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4 RED > 7 Infertility > Flashcards

7 Infertility Flashcards

1
Q

Define fertility

A

measure of the actual outcome of the reproductive process

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2
Q

Define fecundability

A

probability of conceiving each month

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3
Q

Define Fecundity

A

measure of the ability to conceive and produce a live birth

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4
Q

Define infertility

A

the inability to conceive after a period of unprotected intercourse or the inability to carry a pregnancy to full term

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5
Q

What is the NICE definition of infertility?

A

failing to get pregnant after two years of regular unprotected sex

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6
Q

Define subfertility

A

a state of reduced fertility

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7
Q

Name 3 self-inflicted factors reducing fertilifty

A

age

smoking obesity

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8
Q

Name 4 general female factors accounting for infertility

A

ovulatory disorders
disorders of reproductive tract
uterine abnormalities
implantation, growth, and development

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9
Q

Name 5 ovulatory disorders acocunting for infertility

A

absent cycles
idiopathic ovarian failurePCOS
anovulatory cycles
abbreviated luteal phase

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10
Q

What proportion of women are able to conceive with placebo treatment of absent cycles?

A

30%

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11
Q

What is idiopathic ovarian failure?

A

gonadotrophin secretion normal but insufficient to support a normal cycle

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12
Q

What else might Anovulatory cycles be called?

A

Luteinised unruptured follicle syndrome (LUF)

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13
Q

What might cause an abbreviated luteal phase?

A

decreased progesterone

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14
Q

Name 2 disorders of the female reproductive tract

A

tubal damage

endometriosis

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15
Q

What is tubal damaged usually a result of?

A

pelvic infection

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16
Q

Where might endometrial tissue growth escalate?

A

ectopic cites (oviduct, ovary, peritoneal cavity)

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17
Q

What blood tests might you do to diagnose female infertility?

A

FSH
Anti-malarian hormone
Day 21 progesterone (to look for ovulation)

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18
Q

Name 4 maternal problems causing infertility

A

cervical incompetence
implantation defects
autoimmune (lupus)
immunological incompatibility

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19
Q

Genetic abnormalities occur in what percentage of births?

A

0.5% live births

20
Q

Why is the effect of aging on fertility greater in males?

A

other age-related factors like diabetes, HTN

21
Q

Name 5 areas of male disorders causing infertility

A

production, transport, and transmission of spermatozoa
sperm function in female tract
fertilisation and events after

22
Q

Name 2 potentially correctable conditions causing male infertility

A

ductal obstruction

hypogonadotrophic hypogonadism

23
Q

Name 2 life threatening conditions that may underlie male infertility

A

testicular cancer

pituitary tumours

24
Q

When might you do 2 semen analyses 2 months apart?

A

if azoospermic

25
Q

When might you do an endocrine evaluation?

A

sperm conc <5 million/ml
impaired sexual function
other endocrine clinical findings

26
Q

What would be considered normozoospermic?

A

> 15 million spermatozoa/ml
32% rapid forward progressive motility
4% normal morphology

27
Q

What would be considered oligozoospermic?

A

<15 million spermatozoa/ml

28
Q

What would be considered asthenozoospermic?

A

<32% rapid and medium forward progressive motility

29
Q

What would be considered teratozoospermic?

A

<4% spermatozoa with normal morphology

30
Q

What are the 4 causes of a failure in production in sperm?

A

congenital testicular deficiency
maldescended testes
acquired issues
endocrine disorders

31
Q

Name 2 congenital testicular defficiencies causing a fialure in sperm production

A

Klinefelter Syndrome

Y chromosome deletions

32
Q

What is another name for maldescended testes?

A

cryptorchidism

33
Q

Which acquired issues might cause a failure in sperm production?

A

trauma - torsion

orchitis (mumps)

34
Q

What does aspermic mean?

A

no ejaculate

35
Q

What does azoospermic mean?

A

no sperm

36
Q

How many leucocytes in semen would be considered a bit worrying?

A

> 1 million/ml

37
Q

Why might you carry out a sperm vitatlity test (EN test)/

A

non moving sperm is not necessarily dead sperm

38
Q

What is CASA?

A

computer aided sperm analysis

39
Q

what might cause a failure in sperm transmission?

A 
ED
Ejaculatory dysfunction (retrograde, accessory sex gland defects)
40
Q

What causes retrograde ejaculation?

A

incompetent urethral sphincter

41
Q

What are the indications for post-ejaculatory urine analysis?

A 
low volume ejaculate
absent ejaculate (Aspermia)
42
Q

When wouldn’t you carry out post-ejaculatory urine analysis?

A

CBAVD

hypogonadism features

43
Q

What might cause a total failure in sperm transport?

A

infection (bilateral epididymal/vas)

CBAVD

44
Q

What is CBAVD?

A

congenital bilateral absence of vas deferens

45
Q

What gene is CBAVD linked to?

A

CFTR gene mutation on chromosme 7

46
Q

What proportion of men with CF have CBAVD?

A

> 95%

47
Q

Which post-fertilisation processes might be affecting fertility?

A 
centriole function
chromatin decondensation
protamine exchange
pronuclear fusion
activation of genes for placental formation

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