assisted reproductive techniques Flashcards
when should assisted reproductive techniques be offered ?
when unexplained infertility has been diagnosed , IVF should be offered if pregnancy was not achieved after 2 years of regular unprotected intercourse
what are the most common techniques of assisted reproductive techniques ?
intrauterine insemination ( IUI ) In-vitro fertilization ( IVF) intracytoplasmic sperm injection ( ICSI )
what effect do assisted reproductive techniques have on congenital abnormalities ?
no effect / no increase
what are the mandatory requirements for IUI to occur successfully ?
good semen sample
patent fallopian tubes
what are the steps in the procedure of intrauterine insemination ?
- it is done during a natural cycle or after mild ovarian stimulation
- we use folliculometry to asses the follicles , if it is 18 mm or above that means ovulation is about to happen , which is then stimulated using HCG
- semen sample is processed in the lab and filtered of non-viable spermatozoa
- sample is loaded into a catheter and is introduced into the uterine cavity after speculum examination
for IVF/ICSI what must first be done before controlled ovarian stimluation ?
down regulation
what is the aim of down regulation prior to controlled ovarian stimulation ?
inhibit the release of FSH and ~LH from the pituitary gland to reduce the risk of premature ovulation
how is down regulation achieved ?
GnRH agonist or GnRH antagonist
what are the different ovarian stimulation protocols ?
long agonist protocol
short agonist protocol
Antagonist protocol
what is the long agonist protocol ?
GnRH agonist is started almost 2 weeks before stimulation and continued until the day of ovulation triggering
what is the short agonist protocol ?
GnRH agonist is started simultaneously with stimulation and continued until the day of ovulation triggering
what is the antagonist protocol ?
the GnRH antagonist is started a few days after starting ovarian stimulation and continued until the day of ovulation triggering
what is the maximum dose of gonadotrophins that cannot be exceeded ?
450 IU
if a woman is at higher risk of developing OHSS which of the ovarian stimulation protocols should be used ?
antagonist protocol
what is the aim of ovulation triggering ?
to stimulate the effect of endogenous LH surge that will result in ovulation during a natural menstrual cycle
