Beckman Infertility Flashcards
Infertility affects what % of repro. Age women
15%
Define Infertility
Inability to conceive after 1 year of unprotected frequent intercourse
Fecundability Def.
Probability of achieving pregnancy within 1 menstrual cycle
Fecundity Def.
Probability of achieving a live birth in one menstrual cycle
6 steps of successful conception
1) ovulation of competent oocyte
2) prod. Of competent sperm
3) sperm meets egg in repro. tract
4) generation of viable embryo
5) transport embryo to uterine cavity
6) successful implantation
Distribution (%) of infertility associated with men, women or idiopathic
Men: 20%
Women: 65%
Idiopathic: 15%
Best predictor of ovulation
Regular predictable menses
Progesterone changes the Thermo set point to what during the luteal phase
0.6 F higher than basal body temp
Oocyte release occurs how many days prior to the first temperature spike
1 day
Ovulation occurs how many hours after the LH surge
24 hours
Initial Evaluation of Female Ovulation
H&P
Basal Body Temp charting
Ovulation Predictor kits (Urine LH)
Further Eval of Female Ovulation
Mid luteal phase progesterone
Ultrasonography
Endocrine testing
Female Uterus initial eval
Ultrasound
Female Uterus further eval
Saline infusion sonography
Hysterosalpingography (HSG)
MRI
Hysteroscopy
Fallopian Tubes and Peritoneum initial eval
HSG
Fallopian tubes further eval
Laparoscopy and chromotubation
Male initial eval
Semen analysis
Repeat semen analysis (?)
Postcoital test (not routine)
Male further eval
Genetic testing FSH, LH, T levels Prolactin level Epididymal sperm aspiration Testicular biopsy
Most common cause of ovulatory dysfunction in repro age women
PCOS
Causes of amenorrhea
Prego Hypothalamic dysfunction (stress) Ovarian failure Obstruction of repro tract
When is uterine assessment particularly important
Hx of abnormal bleeding, preg loss, preterm delivery, previous uterine surgery
What day of fertilization during normal pregnancy does the embryo enter the endometrial cavity
Day 5
HSG captures what % of anatomic abnormalities
70%
During semen analysis how is the semen collected
Masturbation 🍻 - after 2-3 days of abstinence
Sperm conc. Of healthy semen
15 million/mL
Sperm production and development takes _____ days
70
Low LH + Oligospermia (<5 million/mL) + normal T = ________
Exogenous steroid use 💉
Most common genetic abnormalities in men
Cystic Fibrosis
Somatic and Sex Chromosome Abnormalities
Micro deletions of Y chromosome
Advanced paternal age ____ rates of ______ mutations
Increased; Autosomal-Dominant
