13 - Infertility Flashcards
What is the definition of subfertility?
Failure of conception in a couple having regular (once every 2-3 days) unprotected coitus for one year
Primary: never concieved
Secondary: have concieved in the past, even if abortion or ectopic, and struggling to concieve again
![](https://s3.amazonaws.com/brainscape-prod/system/cm/292/491/964/a_image_thumb.png?1572989080)
If couples try to concieve for three years, what is the likelihood they will get pregnant in the next year?
25%
What are some causes of subfertility in men?
- Pretesticular: HPG axis
- Testicular: sperm production or storage, e.g STIs, torsion
- Post testicular: e.g obstructive or erectile dysfunction
25% of cases reason for subfertility unknown
![](https://s3.amazonaws.com/brainscape-prod/system/cm/292/492/287/a_image_thumb.jpeg?1572989272)
What are the main causes of subfertility in both men and women?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/292/492/425/a_image_thumb.jpeg?1572989331)
What are the three classes of subfertility causes in women?
- Tubular damage
- Uterine/peritoneal disorders
- Ovulatory disorders
![](https://s3.amazonaws.com/brainscape-prod/system/cm/292/492/585/a_image_thumb.png?1572989403)
What are some ovulatory disorders causing subfertility?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/292/492/642/a_image_thumb.jpeg?1572989560)
What are some uterine and peritoneal disorders that lead to subfertility in women?
- Fibroids
- Scarring or adhesions: PID, Asherman, endometriosis, abdominal surgery
- Abnormal uterus from issues with mullerian duct
![](https://s3.amazonaws.com/brainscape-prod/system/cm/292/492/966/a_image_thumb.png?1572989678)
What are some mullerian duct development anomolies?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/292/493/165/a_image_thumb.jpeg?1572989723)
What are some conditions that can cause tubal damage and lead to subfertility?
- Endometriosis
- Pelvic surrgery leading to damage
- Infection like chlamydia
- Ectopic pregnancy
![](https://s3.amazonaws.com/brainscape-prod/system/cm/292/493/215/a_image_thumb.jpeg?1572989795)
What are some important investigations to do when investigating subfertility in both men and women?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/292/493/275/a_image_thumb.jpeg?1572989991)
What are some physical examinations you may do to investigate subfertility?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/292/493/495/a_image_thumb.jpeg?1572990048)
What are some questions may you ask in a history to investigate subfertility?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/292/493/765/a_image_thumb.jpeg?1572990090)
What is a hysterosalpinogram?
Can check patency of tubes by injecting dye into cervix, x-ray and see if dye spills into peritoneum
![](https://s3.amazonaws.com/brainscape-prod/system/cm/292/493/932/a_image_thumb.png?1572990132)
What is some advice a GP can give to a couple who are having fertility issues, without referral?
REASSURE AND MOST WILL CONCIEVE IN A YEAR
![](https://s3.amazonaws.com/brainscape-prod/system/cm/292/494/039/a_image_thumb.jpeg?1572990235)
When should you refer a couple to fertility clinic?
- After 1 year of trying to concieve
- Sooner is woman is older (over 36) or known risk factors for infertility
Everyone entilited to investigations but not all to treatment
![](https://s3.amazonaws.com/brainscape-prod/system/cm/292/494/100/a_image_thumb.png?1572990323)