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Reproduction Y3 JC > Assisted repro > Flashcards

Assisted repro Flashcards

1
Q

What are some of the indications for intrauterine insemination?

A

For same sex relationships,
Inacapble of sex
BBVs

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2
Q

What are some of the indications for in vitro fertilisation ?

A

Unexplained infertility of >2yrs duration
Pelvic disease (endometriosis, tubal disease, fibroids)
Anovulatory infertility
Failed intra uterine insemination (IUI)

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3
Q

What are some of the indications for intra cytoplasmic sperm injection (ICSI)

A

Male infertility
Previous failed IVF fertilisation
Preimplantation genetic diagnosis

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4
Q

What is the difference between IVF and ICSI

A

In IVF the sperm and the egg are allowed to ‘naturally’ swim and meet and fertilise with eachother

In ICSI a sperm is selected and injected directly into the egg to fertilise it

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5
Q

What are some of the risks of doing ICSI (intra cytoplasmic sperm injection)?

A 
Genetic abnormalities (hypospladias)
Kleinfelter syndrome
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6
Q

What couples are more likely to experience infertility?

A

Increasing parental age
Chlamydia (leading to blocked tubes)
Endometriosis
Ovulatory disorders (polycystic ovarian disease)

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7
Q

What are some of the indications for assisted reproductive treatment

A

Fertility preservation in cancer
Transgender
To avoid BBV between patients
Preimplantation diagnosis of inherited disorders
To treat single and same sex couples
Wanting to use surrogates when have abscent or abnormal uterus

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8
Q

What are some of the criteria requiring to be met before undergoing assited reproductive treatment?

A

Females limit to 4units alcohol/week
BMI 19-29 in both parents
Stop smoking
Folic acid for females 0.4mg for 3months prior but if obese or diabetes then 5mg
Rubella vaccination
Cervical smear normal
Everything else optimal (medications, no BBV, ovarian reserve testing)

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9
Q

What are the risks of ovarian hyperstimulation syndrome?

A

More prone to clots, get ascites, thrombosis

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10
Q

What population group is more likely to get ovarian hyperstimulation syndrome?

A

Low BMI

Polycystic ovarian disease

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11
Q

What is the risk of ectopic pregnancy when using assisted reproductive fertilisation

A

4-8% risk which is 2-3x more than the general population

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12
Q

Man presents with purfuse pus from his urethra, with pain upon peeing. Iikely diagnosis?

A.herpes
B. HPV
C. Syphilis
D. Gonorrhoea

A

GONorrhoea (perfuse pus)

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13
Q 
Chancur occurs at what stage of syphilis?
A. Primary
B. Latent
C. Tertiary
D, secondary
A

Primary

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14
Q 
Which of these infections can result in PID (pelvic inflammatory disase)
A. Syphilis
B. HPV
C. Chlamydia
D. HIV
A

Chlamydia

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15
Q 
This STI is the great imitator
A. Hiv
B. Syphilis
C. HPV
D. Gonorrhoea
A

Syphilis

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16
Q 
The vaccine for HPV is recommended in HIV negative females of which age?
A. 11-13
B. >40
C. 9-26
D. 25-35
A

11-13

17
Q

Viral shedding is higher with which genital herpes simples?
A. Type 1
B. Type 2

A

Type 2

18
Q

What are some of the causes for fetus ‘large for dates’?

A

Wrong date concieved thought

Fetal macrosomia
Polydramnios
Diabetes
Multiple pregnancies

19
Q

What is the diagnostic criteria of foetal macrosomia?

A

Big baby

If estimated foetal weight >90th centile
AC >97th centile

20
Q

At what gestational age does ultrasound have a limit for estimating foetal macrosomia? What else can skew the estimation?

A

Only really reliable <38wks

If mom obese then results skewed

21
Q

Pregnant patient presents with abdominal discomfort, on examination the abdomen is tense and shiny and you cant feel any part of the fetus. She has type 1 diabetes confirmed. An ultrasound is performed which confirms the diagnosis. What is the likley diagnosis?

A

Polydramnios (exessive fluid in the amniotic sac )

22
Q

What is the diagnostic parameters that would diagnose polydramnios

A

Amniotic sac >25cm

OR

> 8CM In any pocket of the sack without the cord.

23
Q

If a diagnosis of polydramnios is made, at what gestational age must pregnancy be induced to avoid complicatoins?

A

Week 40

24
Q

What is considered term for a pregnancy?

A

37 weeks

25
Q

What are some of the possible complications of polydramnios?

A

Cord prolapse in labour, post partum haemorrhage

26
Q

A type 1 diabetic presents to you saying she wants to start a family, what advice/medication do you give her?

A

Aim for 48mmoml/l HBA1C

Avoid pregnancy if >86

Give high dose folic acid 5mg for 3 months prior to conception and continue until week 12 of pregnancy
Diabetes can get worse during pregnancy so need to have checks more often withyour eyes.
Stop smoking
Healthy diet

27
Q

In fertility clinics why may you want to measure the progesterone level?

A

As it peaks it signal ovulation

28
Q

When does your progesterone level peak in relation to ovulation

A

7 days prior to expected period to signify corpus luteum formation

It peaks 7 days after ovulation has occured

If >30nmol/l then ovulation

Reproduction Y3 JC (9 decks)

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