Assessment of infertility Flashcards
factors affecting infertility
chlamydia
- Older
Obesity
infertility
failure to achieve a clinical pregnancy after 12 months of more of regular unprotected sex in a couple who have never had a kid
primary infertility
couple whom have never concieved
secondary infeetility
couple previously ocncieved although pregnancy may not havhe been successful
incresed chance of conception
Woman aged under 30 years
* Previous pregnancy
* Less than three years trying to conceive
* Intercourse occurring around ovulation
* Woman’s body mass index (BMI) 18.5 – 30m/kg2
* Both partners non-smokers
* Caffeine intake less than two cups of coffee daily
* No use of recreational drugs
common causes of secondary infertility
tubal disease
fibroids
endometriosis/adenomyosis
weight related
age related
anovulatory infertility
inability to concieve due to absent or irregular periods
causes of anovulatory infertility
PCOS
hypothalamic dysfunction
premature ovarian failure
thyroid disorders
hyperprolactinaemia
features of premature ovarian failure
- High FSH
- High LH
- Low oestradiol
clinical features of premature ovarian failurw
hot flushes, night sweats m atrophic vaginitis, amenorrhoea , infertility
premature ovarian failure
Occurs when the ovaries stop functioning normally before age 40
tubal disease
any condition affecting fallopian tubes impacting their structure/ function
endometriosis
presence of endometrial glands outside uterine cavity
male causes of infertility
hypothyroidism
diabetes
hyperprolactinaemia
erectile dysfunction
ejaculatory failure
HSG (Hysterosalpingography) and HyCoSy (Hysterosalpingo-Contrast Sonography)
An X-ray procedure that uses a contrast dye to visualize the uterus and fallopian tubes
when to perform hysteroscopy
in cases wherre suspected or known endometrial pathology
when to perform pelvic ultrasound
when abnormality on pelvic exammination
investigations in female for infeertility
end cervical swab for chlamydia and gonococci
cervical smear if due
blood for rubells immunity
rubella syndrome/ congenital rubella
group of physical abnormalities that have developed in an infant as a result of maternal infection
what is rubella characterised by
rash at birth
low weight
small head size
hert abnormalities
visual problems
bulging fontanelle
antibiotic for chlamydia
aithromycin
if allergic to macrolide - doxy
group 1 ovulatory disorders q
hypothalmic
stress, excessive excersize, anorexia etc
group 2 ovulatory disorders
hypothalamic pituitary dysfunction
pcos
group 3 ovulatory disorders
ovarian failure
tubal disease
when fallopian tubes are blocked or damaged
tubal disease management
tubal surgery
radiological selective salpingography
treatment of male infertility
Surgery to obstructed vas deferens (50% success following vasectomy)
Intrauterine insemination in mild disease
Intracytoplasmic sperm injection (ICSI)
Surgical sperm aspiration from epididymis or testicle combined with ICSI
Donor sperm insemination
