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Reproductive System > 15) Contraception and Infertility > Flashcards

15) Contraception and Infertility Flashcards

1
Q

What are some examples of natural contraceptive methods?

A

Fertility awareness method, lactational amenorrhoea

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2
Q

How does the fertility awareness method work?

A

Use of fertility indicators to identify fertile points in the cycle e.g. body temp

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3
Q

What are the advantages of natural contraceptive methods?

A

No hormones or contraindications

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4
Q

What are the disadvantages of natural contraceptive methods?

A

Not as effective, unreliable

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5
Q

How does breastfeeding affect ovulation?

A

Delays return of ovulation after childbirth (6 months)

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6
Q

What are some examples of barrier contraception?

A

Male/female condoms, female diaphragm

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7
Q

What are the advantages of barrier contraception?

A

Prevent STIs, inserted anytime before intercourse

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8
Q

What are the disadvantages of barrier contraception?

A

Sensitivity to latex
Female condoms not widely available
Spermicide can cause local reaction

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9
Q

What contraceptive methods work by preventing ovulation?

A

COCP, progesterone depot, progesterone implant

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10
Q

What are the advantages of the COCP?

A

Relieves menstrual disorders and reduces risk of ovarian cysts and cancer

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11
Q

What are the disadvantages of the COCP?

A

User dependent
Side effects (mood and breast tenderness)
Increased of thromboembolism and MI

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12
Q

How is the COCP administered?

A

Taken for 21 days and then a 7 day break

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13
Q

How is the progesterone depot administered?

A

Subcutaneous/IM injection, lasts 8-13 weeks

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14
Q

What are the advantages of the progesterone depot?

A

Convenient, relieves menstrual disorders

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15
Q

What are the disadvantages of the progesterone depot?

A

Altered and irregular bleeding
Delayed return to fertility
Small loss of bone mineral density

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16
Q

How is the progesterone implant administered?

A

Flexible rod below skin in upper arm, 3 years of protection

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17
Q

What are the advantages of the progesterone implant?

A

Long duration, relieves menstrual disorders

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18
Q

What are the disadvantages of the progesterone implant?

A

Small procedure
Local adverse effects
Changes in bleeding pattern

19
Q

What is an example of contraceptive that inhibits sperm transport? What is its action?

A

Progesterone only pill

Thickens cervical mucus

20
Q

How does the intrauterine system work?

A

Using progestogen, reduces endometrial proliferation and prevents implantation, also thickens cervical mucus

21
Q

What are the advantages of the intrauterine system and device?

A

Convenient, long duration and relieve menstrual disorders

Device can be emergency contracpetion

22
Q

What are the disadvantages of the intrauterine system?

A

Insertion unpleasant
IUS displacement
Menstrual irregularity in first 6 months
Risk of uterine perforation

23
Q

How does the intrauterine device work?

A

Copper toxic to sperm and ovum so no fertilisation. Also copper causes endometrial inflammation to prevent implantation

24
Q

What are the disadvantages of the intrauterine device?

A

Insertion unpleasant
IUD displacement
Heavy peirods
Risk of uterine perforation

25
Q

What is a vasectomy?

A

Vas deferens interrupted to prevent sperm entering ejaculate

26
Q

What is tubal ligation?

A

Fallopian tubes cut or blocked to stop ovum travelling from ovary to uterus

27
Q

Define infertility:

A

Failure of conception in a couple having regular, unprotected coitus (2+ per week) for one year

28
Q

What examinations may be performed to investigate infertility?

A 
BMI
Secondary sexual characteristics 
Galactorrhoea
Pelvic examinations
Testicular size and descent
29
Q

What are some of the causes of infertility? (general)

A 
Male factors
Ovulatory disorders
Tubal damage
Uterine or peritoneal disease 
Other factors (unexplained)
30
Q

What are some male factors causing infertility?

A

Idiopathic oligospermia
Varicocele
Abnormal sperm production
Hypothalamic-pituitary dysfunction

31
Q

What are some ovulatory disorders causing infertility?

A 
Hypothalamic-pituitary failure
Polycystic ovary syndrome 
Congenital adrenal hyperplasia
Adrenal tumours
Turner's
32
Q

What are the 3 core signs of polycystic ovary syndrome?

A

Polycystic ovaries
Anovulation
Hyperandrogenism - hirsutism (facial hair)

33
Q

What can cause tubal damage leading to infertility?

A

Past pelvic infection e.g. chlamydia
Previous pregnancy or pelvic surgery
Developmental anomaly
Endometriosis

34
Q

What uterine and peritoneal disease can cause infertility?

A

Endometriosis
Uterine fibroids
Cervical stenosis or hostility (acidic)

35
Q

What is endometriosis?

A

Presence of endometrial tissue in sites other than uterine cavity

36
Q

What are some signs of endometriosis?

A

Dysmenorrhoea, dyspareunia, chronic pelvic pain, infertility

37
Q

How is endometriosis diagnosed?

A

Laparoscopy

38
Q

What is the management of endometriosis?

A

Anti-inflamms and pill to regulate periods

39
Q

What investigations can be performed in female infertility?

A

LH and FSH (day 2)
Progesterone (day 21)
Pelvic USS
Tubal patency by hysterosalpography

40
Q

What investigations can be performed in male infertility?

A

Sperm analysis
Antisperm antibodies
USS
FSH, LH and testosterone

41
Q

What treatment is there for inducing ovulation?

A

Clomefine citrate - increases GnRH
GnRH agonists
Changes to weight e.g. if anorexic

42
Q

What treatment is there for tubal occlusion?

A

Surgery

Assisted conception

43
Q

What are some treatments for male infertility?

A

Artificial insemination
Intracytoplasmic sperm injection
GnRH agonists or dopamine agonists

Reproductive System (24 decks)

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