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ETA 4: REPRODUCTION > 5: Conception, Contraception & Infertility > Flashcards

5: Conception, Contraception & Infertility Flashcards

1
Q

What are the components of Semen? (5 things)

A
  1. Clotting factors
  2. Fructose
  3. Alkaline fluid
  4. Prostaglandins
  5. Proteolytic Enzymes
  6. Alkaline fluid (yes again)

CFAPPA

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2
Q

What Semen components are from the Seminal Vesicles? (4 things)

A
  1. Clotting factors
  2. Fructose
  3. Alkaline fluid
  4. Prostaglandins
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3
Q

What Semen components are from the Prostate? (1 thing)

A
  1. Proteolytic enzymes

Pro and Pro

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4
Q

What Semen components are the Bulbourethral glands? (1 thing)

A
  1. Alkaline fluid
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5
Q

What is the purpose of Alkaline fluid (from Seminal Vesicles) in Semen?

A

Neutralises acid in female genital tract

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6
Q

What is the purpose of Prostaglandins in Semen?

A

Stimulate female reproductive tract

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7
Q

What is the purpose of Proteolytic enzymes in Semen?

A

Breaks down clotting factors → allows reliquification of semen → moves easier through reproductive tract

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8
Q

What is the purpose of Alkaline fluid (from Bulbourethral glands) in Semen?

A

Lubricate end of penis & urethral lining

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9
Q

What is the 4 steps of of penile erections mechanism?

A
  1. Stimulation
  2. Spinal Reflex
  3. PS Activation
  4. Haemodynamic Changes

Sexy Sexy Punani Humpme

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10
Q

What are the stimulations for penile erections? (2 things)

A
  1. Psychogenic
  2. Tactile (sensory afferents) of penis and perineum

Mind and Touch

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11
Q

Where are the spinal nuclei for PS activation of penil erections located?

A

S2 - S4

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12
Q

What must happen to central arteries of the Corpora Cavernosa to maintain an erection?

A

Vasodilation

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13
Q

What does vasodilation of the central arteries of the Corpora Cavernosa depend on?

A

Low intracellular Calcium levels in the smooth muscle cells of arteries

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14
Q

What causes calcium levels in the smooth muscle cells of arteries to decrease? (3 things)

A
  1. Sympathetic arterial vasoconstrictor nerves inhibition
  2. Acivation of PS NS
  3. Activation of Non-adrenergic & Non-cholinergic autonomic nerves to arteries to release nitrous oxide (NO)

NO is what maintains the erection

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15
Q

What does Nitrous Oxide (NO) do?

A

Diffuses into vascular SM → Decreases calcium levels → Relaxation of SM (Vasodilation)

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16
Q

In general what is the mechanism of maintaining penile erections? (2 main steps)

A
  1. Reduce Calcium levels in the smooth muscle cells of arteries by:
  2. Sympathetic arterial vasoconstrictor nerve inhibition
  3. Activation of PS NS
  4. Activation of Non-Adrenergic & Non-Cholinergic Autonomic Nerves → Release NO
  5. Low Calcium levels → Vasodilation of Central Arteries of Corpora Cavernosa → Maintains Erection
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17
Q

What are the causes of erectile dysfunction? (5 causes)

A
  1. NO blocking factors (alcohol / anti-hypertensives / diabetes)
  2. Psychological
  3. Drugs
  4. Tears in fibrous tissue of Corpora Cavernosa
  5. Vascular defects

No Pointing Dick To Vagina

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18
Q

Why is the “pull-out” method ineffective?

A

Ejaculate is held in the prostatic urethra → leakage can occur

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19
Q

What is ejaculation controlled by?

A

Sympathetic Control (L1 and L2)

Remember: Point & Shoot

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20
Q

What occurs during ejactulation? (3 things)

A
  1. Glands & Ducts (SM) contraction
  2. Bladder internal sphincter control
  3. Rhythmic striatal musclular contractions
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21
Q

What muscles are involved in the rhythmic striatal musclular contractions during ejactulation? (4 muscles)

A
  1. Pelvic floor
  2. Ischiocavernous
  3. Bulbospongiosus
  4. Hip & Anal muscles
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22
Q

What are the phases of the female sexual response? (3 phases)

A
  1. Sexual excitement
  2. Plaeau phase
  3. Orgasm
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23
Q

What occurs in Sexual Excitement phase of the Female Sexual Response?

A

Blood engorgement & erection of

  1. Clitoris
  2. Vaginal mucosa
  3. Breast
  4. Nipples
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24
Q

What occurs in the Plateau phase of the Female Sexual Response?

A

Glandular activity

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25
Q

What is special about the Female orgasm?

A

No refractory period

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26
Q

What happens to the sperm immediately after ejaculation?

A

Coagulates (because of fibrinogen clotting factors)

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27
Q

What is the purpose of sperm coagulating?

A

Prevents sperm being lost in the vagina

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28
Q

What happens after the sperm coagulates?

A

Liquefies (because of prostatic proteolytic enzymes)

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29
Q

What happens to the sperm that enters the vagina?

A

Travels 15-20cm to the uterine tubes

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30
Q

What is capacitation?

A

The maturation of sperm during its passage into the uterus

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31
Q

What is the purpose of sperm capacitation?

A

Gives sperm the “capacity” to fertilise the ovum

32
Q

What happens in sperm capacitation? (2 things)

A
  1. Removal of glycoprotein coat → changes cell membrane
  2. Tail movements become whip-like thrashing
33
Q

How long does sperm capacitation last?

A

Several hours

34
Q

What happens after capacitation?

A

Sperm push through granulosa cells (around oocyte) and bind to proteins on zona pellucida → triggers acrosomal reaction

35
Q

What triggers the acrosomal reaction?

A

Sperm binding to proteins on the Zona Pellucida

36
Q

What is the acrosomal reaction?

A

Acrosomal enzymes released from sperm → break down Zona Pellucida

37
Q

What occurs during fertilisation?

A

Sperm moves into cytoplasm → forms zygote

38
Q

How is polyspermia blocked?

A

By cortical reaction → Zona Pellucida hardened to prevent more sperms entering

39
Q

What are the 7 methods of contraception?

A
  1. Natural
  2. Prevent Sperm entering Ejaculate
  3. Prevet Sperm reaching Cervix (BARRIER Method)
  4. Prevent Ovulation
  5. Inhibit transport along Fallopian Tube
  6. Inhibit Sperm passing through Cervix
  7. Inhibit Implantation
40
Q

What are the Natural methods of contraception?

A
  1. Abstinence
  2. Coitus interruptus (pull out method) (sounds like a HP spell lol)
  3. Rhythm method
41
Q

How does Preventing Sperm entering Ejactulate work?

A

Divide vas deferens bilaterally

42
Q

How does Preventing Sperm reaching Cervix (BARRIER Method) work? (3 things)

A
  1. Condoms
  2. Diaphragm (thing diagonally across cervix)
  3. Cap (fits across cervix)
43
Q

What are the types of Preventing Ovulation? (4 types)

A
  1. COCP
  2. Depot Progesterone Injection
  3. Progesterone Only Pill
  4. Progeserone Implants
44
Q

How does the COCP (Combined Oral Contraceptive Pill) work?

A

Inhibits follicular development by negative feedback to the hypothalamus / pituitary → oestrogen reduces positive feedback so there’s no LH surge

45
Q

What is the Combined Oral Contraceptive Pill made up of

A

Oestrogen and Progesterone

46
Q

How does Inhibiting Transport along the Fallopian Tube work?

A

Block fallopian tube using:

  • Clips
  • Rings
  • Ligation
47
Q

What is used to Inhibit Sperm passing through the Cervix? (2 things)

A
  1. Progesterone Only Pill (POP)
  2. Progesterone Implant
48
Q

What are the 3 types of Inhibiting Implantation?

A
  1. Hormonal
  2. Post-coital
  3. Inta-Uterine Device (IUD)
49
Q

What Hormonal methods are used to Inhibit Implantation? (4 things)

A
  1. COCP
  2. POP
  3. Progesterone Implant
  4. Depot Progesterone Injection
50
Q

What Post-Coital methods are used to Inhibit Implantation?

A

Combined HIGH dose of Oestrogen / Progesterone

51
Q

How long after intercourse can Post-Coital methods of Inhibiting Implantation be used?

A

Upto 72 hours after intercourse

52
Q

What is the definition of infertility?

A

Inability to conceive within 1 year

53
Q

What are the 2 general male factors of infertility?

A
  1. Poor semen quality
  2. Coital impairement
54
Q

What are the factors of Poor semen quality? (4 things)

A
  1. Low sperm count
  2. Poor sperm morphology / motility
  3. Low ejaculation volume
  4. Sperm autoimmunity (antibodies kill sperm)
55
Q

What are the factors of Coital impairement? (2 things)

A
  1. Erectile dysfunction
  2. Retrogade ejactulation (early ejac innit)
56
Q

What are the 3 general female factors of infertilty?

A
  1. Ovulatory Failure
  2. Impaired Gamete / Zygote transport
  3. Implantation Defects
57
Q

What are the factros of Ovulatory Failure? (2 things)

A
  1. Hormone Imbalance
  2. Polycystic Ovarian Syndrome (PCOS)
58
Q

What are the factors of Impaired Gamete / Zygote Transport? (3 things)

A
  1. Tube defects
  2. Anti-sperm antibodies
  3. Non-optimal cervical mucus
59
Q

What are the factors of Implantation defects? (2 things)

A
  1. Chromosomal abnormalities
  2. Endometrial abnormalities
60
Q

What are the KEY causes for infertility? (2 things)

A
  1. Coital Problems
  2. Anovulation
61
Q

What are coital problems?

A

When sperm can’t enter at the cervix so no fertilisation occurs

62
Q

What is anovulation?

A

Failure to ovulte

63
Q

What are the reasons for anovulation? (8 things)

A
  1. Stress
  2. Hyperprolactinaemia
  3. Ovarian failure
  4. PCOS (Polycystic Ovarian Syndrome)
  5. Premature menopause
  6. Excercise
  7. Weight Loss
  8. Pituitary problems

SHOP PEWP

64
Q

How is anovulation diagnosed?

A

Low serum progesterone @ mid-luteal phase (day 21)

This indicates no Corpus Luteum therefore no ovulation has occured

65
Q

What is the differential diagnosis of infertility causes if:

  • LH: High
  • FSH: Very High
  • Oestrogen: Low
A

Menopause

66
Q

What is the differential diagnosis of infertility causes if:

  • LH: High
  • FSH: High
  • Oestrogen: Low
A

Ovarian Failure

67
Q

What is the differential diagnosis of infertility causes if:

  • LH: Low
  • FSH: Low
  • Oestrogen: Low
A

Hypothalamus / Pituitary Failure

68
Q

What is the differential diagnosis of infertility causes if:

  • LH: Very High
  • FSH: Low
  • Oestrogen: Normal
A

PCOS

69
Q

What are the 3 treatment types of infertility?

A
  1. Drugs to correct hormone problems
  2. Overcome tubal occlusion (surgery
  3. Overcome timing / fertilisation issues by IVF
70
Q

How do Drugs to correct hormone problems of infertility work?

A

They induce ovulation

71
Q

What are the ovulation inducing drugs for treating infertility? (3 types)

A
  1. Anti-oestrogen
  2. Gonadotrophins (FSH administration)
  3. GnRH agonists
72
Q

How does anti-oestrogen work to treat infertility?

A

Induces ovulation by:

  • Reduces negative feedback to hypothalamus / pituitary
  • Increases GnRH
  • Increases FSH
73
Q

What are the 5 steps of IVF?

A
  1. Stimulate ovary + retrieve oocyes
  2. Retrieve sperm
  3. Fertilise invitro
  4. Allow embryo to develop invitro
  5. Transfer embryo to uterus
74
Q

What are the variations of IVF if there is inadequate sperm / sperm transport? (5 things)

A
  1. ZIFT (Zygote Intrafallopian Transfer)
  2. GIFT (Gamete Intrafallopian Transfer)
  3. TESA (Testicular Sperm Aspiration)
  4. ICSI (Intracytoplasmic Sperm Injection)
  5. IUI (Intrauterine Insemination)

Ya zift adil hadiya lel tesa di 3ashan ana CSI agent 6ayb? IUI

75
Q

What are the variations of IVF if there are inadequate eggs? (2 things)

A
  1. Egg donation
  2. CT (Cytoplasmic Transfer)

ETA 4: REPRODUCTION (10 decks)

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