Flashcards in Session 7 - Group Work Deck (24)
Suggest what proportion of young couples have regular unprotected sex might be
expected to conceive within a year?
In Western European populations, what proportion of primary infertility is due to
problems with the male partner?
List the possible points in the female reproductive system where problems may lead to
infertility. Write beside each the approximate proportions of women in which each type
of problem is identified as the cause
Failure to ovulate 28%
Fallopian tube problems 22%
Uterine problems 11%
Cervical problems 3%
What is the normal range of volume in a single ejaculate?
What is the normal range of sperm count (millions/ml)?
What other factors are assessed in semen analysis?
motility and morphology
He says he has no problems with sexual performance, but on occasions men suffer
erectile dysfunction. From your knowledge of the structure and function of the male
system what are the likeliest causes of erectile dysfunction in young men?
Endocrine (e.g., diabetes)
What is the physiological basis of drugs designed to improve erectile function?
Increase penile blood flow
What is the normal range of length of menstrual cycle?
f you know the date that a menstrual bleed began, how would you most accurately
calculate when the previous ovulation had occurred?
14 days before. Life of corpus luteum
Which hormone provides evidence that ovulation has occurred? When, relative to the
onset of a menstrual bleed should you measure it, and in what body fluid?
Day 21 (at peak of progesterone curve) in blood
Why is it useful to keep a daily record of body temperature on rising in the morning?
Why does the temperature have to be taken at the same time each day?
Progesterone elevates basal temperature
Circadian rhythm of body temperature will confuse results if not same time of
What is the difference between primary and secondary amenorrhoea?
Primary – never had periods
Secondary – cessation of periods after they have begun (after a 3 month
cessations of menses)
What are the two commonest causes of secondary amenorrhoea and what hormone
tests will you use to distinguish them?
Pregnancy – Human chorionic gonadotrophin
Fall in body weight – Gonadotrophin levels
Hyperprolactinaemia may lead to infertility. What clinical sign may indicate a diagnosis
Production of small quantities of milk
Look back a session or two, what drug could be used to treat hyperprolactinaemia. How
does it work?
Dopamine agonist – mimics effects of prolactin inhibitory hormone
How, in principle, might you test whether uterine tubes are patent
Passage of radio-opaque dye from uterine cavity, hysterosalpingography
What particular feature in a patient’s history might lead you to suspect that the uterine
tubes could be blocked?
Previous pelvic infection
What properties of cervical mucus facilitate sperm survival and transport?
Alkalinity, lowered viscosity
How might you establish whether cervical sperm transport is disturbed?
Post coital test – collect cervical mucus soon after copulation
How in principle would you set about inducing ovulation in a woman whose cycles are
anovulatory? Suggest which types of drugs or hormones might be used and why.
Use an anti-oestrogen to reduce inhibition of FSH & LH e.g., clomiphene given for a few days
prior to expected time of ovulation
In polycystic ovarian syndrome (PCOS), exposure of follicles to androgens may lead to
inhibition of FSH, but not LH secretion. From what you know of the control of
gonadotrophin secretion, by what mechanism might FSH secretion be inhibited
selectively? Why might there be no LH surges in this condition?
Follicles may still secrete inhibin which selectively inhibits FSH, thus reducing FSH in respect to
LH (hence, ratio changed)
Androgens may suppress LH surges (consider the role of testosterone in the male which inhibits
LH release from the pituitary).
What features of excess androgens may be present?
hirsutism (which can be blocked by anti-androgen therapy)
oily skin / acne