Assessment of Infertility Flashcards
what examinations can be helpful in female infertility?
general (height, weight, secondary sexual characteristics etc) pelvic examination (assess for tenderness, ovarian/uterine abnormalities and uterine mobility) endocervical swab cervical smear if due trans-vaginal US is done to look for structural abnormality/pathology
helpful examinations in male infertility?
general exam genital examination looking at - testes descended? - bilateral presence of vas deferens - bilateral presence of epididymis - signs of variocele/other swelling - testicular volume
normal testicular volume in adult male?
12-25ml
how can semen be analysed?
seminogram evaluates semen and sperm cells - measures volume of semen
- pH of semen
- density and conc of sperm in sample
- sperm motility (what proportion are moving)
- sperm progression (how well they are moving)
- sperm morphology
normal sperm pH?
7.2 or above
how is sperm sample collected and analysed?
no ejaculation for 72 hrs before giving sample
no caffeine or alcohol recommended in days before
complete sample obtained
sample assessed within 1hr of production
sample kept at body temp
how can tubal patency be assessed in females?
laparoscopy (preferred where there is possible tubal disease or pelvic inflammation such as PID or previous pathology such as ectopic)
hysterosalpingogram can be done if laparoscopy is contraindicated and there are no known risk factors for tubal/pelvic disease
when might laparoscopy be contraindicated?
obesity
crohns
what further tests might be done to investigate infertility?
hysteroscopy (if known or suspected endometrial pathology) scrotal US (abnormality on examination) chromosome analysis endocrine profile
what endocrine tests would be done on males and females?
male = FSH, LH, testosterone, prolactin, TSH female = FSH, LH, oestradiol, mid-luteal progesterone, free androgen index, testosterone and SHBG, prolactin, TSH
