Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MRCOG Subfertility > Sub-fertility > Flashcards

Sub-fertility Flashcards

1
Q

How common is sub fertility?

A

14% 1 in 7 couples

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When does ovulation occur?

A

12-16 days before start of next period

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What % of couple will concieve following 1 year & 2 year of regular unprotected intercourse?

A

1 year 84%
2 year 92%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

When should someone be referred if not conceived with IUI?

A

After 6 cycles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Whe should someone be referred following regular unprotected sexual intercourse?

A

1 year of sexual intercourse or earlier if
>36 years or
known clinical cause of sub fertility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What % subfertilty caused by male and female factors?

A

Male 20-30%
Female 20-35%
Combine 25-40%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What % of sub fertility is no cause found?

A

10-20%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the most common cause of female infertility?

A

Ovulation dysfunction
21% of female infertility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How long to sperm survive in female reproductive tract?

A

7 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What frequency of sexual intercourse optimises chance of becoming pregnant?

A

Sexual intercourse every 2-3 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

When trying to become pregnant how much alcohol can the woman/man have?

A

Woman - 1-2 units, 1-2 times per week
Man 3-4 units/day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

A BMI of what cut off for men and women is associated with taking longer to conceive?

A

BMI 30

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How can ovarian response to predicted gonadotrophin stimulation in IVF?

A
  1. Total astral follicle count on TVUS, Day 3 cycle
    - <4 low responded
    - >16 high responder
  2. AMH
    - <5.4 low responder
    - >25 high responder
  3. FSH
    - >8.9 low response
    - < 4 high response
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Regular menus up to how many days are normally indicative of ovulation?

A

26-36 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What blood test confirms ovulation?

A

Progesterone, 7 days before end of cycle.
Day 21 if 28 day cycle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

WHO classification of ovulation disorders. What is group 1? What would be seen on blood?

A

Hypogonadotrophic hypogonadism

  • Low LH/FSH
  • Normal prolactin
  • Low oestrogen

10% ovulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

WHO classification of ovulation disorders. What is group 2? What would be seen on blood?

A

Hypothalamic pituitary dysfunction

1) LH/FSH abnormality
2) Normal oestrogen

85% ovulation disorders
PCOS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

WHO classification of ovulation disorders. What is group 3? What would be seen on blood?

A

Ovarian failure

  1. High gonadotrophins
  2. Hypogonadism, low oestrogen

4-5% ovulation disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What % of sub fertility is caused by tubal factors?

A

14%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What % of tubal obstruction detected at HSG will be confirmed at laparoscopy?

A

38%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What % of tubal patency detected at HSG will be confirmed at laparoscopy?

A

94%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Who should HSG not be offered to?

A

PID
Previous ectopic
Endometriosis

Need more reliable test - HyCoSy or Lap & Dye

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What imaging and what infection screening should be performed when Ix sub fertility?

A

USS pelvis
Viral status (HIV, Hep B, Hep C, Rubella)
Chlamydia

24
Q

For what infections can sperm washing be offered?

A

Hep C and HIV

25
Q

When should sperm washing happen for HIV+ve male?

A

Not compliant with HAART
Plasma viral load >50
Confection with other infection

26
Q

What prophylaxis if given to women undergoing HSG

A

Doxycycline ot azithromycin

27
Q

In unexplained sub fertility, what is chance of spont pregnancy with each menstrual cycle?

A

2-4%
15% in 1 year, 35% 2 years

28
Q

Unexplained fertility, most important predictor of successful conception>

A

Age of woman

29
Q

1st line treatment for unexplained sub fertility?

A

Expectant management for 2 years

30
Q

When to offer IVF in unexplained sub fertility

A

After 2 years

31
Q

When to offer IUI as alternative to vaginal sexual intercourse?

A

Difficulty sexual intercourse - physical/psychosexual
Sperm washing
Same sex

32
Q

If no pregnancy following 6 IUI what should happen?

A

Assess ovulation, tubal patency, semen analysis

If normal offer further 6 IUI

33
Q

Low sperm count is found to be the cause of what % of sub fertility?

A

20%
Contributory in further 25%

34
Q

What % of WHO criteria for sperm quartity will be a false +ve, following 1 & 2 test?

A

1 test 10% false +ve
2 test 2% false +ve

35
Q

How long should a repeat sperm count be sent?

A

3 months

36
Q

If azoospermia or severe oligozoospermia, when should the repeat sperm count be sent?

A

2-4 weeks

37
Q

What % of men with poor sperm quality if no cause found?

A

30-50%

38
Q

What is the normal values on sperm count:
Semen volume

A

> 1.5ml

39
Q

What is the normal values on sperm count:
pH

A

> 7.2

40
Q

What is the normal values on sperm count:
Spem concentration

A

> 15 million per ml

41
Q

What is the normal values on sperm count:
Total number of sperm

A

> 39 million per ejaculate

42
Q

What is the normal values on sperm count:
Total motility (progressive & non progressive)

A

> 40 motile
32 progressive motility

43
Q

What is the normal values on sperm count:
Vitality

A

> 58%

44
Q

What is the normal values on sperm count:
Sperm morphology

A

> 4%

45
Q

List causes of hypothalamic hypogonadism causes of male subfertiliy

A

Congenital - Kallman
Acquire - pituitary lesion, hyperprolactinoma, anabolic steroids

46
Q

Causes of non obstructive azoospermia (testicular), what is seen on Ix

A

Reduction in testicular size and elevated FSH
Most common cause of male infertility

Cryptorchidism
Torsion
Trauma
Orchitis
Chromosome disorders (Klinefelter’s syndrome, Y-chromosome microdeletions)
Systemic disease
Radiotherapy or chemotherapy
Idiopathic (66%)

→ offer cryopreservation

47
Q

List causes of obstructive azoospermia, what seen on tests?

A

Normal testes size, normal FSH

  • Congenital absence vans deference (CF)
  • Varicocele

→ also consider anejacualtion or retrograde ejaculation

48
Q

How does myotonic dystrophy effect male fertility?

A

Testicular atrophy, primary hypogonadism
- Oligo/azospermia
- Impaired secondary sexual characteristics
- Low testosterone, high FSH/LD

49
Q

What is the medical treatment of male hypogonasotrophic hypogonadism?

A

FSH and hCG to stimulate spermatogenesis

50
Q

What is the medical treatment of male anejacualtion?

A

Alpha-agonistic drugs
Parasympathetic drugs

51
Q

What can be offered to men with obstructive azoospermia?

A

Surgical correction of obstruction
IVF/ICSI

52
Q

Does surgical treatment of varicocele improve pregnancy rates?

A

No, do not offer

53
Q

Which men are offered IVF/ICSI?

A

Azoospermia, oligosperma, unexplained infertility

54
Q

Chances of successful prengnay with each cycle IVF?

A

15-20%

55
Q
A

MRCOG Subfertility (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions