Assisted Reproduction Flashcards
What is clomiphene?
medication treating infertility in women who dont ovulate
Why is hypothalmic amenorrhea how can it be treated?
menstruation stops for several months due to problem with hypothalamus, clomiphene used to reset ovarian feedback
for what other treatment is clomiphene used?
PCOS
What primary hormone in pituitary gonadotrophin?
FSH
What is in urinary gonadotrophin?
Mix of LH and FSH, recombinant FSH
What is a high risk for gonadotrophins?
multiple pregnancies
What is hyperprolactinanemia?
elevated serum prolactin, enhances breast development and lactation, treated by dopamine agonists
How is IVF carried out?
Natural cycles, monitor LH surge, retrieve ovum laparoscopically, fertalise invitro replace fertilised ovum
What are the NICE guidelines?
suitable patients should have 3 cycles of IVF treatment for 50% chance of pregnancy
What are the chances of IVF with natural cycles?
Low success rate, high tech, 6-7 cycles for 50% chance
What is COH?
involving the use of fertility medications to induce ovulation by multiple ovarian follicles.
How does COH work?
Produces multiple eggs, fertilise and produce multiple embryos, freeze spare embryos, achieves higher pregnancy rates and avoids COH syndrome
What does COH abolish?
endogenous gonadotrophins with LHRH agonist
What does IVF COH do?
Downregulates with LHRH agonist at d21, maintains endometrium
For COH what is the risk of hyperstimulation?
over 20 oocytes
What should you do at high risk of OH syndrome?
Abondon cycle
What should you do at moderate risk of OH syndrome?
Replace embryos in later cycle
Who needs IVF?
Diminished ovarian reserve, endometriosis
What is the exclusion criteria for IVF?
Age under24, over 40, smoker or partner does, BMI less than 19 over 30, FSH over 10 3x
What is the anti mullerian hormone?
Protein hormone of TGF beta family
Where is AMH secreted?
within ovary
What is AMH secreted by?
small antral and pre anteral follicles in ovary
What does AMH inhibit?
Follicular recruitment
What is AMH a good marker of?
Ovarian reserve
