CH. 46 Female Infertility Flashcards

1
Q

what is the function of the cervix?

A

to secrete mucus for the mobility of the sperm, and keep pregnancy within the uterus

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2
Q

what would be two indications to evaluate the cervicx with ultrasound?

A
  • pregnancy
  • Hx of miscarriage (incompetent cervix)
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3
Q

what is the normal cervical length?

A

> 3cm

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4
Q

when evaluating the uterus what structures are you assessing?

A
  • structural anatomy of the myometrium
  • endometrium
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5
Q

can you typically see the fallopian tubes?

A

no

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6
Q

how can they evaluate the function of the fallopian tubes?

A

hysterosalpingogram or Saline Infused sonogram (SIS)

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7
Q

list the ovarian phases

A

follicular phase, ovarian phase, and luteal phase

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8
Q

what should the size of a follicle in the follicular phase be?

A

less than 5mm

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9
Q

what size should a dominant follicle be in the ovarian phase?

A

22mm

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10
Q

what size should a corpus lutein cyst be in the luteal phase?

A

2-5mm

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11
Q

what is the sonographic appearance of the dominant follicle?

A
  • round
  • anechoic
  • approx 2.2cm
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12
Q

what is the sonographic appearance of the corpus luteum?

A

small hypoechoic structure peripherally within the ovary that can also be filled with blood and be more echo-filled with a ring of fire

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13
Q

describe PCOS

A
  • inhibits FSH and LH
  • never produces a dominant follicle and doesn’t ovulate like it should
  • have at least 19 small follicles around the periphery of the ovary
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14
Q

list two factors that may cause pain and infertility in the peritoneal cavity

A
  • adhesions
  • endometriosis
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15
Q

describe how you would perform a fertility series of ultrasound.

A
  • make sure follicles are <15mm
  • scan after meds are given and assess growth of follicles and endo thickness. you want follicles to get to >20mm and make sure endo becomes trilaminar
  • monitor every few days and measure follicles
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16
Q

what are the two most common drugs used to stimulate follicles?

A
  • pergonal
  • clomid
17
Q

what can be a consequence of using these fertility drugs?

A

ovarian hyperstimulation syndrome

18
Q

what is ovarian hyperstimulation syndrome (OHS)?

A

where the ovaries produce multiple large cysts that don’t ovulate and ovaries become very enlarged

19
Q

how does OHS appear on ultrasound?

A
  • enlarged ovaries
  • multiple large, anechoic cysts
20
Q

how is insemination performed?

A
  • strong sperm is collected and is placed directly in the uterus with a catheter for fertilization
21
Q

how is IVF performed?

A
  • when there is fertilization of an egg outside the body
  • they aspirate the oocytes, incubate them until fertilization occurs and then the embryos are placed into the uterus
22
Q

where is the embryo placed with traditional IVF?

A

the uterus

23
Q

what does GIFT stand for?

A

gamete intrafallopian transfer

24
Q

where are the sperm and egg placed in GIFT?

A

in the fallopian tube

25
Q

where does fertilization take place in GIFT?

A

in the fallopian tube

26
Q

What does ZIFT stand for?

A

zygote Intrafallopian transfer

27
Q

where are the sperm and egg joined with ZIFT?

A

in a petri dish

28
Q

where is the embryo placed after several days with ZIFT?

A

the fallopian tube

29
Q

list three complications of assisted reproduction

A
  • ovarian hyperstimulation syndrome
  • multiple gestations
  • ectopic pregnancy