1b Infertility Flashcards
What is Infertility?
A disease of the reproductive system defined by the failure to achieve a clinical
pregnancy after ≥12 months of regular unprotected sexual intercourse.
What is primary infertility?
not had a live birth previously
What is secondary infertility?
Had a live birth over 12 months ago
What is the most common cause on infertility?
Combined Male and Female Factors
Cost of infertility to the couple:
- No biological child
- Impact on couples wellbeing
- Impact on larger family
- Treatments and Investigations (which often fail = more distress)
What is the cost of infertility to society?
- Less births
- Less tax income
- Investigation costs
- Treatment costs
What are the pre-testicular causes of infertility? - MALE
Endocrinopathies eg Klinefelter 47XXY
Issues with HPG Axis, T, PRL
What is cryptochordism?
Undescended testis - testis start embryologically in the inguinal canal, therefore undescended means they are left there
What toxins can cause infertility?
Chemo, Toxins, Drugs, Smoking
What are the testicular causes of Infertility
Cryptochordism
Immunological
Vascular
Trauma / Surgery
Toxins
What are the post testicular causes of infertility?
Congenital
Obstructive Azoospermia
Erectile Dysfunction
Latrogenic
What are the uterine causes of infertility?
Congenital Malformation
Infection
Scarring/Inflammation/Adhesions/Fibroids
What are the tubular causes of infertility? - FEMALE
Infection, Trauma, Endometriosis
What are the ovarian causes of infertility?
Anovulation - no ovulation
Corpus Luteum Insufficiency
What is endometriosis?
Presence of functioning endometrial tissue outside the uterus
Why does endometriosis cause increased period pains
Endometriosis responds to oestrogen
Mid cycle oestrogen increases therefore exacerbates menstrual pain
What are the symptoms of endometriosis?
Increased menstrual Pain
Menstrual irregularities
Deep dyspareunia
Infertility
What are fibroids?
BENIGN TUMOURS OF THE MYOMETRIUM
What are the symptoms associated with fibroids?
Usually Asymptomatic
Increased menstrual Pain
Menstrual irregularities
Deep dyspareunia
Infertility
How is Oestrogen made in Males?
Aromatised from testosterone
Describe the HPG Axis?
- kiss peptin binds to kiss peptin receptors
- Stimulates GnRH release
- Binds to gonadotrophs - FSH and LH secretion, which leads to T and O secretion
Describe the hormone profile in hyperprolactinaemia?
↓GnRH (Not measurable in the systemic circulation)
↓LH
↓FSH
↓Testosterone