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Reproduction and Sexuality > 3.5.3 Assisted Reproductive Treatments > Flashcards

3.5.3 Assisted Reproductive Treatments Flashcards

1
Q

Describe the assisted reproductive technique of IVF and the indications of it.

A

IVF – in vitro fertilization, stimulate ovulation with hCG → US guided oocyte retrieval → IVF

Indications – tubal or pelvic factor, severe male infertility

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2
Q

What are the characteristics of egg cryopresentation?

A
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3
Q

What are the characteristics of rFSH stimulation?

A
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4
Q

What are the characteristics of Clomiphene citrate?

A
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5
Q

What are the main causes of infertility?

A

Male factor - 35%

Female - 50% - Tubal/pelvic path - 35%

Anovulation/oligoovulation -15%

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6
Q

What are some possible uterine anomalies?

A

Bicornuate

Didelphys

Unicornuate

Septate

T-shaped

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7
Q

What are the characteristics of IVF?

A

Requires careful monitoring

Risk of OHSS

Embryo transfer 5 days after retrieval

Can control number of embryos transferred

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8
Q

What is the risk for multiple gestation with Clomid and rFSH?

A

Clomid - 7% twins, 0.5% triplets

rFSH - 20% twins and 5% triplets

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9
Q

What are some possible causes of occluded fallopian tubes?

A

PID - particularily chlamydia

Endometriosis

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10
Q

If patient doesn’t want kiddos and has PCOS what are some treatment options?

A

OCPs, spironolactone, mirena IUD, provera,

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11
Q

What happens to the rate of fetal aneuploidy by maternal age?

A
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12
Q

What are teh important characteristics of oligospermia?

A
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13
Q

How does paternal age relate to fertility?

A

INcrease in spermatic DNA fragmentation but no increase in aneuploidy

Greater the 40 have greater risk of autism

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14
Q

What is the treatment of endometriosis?

A

If not wanting kids

Surgical fulguration/excision of endo

Menstrual suppression

If wanting kids - IVF if tubes are blocked, consider suppression prior to cycle w/ GnRH agonist

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15
Q

What is recurrent pregnancy loss?

A

2 or more sAB (clinical losses)

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16
Q

What is ICSI?

A

Intracytoplasmic sperm injection

17
Q

Describe the hormonal evaluation for a female with reproductive issues?

A
18
Q

What does HSG give information about?

A

Uterine cavity, anomalies, tubal patency and presence of hydrosalpinges

19
Q

What is the most common cause of teratospermia?

A

Varicocele

20
Q

What are the characteristics of endometriosis?

A
21
Q

What are some of the psychological impacts of infertility?

A
22
Q

What are the characteristics of a male semen analysis?

A
23
Q

What is the use of Hysteroscopy with laparoscopy?

A

Gives same information and can be therapeutic.

Can treat endometriosis, fibroids etc

Consider in patients with severe dysmenorrhea

24
Q

What is the definition of infertility and what is the dependence on age?

A

Def - inability to conceive after one year

Age dependence - After age of 35 and treatment warrented after 6mo. After 40 many recommend referral to specialist after 3mo.

25
Q

What are some possible treament options for tubal disease?

A

IVF

Tuboplasty

Tubal reanastamosis - if history of BTL

26
Q

What are the characteristics of PCOS?

A

Complex ovulatory dysfunction involving the hypothalamus, pituitary, ovaries, and other tissues all contributing to an endocrine imbalance associated with hirsutism and infertility

27
Q

Describe the epidemiology of infertility.

A
28
Q

What are some possible causes of azoospermia?

A
29
Q

What are the semen analysis parameters?

A
30
Q

What are possible causes of motility dysfunction in male sperm?

A
31
Q

What is fecundity?

A

Probability a single cycle will result in live birth

32
Q

What are some possible causes for low volume of semen?

A

Obstruction

Absence of vas deferens

Retrograde ejaculation

Androgen deficiency

33
Q

When would it be a good idea as a physician to refer a couple to a specialist for fertility issues?

A
34
Q

What all goes into a female infertility evaluation?

A
35
Q

How does age relate to fertility?

A

Women’s fertility decreases with age

After 34 - 11% infertility

At 40 - 33% infertility

At 45 - 87% infertility

36
Q

Describe the assisted reproductive technique of controlled ovarian stimulation.

A

clomiphene and letrozole, monitor follicle growth with US and estradiol level

37
Q

What are some ways to preserve fertility?

A

Safe sex practices

Stop smoking

EtOH in moderation

Decrease caffeine intake

Maintain healthy weight

Reproduction and Sexuality (58 decks)

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