12 Contraception and Infertility Flashcards
What are the 6 categories which we can divide contraception into?
- Natural
- Hormonal
- Barrier
- Prevention of implantation
- Sterilisation
- Emergency contraception
Explain how the lactational amenorrhea method works as contraception.
Breast feeding delays return of ovulation
Suckling stimulus- effect of prolactin
Only effective up to 6 months
Must be exclusively breast feeding
Must be amenorrhoeic
How effective are barrier methods (if used correctly) of contraception?
Male/Female condoms/ Diaphragm/ Caps (+ spermicide)
98%
Also protect against STIs
Differentiate between the effects of progesterone given at high and low doses.
- Moderate/High
- Progesterone enhances negative feedback of natural oestrogen
- No LH surge, no ovulation
- Lower
- Thicken cervical mucus
- Ovulation still likely
How does the combined oral contraceptive pill work? (98% effective if used correctly)
- Primary
- PREVENTS OVULATION
- Secondary
- Reduce endometrial receptivity to inhibit implanatation
- Thicken cervial mucous
What does the COCP increase your risk of? What does it decrease your risk of?
Increase risk: breast and cervical cancer, vein thromboembolism, MI/stroke
Decreased risk: ovarian/endometrial cancer
How does the progesterone injection work? What are the advantages and distadvantages?
- Prevents ovulation
- Thickens cervical mucus
- Prevents endometrial proliferation
Why does the progesterone implant not always stop ovulation?
Hormone level can fluctuate- esp towards end of 3 years
Patients who have the progesterone implant will fall into 3 categories broadly on the effects the implant will have on them. What are these categories?
- Amennorhoea
- Bleed all the time
- Irregular periods
What are the advantages and disadvantages of low dose progesterone pill?
Differentiate between 2 types of coils.
(Action, how long it lasts)
What are the advantages and disadvantages of the coil.
Outline the methods of sterilisation in males and females as well as their failure rates.
What are the options for emergency contraception?
Define subfertility.
Failure of conception in a couple having regular, unprotected sex for one year (2-3 times per week)
What is the difference between primary an secondary infertility?
What are the main causes of subfertility? (general)
Male causes of infertility can be categorised as pre-testicular, testicular or post testicular. Give examples of causes in each of these categories:
What investigations would a GP carry out into infertility for a male?
What management and investigations would a GP carry out into infertility for a female?
What is a hysterosalpinogram?
What are the 3 main types of fertility treatment offered?
(Everybody entitled to investigations into infertility on the NHS BUT not necessarily treatment)
Which hormone provides eveidence that ovulation has occured? When should it be measured?
Progesterone: 7 days before 1st period
During which phase of the ovarian cycle does body temperature rise?
Luteal
