex how often?

2-3 times per weeks throughout the menstrual cycle

24

What are some lifestyle measures that are advised in both men and women with subfertility?

Stop smoking, cut back alcohol, lose/gain weight as appropriate

25

All women aiming to get pregnant should take which supplement?

Folic acid

26

What is the treatment for subfertility if semen analysis is normal, tubal patency has been confirmed and the female partner has a BMI < 30?

Ovulation induction

27

If a patient is amenorrhoeic, what should be done before starting ovulation induction?

Progesterone challenge test

28

What is the first line ovulation induction agent?

Clomifene citrate

29

When in the menstrual cycle is clomifene citrate given?

Days 2-6

30

What type of drug is clomifene citrate?

Anti-oestrogen