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Endocrinology > Assessment of Infertility > Flashcards

Assessment of Infertility Flashcards

1
Q

define infertility

A

failure to achieve a clinical pregnancy after 12 months of more of regular unprotected sexual intercourse (in absence of known reason) in a couple who have never had a child

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2
Q

infertility can be broken into 2 - name them

A

primary or secondary

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3
Q

define:

(a) primary infertility

(b) secondary infertility

A

(a) primary infertility

couple who have nerve conceived

(b) secondary infertility

couple previously conceived, although pregnancy may not have been successful e.g. miscarriage or ectopic pregnancy

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4
Q

what increases the chance of fertility?

A 
woman < 30
previous pregnancy
intercourse around ovulation
healthy BMI
non-smokers
low caffeine intake
no recreational drugs
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5
Q

nae the condition that results in infertility that affects 1% of the population that is more common in females

A

anorexia nervosa

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6
Q

clinical features of anorexia nervosa?

A 
low BMI
loss of hair
increased lanugo
low pulse and BP
anaemia
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7
Q

endocrine features of anorexia nervosa - low or high?

(a) FSH
(b) LH
(c) oestradiol

A

(a) FSH - LOW
(b) LH - LOW
(c) oestradiol - LOW

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8
Q

name the commonest endocrine disorder in women

A

polycystic ovarian syndrome

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9
Q

polycystic ovarian syndrome clinical features?

A 
inherited
obesity
hirsutism
acne
cycle abnormalities
infertility
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10
Q

endocrine features of PCOS - low or high?

(a) androgens
(b) LH
(c) glucose

A

endocrine features of PCOS - low or high?

(a) androgens - HIGH
(b) LH - HIGH
(c) glucose - IMPAIRED

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11
Q

diagnosis of PCOS is 2 out of the 3 what?

A

chronic anovulation
polycystic ovaries
hyperandrogenism

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12
Q

what can cause premature ovarian failure?

A

idiopathic
genetic - turners or fragile X
chemo or radiotherapy
oophorectomy

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13
Q

clinical features of premature ovarian failure?

A

hot flushes
night sweats
atrophic vaginitis

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14
Q

endocrine features of premature ovarian failure - low or high?

(a) FSH
(b) LH
(c) oestradiol

A

(a) FSH - HIGH
(b) LH - HIGH
(c) oestradiol - LOW

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15
Q

tubal disease can be either what 2 things?

A

infective or non-infective

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16
Q

what is a hydrosalpinx?

A

a condition that occurs when the fallopian tube is blocked and fills with serous or clear fluid near the ovary

the blocked tube may become substantially distended giving the tube a characteristic sausage-like shape

17
Q

clinical features of hydrosalpinx due to pelvic inflammatory disease

A

abdominal pain
vaginal discharge
infertility
ectopic pregnancy

18
Q

presence of endometrial glands outside uterine cavity defines what?

A

endometriosis

19
Q

endometriosis clinical features?

A

dysmenorrhoea dysparenuia
menorrhagia
painful defaecation
chronic pelvic pain

uterus may be fixed and retroverted

scan may show characteristic ‘chocolate’ cysts on ovary

infertility or asymptomatic

20
Q

clinical features of non obstructive disorders in male such as 47 XXY, chemo/radiotherapy?

A

low testicular volume

reduced secondary sexual characteristics

vas deferens present

21
Q

endocrine features of non-obstructive disorders - low or high?

(a) FSH
(b) LH
(c) testosterone

A

(a) FSH - HIGH
(b) LH - HIGH
(c) testosterone - LOW

22
Q

give examples of obstructive causes

A

cystic fibrosis, infection or vasectomy

23
Q

clinical features of obstructive causes of infertility

A

normal vesicular volume

normal secondary sexual characteristics

vas deferens may be absent

24
Q

endocrine features of non-obstructive disorders - low or high or normal?

(a) FSH
(b) LH
(c) testosterone

A

(a) FSH - NORMAL
(b) LH - NORMAL
(c) testosterone - NORMAL

25
Q

what is examined in a female with infertility?

A

BMI
general - body hair and galactorrhea
pelvic examination - uterine and ovarian abnormalities/tenderness and mobility

26
Q

what is examined in a male with infertility?

A 
BMI
general
size/position of testes
penile abnormalities
presence of vas deferens
presence of varicoceles
27
Q

name the test of tube patency

A

hysterosalpingiogram or laparoscopy

28
Q

in who is a hysterosalpingiogram performed?

A

those with previous pelvic surgery, Crohns or obesity

rest get laparoscopic

29
Q

what is only performed in cases where suspected or known endometrial pathology?

A

hysteroscopy

30
Q

name the non-invasive investigation to view the inner pelvis?

A

pelvic US

Endocrinology (31 decks)

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