Assisted Reproduction

Question 1

What is clomiphene?

Answer 1

medication treating infertility in women who dont ovulate

Question 2

Why is hypothalmic amenorrhea how can it be treated?

Answer 2

menstruation stops for several months due to problem with hypothalamus, clomiphene used to reset ovarian feedback

Question 3

for what other treatment is clomiphene used?

Answer 3

PCOS

Question 4

What primary hormone in pituitary gonadotrophin?

Answer 4

FSH

Question 5

What is in urinary gonadotrophin?

Answer 5

Mix of LH and FSH, recombinant FSH

Question 6

What is a high risk for gonadotrophins?

Answer 6

multiple pregnancies

Question 7

What is hyperprolactinanemia?

Answer 7

elevated serum prolactin, enhances breast development and lactation, treated by dopamine agonists

Question 8

How is IVF carried out?

Answer 8

Natural cycles, monitor LH surge, retrieve ovum laparoscopically, fertalise invitro replace fertilised ovum

Question 9

What are the NICE guidelines?

Answer 9

suitable patients should have 3 cycles of IVF treatment for 50% chance of pregnancy

Question 10

What are the chances of IVF with natural cycles?

Answer 10

Low success rate, high tech, 6-7 cycles for 50% chance

Question 11

What is COH?

Answer 11

involving the use of fertility medications to induce ovulation by multiple ovarian follicles.

Question 12

How does COH work?

Answer 12

Produces multiple eggs, fertilise and produce multiple embryos, freeze spare embryos, achieves higher pregnancy rates and avoids COH syndrome

Question 13

What does COH abolish?

Answer 13

endogenous gonadotrophins with LHRH agonist

Question 14

What does IVF COH do?

Answer 14

Downregulates with LHRH agonist at d21, maintains endometrium

Question 15

For COH what is the risk of hyperstimulation?

Answer 15

over 20 oocytes

Question 16

What should you do at high risk of OH syndrome?

Answer 16

Abondon cycle

Question 17

What should you do at moderate risk of OH syndrome?

Answer 17

Replace embryos in later cycle

Question 18

Who needs IVF?

Answer 18

Diminished ovarian reserve, endometriosis

Question 19

What is the exclusion criteria for IVF?

Answer 19

Age under24, over 40, smoker or partner does, BMI less than 19 over 30, FSH over 10 3x

Question 20

What is the anti mullerian hormone?

Answer 20

Protein hormone of TGF beta family

Question 21

Where is AMH secreted?

Answer 21

within ovary

Question 22

What is AMH secreted by?

Answer 22

small antral and pre anteral follicles in ovary

Question 23

What does AMH inhibit?

Answer 23

Follicular recruitment

Question 24

What is AMH a good marker of?

Answer 24

Ovarian reserve

Question 25

When is AMH elevated?

Answer 25

In PCOS

Question 26

How can artificial insemination be done?

Answer 26

Vaginal, intrauterine, partner, donor, fresh/frozen

Question 27

What happens to artificial insemination?

Answer 27

Quarantined for 3 months - check for infections disease, inseminate on day of LH via intrauterine

Question 28

How is male infertility in oligospermia resolved?

Answer 28

IVF

Question 29

How is male infertility in Azoospermia resolved?

Answer 29

Previous donor, now ICSI

Question 30

What else uses ICSI?

Answer 30

Obstructive azoospermia

Question 31

What does ICSI do?

Answer 31

Used with IVF and guidelines, 60% in private rest in nhs, treats male subfertility

Question 32

What is ICSI?

Answer 32

Intracytoplasmic sperm injection