17.) Necessary Tests For Infertile Couples Flashcards
Define infertility and explain its primary and secondary forms.
Infertility is the inability to conceive after 1 year of unprotected intercourse.
- Primary infertility: No previous pregnancies; the couple has never conceived.
- Secondary infertility: Inability to conceive after at least one prior pregnancy, regardless of outcome.
What are the primary requirements for male fertility, and what factors can impair spermatogenesis?
Male fertility depends on the production of adequate, healthy sperm. Impairments in spermatogenesis can result from:
- Genital anomalies (e.g., agenesis of ductus deferens, cryptorchidism).
- Infections (e.g., Gonorrhea, Trichomoniasis).
- Substance intoxications (e.g., from alcohol, drugs, certain medications).
- Endocrine disorders (e.g., Klinefelter syndrome, adiposogenital dystrophy).
- Mechanical factors (e.g., varicocele, epididymal cysts).
How is a semen sample collected for analysis, and what are the collection requirements?
A semen sample should be collected following:
- 5 days of sexual abstinence to ensure optimal sperm concentration.
- Avoidance of alcohol, drugs, and certain medications to prevent compromised results.
- Morning collection after urination, using a sterile container, to minimize contamination and maximize sample quality.
Describe the parameters of a normal spermogram.
A normal spermogram includes:
- Volume: 2–6 mL.
- Sperm concentration: 40–120 million/mL.
- Motility: More than 60% of sperm are actively motile.
- Speed: Sperm move at over 20 micrometers/second.
- Morphology: At least 75% of sperm have a normal structure.
What are common abnormalities in a spermogram and their implications?
Common abnormalities include:
- Oligospermia: Low sperm count, which can reduce fertility.<15mill/ml
- Azoospermia: Absence of sperm, leading to infertility.
- Aspermia: No ejaculation, often due to obstruction or nerve issues.
- Asthenozoospermia: Reduced motility, hindering sperm’s ability to reach and fertilize the egg.
- Teratozoospermia: High percentage of abnormally shaped sperm, impacting fertility.
- Necrozoospermia: More than 50% non-motile or dead sperm, indicating poor viability.
- Hypospermia: Low semen volume (<2 mL), possibly affecting sperm delivery.
- Hyperspermia: Excess semen volume (>6 mL), which may dilute sperm concentration.
What tests are recommended for female infertility, particularly for anatomical or functional assessments?
Female tests include:
- Vaginal examination for congenital anomalies (e.g., vaginal aplasia, gynatresia).
- Cervical evaluation using the Insler score to assess cervical mucus quality (important for sperm penetration).
- Endometrial biopsy for suspected endometritis or uterine pathologies.
- Hysterosalpingography (HSG): An X-ray test to examine uterine and tubal patency.
- Laparoscopy: For a detailed view of pelvic organs, assessing for endometriosis or adhesions.
What is the Insler Cervical Score, and how is it used in infertility testing?
The Insler Cervical Score evaluates cervical mucus quality and cervical opening during ovulation, assessing:
- Mucus quantity and consistency.
- Spinbarkeit (stretchability): Reflects mucus elasticity.
- Ferning: Indicates crystallization patterns of mucus under a microscope.
- Cervix openness: Measures cervical dilation, often increasing during ovulation.
- Scoring: A high score suggests optimal conditions for sperm penetration.
Explain basal body temperature (BBT) tracking and its relevance in female infertility evaluation.
BBT tracking involves daily measurement of body temperature upon waking. After ovulation, progesterone causes a slight rise in BBT, forming a biphasic pattern if ovulation occurs.
- Monophasic pattern: Suggests anovulation, indicating potential fertility issues.
- Biphasic pattern: Confirms ovulation, which is essential for natural conception.
What role does folliculometry play in infertility evaluation for females?
Folliculometry, an ultrasound assessment, monitors follicle growth to:
- Confirm ovulation timing.
- Identify dominant follicle (typically 1.5–2 cm).
- Detect early rupture or non-rupturing cysts, both of which can indicate ovulatory dysfunction or polycystic ovary syndrome (PCOS).
What endocrine tests are important in diagnosing female infertility?
Key tests include:
- FSH and LH: Evaluate ovarian function and the menstrual cycle phase.
- Estradiol and progesterone: Assess ovarian reserve and luteal function.
- Prolactin: Elevated levels can interfere with ovulation.
- TSH: Thyroid dysfunction can disrupt menstrual cycles and fertility.
