Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Repro > 7. Infertility (lecture) > Flashcards

7. Infertility (lecture) Flashcards

1
Q

what is the definition of infertility?

A

failure of conception in a couple having regular, unprotected coitus for one year

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is primary and secondary infertility?

A

primary: no previous pregnancy
secondary: previous pregnancy, successful or not

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

about how many couples will have difficulty conceiving in the UK?

A

1 in 7 couples

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what aspects of history do you ask for in an infertile female?

A 
age
duration of infertility
menstrual cycle - length and predictability of cycle, age of menarche
tubal / pelvic surgery
PID
menorrhagia (abnormally heavy periods)
pelvic pain
sexual history - any infections?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what aspects of history do you ask for in an infertile male?

A 
general health
alcohol / smoking
previous surgery to the testes
drug history
previous infections
sexual dysfunction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what do you examine in infertility?

A

BMI
signs of secondary sexual characteristics (e.g. chromosomal abnormalities)
galactorrhoea (milky secretion from the breasts)
pelvic examination - feel for structural abnormalities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

additionally, what do you check for in males?

A

testicular size and check for descent (from lumbar spine)

do NOT perform male examination without relevant history

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are the most common aetiology of infertility?

A 
male factors - 30%
Ovulatory disorders - 25%
tubal damage - 20%
uterine / peritoneal disease <10%
others (no identified male / female cause) - 25%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is the most common male factor causing infertility?

A

idiopathic oligospermia (deficiency of sperm cells in the semen)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

aside from idiopathic oligospermia, what are the other causes of infertility in males?

A

Varicocele
Abnormal sperm production (e.g. testicular disease)
Hypothalamic / pituitary dysfunction (not enough testosterone, so can’t produce sperm)
Ductal obstruction - post infective epididymitis, post vasectomy
Failure to deliver sperm to the vagina (hypospadias, impotence)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is hypospadias? (leading to failure to deliver sperm to vagina)

A

a congenital condition in males in which the opening of the urethra is on the underside of the penis (instead of at glans penis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is impotence in men (leading to failure to deliver sperm to vagina)?

A

inability in a man to achieve an erection or orgasm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is varicocele in men (leading to infertility)?

A

when veins become enlarged inside scrotum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are the different classifications of ovulatory disorders?

A
  1. Hypothalamic pituitary failure (GnRH to AP)
  2. Hypothalamic-pituitary-ovarian dysfunction (GnRH, or AP affecting ovaries theca cells)
  3. Ovarian failure (has stimulation but theca cells not producing oestrogen)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is polycystic ovary syndrome?

A

syndrome consisting of polycystic ovaries and systemic features resulting from elevated androgens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are the causes of polycystic ovary syndrome?

A

unknown pathophysiology, but appears to have genetic component

17
Q

what does polycystic ovary syndrome cause?

A

Increased androgen secretion (testosterone)
Raised LH/FSH ratio (disrupt ovulation, not enough FSH to cause follicles to mature in time for the LH surges)
Insulin resistance
Multiple small ovarian cyst
Anovulation

18
Q

what is anovulation in PCOS?

A

ovaries do not release an oocyte during a menstrual cycle, so no ovulation

19
Q

what are examples of anovulation in PCOS?

A

amenorrhoea (absence of menstrual periods)

oligomenorrhoea (infrequent menstrual periods)

20
Q

what are clinical features of ovulatory disorders e.g. PCOS?

A 
Hirsutism 
Acne
Obesity
Male-pattern baldness
Oligomenorrhoea (infrequent menstrual periods)
Psychological symptoms
21
Q

what is Hirsutism in PCOS?

A

excessive body hair in men and women on parts of the body where hair is normally absent or minimal, such as on the chin or chest in particular

22
Q

what are psychological symptoms that can be present in PCOS?

A

mood swings
depression
anxiety

23
Q

what is the Rotterdam Diagnostic criteria for PCOS?

A

2/3 of the following:
Polycystic ovaries (12 or more follicles on ultrasound)
Oligo-ovulation / anovulation
Clinical and or biochemical signs of hyperandrogenism
Exclusion of other causes of androgen excess

24
Q

what is Oligo-ovulation? (PCOS)

A

infrequent, irregular ovulation

25
Q

what is anovulation? (PCOS)

A

the ovaries do not release an oocyte during a menstrual cycle, ovulation doesn’t happen

26
Q

what is hyperandrogenism? (PCOS)

A

excess androgens (testosterone)

27
Q

what are causes of tubal damage causing infertility?

A 
past pelvic infection e.g. Chlamydia
previous pregnancies
pelvic surgery
endometriosis
Mullerian developmental anomaly
28
Q

what is endometriosis? (cause of tubal damage causing infertility)

A

Presence of endometrial tissue in sites other than the uterine cavity (commonly pelvic cavity)

affects 10-15% women
(tissue that behaves like the lining of the womb (the endometrium) is found outside the womb)

29
Q

what does Mullerian duct form?

A

primordial anlage of the female reproductive tract:

fallopian tubes, uterus, the uterine cervix

30
Q

what are causes of uterine / peritoneal disease leading to infertility?

A 
endometriosis
Asherman's syndrome
uterine fibroids
cervical stenosis
cervical hostility
31
Q

what causes cervical hostility?

A

infection or female sperm antibodies

32
Q

what is Asherman’s syndrome? (cause of uterine / peritoneal disease leading to infertility)

A

formation of adhesions (scar tissue) inside the uterus and/or the cervix

33
Q

what are uterine fibroids? (cause of uterine / peritoneal disease leading to infertility)

A

benign smooth muscle tumours of the uterus
(Most women have no symptoms while others may have painful or heavy periods. If large enough, they may push on the bladder causing a frequent need to urinate)

34
Q

what are clinical features of endometriosis?

A

Dysmenorrhoea (low anterior pelvic pain which occurs in association with periods)
Dyspareunia (difficult or painful sexual intercourse)
chronic pelvic pain
infertility

35
Q

what are causes of other factors leading to infertility?

A

unexplained infertility
poorly controlled diabetes
coital problems (sex position)
multifactorial in 5-10% of cases

Repro (78 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions