2.3a Infertility Flashcards
1
Q
Infertility
A
- Prolonged time to conceive
- If a couple does not achieve pregnancy after 1 year of unprotected sex they are advised to seek fertility evaluation
- Evaluation is recommended at 6 months for women older than 35 and have risk factors for infertility.
2
Q
Sterility
A
- Inability to conceive
3
Q
Primary Fertility
A
- Difficulty conceiving when there has never been a pregnancy
4
Q
Secondary Fertility
A
- Difficulty conceiving after having had a pregnancy regardless of outcome
5
Q
Fecundity
A
- Ability to carry pregnancy to live birth.
6
Q
Fertility Requirements
A
- Normal reproductive tract in both male and female
- Normal hypothalamic-pituitary-gonadal axis that supports gametogenesis (meiosis of gametes)
- Sperm remains viable in female reproductive tract for 48 hours but only few retain fertilization potential after 24 hours.
- Ova remains viable for 24 hours.
7
Q
Causes of Female Infertility
A
- Delaying pregnancy towards later in life
- Organ damage from toxins and diseases (endometriosis)
- Obesity
- Smoking
- Tubal Infection
- Depression
8
Q
Causes of Male Infertility
A
- Unfavorable sperm production (>50 y/o)
- Physical or endocrine dysfunction
- Cumulative metabolic disease
- Toxins
9
Q
Causes of Infertility
A
- 10% - 20% have idiopathic causes of infertility
10
Q
Female Infertility Causes (cont)
A
- Hormonal and ovulatory factors
- Tubal/Peritoneal factors
- Uterine factors
- Vaginal-cervical factors
11
Q
Male Infertility Causes (cont)
A
- Structural disorders
- Hormonal disorders
12
Q
Causes of Decreased fertility
A
- Heavy caffeine/alcohol consumption
- Hyperprolactinemia (increased prolactin)
- Very low weight or poor diet
- Cancer treatment (ovarian surgery)
- Primary amenorrhea (failure of menses by age 15)
- Secondary amenorrhea (failure of menses 3x in a row)
- Ovulatory dysfunction (obesity, polycystic ovarian syndrome, strenuous exercise, endocrine dysfunction)
- Early menopause (before age 40) runs in family. Menopause is when ovaries don’t respond to ovulation inducing drugs
- Smoking, depression, environmental pollution exposure.
13
Q
Tubal/Peritoneal Factors
A
- Impaired tubal motility and patency can come from infection, adhesion, scarring, tumor, or intentional sterilization
- One tube can be shorter than the other causing abnormal uterus
- Inflammation can cause pelvic infection which impairs fertility
14
Q
Endometriosis
A
- Inflammatory peritoneal damage caused by endometrial tissue migrating out of uterus and implanted on pelvic organs or connective tissue.
- This results in adhesions which lead to pelvic distortion.
- Inflammatory changes are high risk factor for ovarian dysfunction and blocked tubal transport.
15
Q
Uterine Factors
A
- Minor anomalies are common, Major are rare
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