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OB 1 > Chapter 37: Assisted Reproductive Technologies > Flashcards

Chapter 37: Assisted Reproductive Technologies Flashcards

1
Q

the number of follicles measuring 2 to 10 mm early in the ovarian cycle. This count helps assess a woman’s potential for success with fertility treatments. It varies according to a woman’s age and is used to obtain an overall sense of a woman’s reserve relative to her age-matched peers

A

antral follicle count (AFC)

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2
Q

Clinical treatments and laboratory procedures used to establish a pregnancy. This includes treatments in which both eggs and sperm are handled but in general would exclude the treatment if eggs are only stimulated and not retrieved; or if only the sperm are handled.

A

assisted reproductive technologies

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3
Q

Transfer of embryo 5 to 6 days after egg retrieval, 4 to 5 days after fertilization

A

blastocyst (embryo)

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4
Q

transfer of embryo 3 days after egg retrieval, 2 days after fertilization

A

cleavage-stage (embryo) transfer

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5
Q

fertility medication used for controlled ovarian hyperstimulation of a single or multiple follicles

A

clomiphene citrate

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6
Q

process that promotes the development of multiple follicles in the ovary using clomiphene citrate, letrozole, or injectable gonadotropins

A

controlled ovarian hyperstimulation

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7
Q

process, usually using liquid nitrogen, to free embryos or gametes

A

cryopresevation

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8
Q

in vitro fertilized embryo transfer into the uterine cavity at the cleavage or blastocyst stage

A

embryo transfer

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9
Q

primary hormone produced by ovarian follicles in women of childbearing age

A

estradiol

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10
Q

the ability to conceive, have ongoing pregnancy, and produce offspring

A

fecundity

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11
Q

period during which the viability and survivability of both oocytes and sperm are maximum, refers to the 4 to 5 day interval ending on the day after ovulation

A

fertile window

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12
Q

capacity to produce offspring

A

fertility

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13
Q

first half of the ovarian cycle characterized by high levels of circulating follicle-stimulating hormone (FSH), which result in ovarian follicle maturation

A

follicular phase

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14
Q

An ART option rarely used, where the sperm and ova are placed directly in the ampullary portion of the fallopian tube for in vivo fertilization

A

gamete intrafallopian transfer

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15
Q

hormone produced by the trophoblastic cells of the normal developing placenta or by abnormal germ cell tumors, molar pregnancies, and choriocarcinoma

A

Human chorionic gonadotropins

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16
Q

an endovaginal sonogram which allows for the evaluation of the fallopian tubes, uterus, and ovaries by following the course of a saline being instilled from the cervix to the ends of the fallopian tubes. No x-ray is needed

A

Hysterosalpingo contrast sonography

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17
Q

process whereby ova and sperm come into contract outside the body and fuse to form a zygote from extracted ova and sperm in a laboratory setting

A

in vitro fertilization

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18
Q

failure to achieve a pregnancy after 12 months or more of regular, unprotected intercourse. If the woman is under the age of 35. For those women over the age of 35, diagnosed if there is a failure to achieve a pregnancy after 6 months or more, of regular, unprotected intercourse

A

infertility

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19
Q

injection of a single sperm into an ovum

A

intracytoplasmic sperm injectionj

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20
Q

placement of seminal fluid-free sperm through the cervix directly into the uterine cavity

A

intrauterine insemination

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21
Q

fertility medication used for controlled ovarian hyperstimulation of a single or multiple follicle, used instead of clomiphene citrate

A

letrozole

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22
Q

second half of the ovarian phase, when the corpus luteum secretes high levels of progesterone that act on the endometrium

A

luteal phase

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23
Q

first 5 days of the menstrual cycle, characterized by endometrial shedding

A

menstrual phase

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24
Q

excessive response to ovulation induction therapy with some severe cases requiring hospitalization

A

ovarian hyperstimulation syndrome

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25
Q

estimation of a woman’s remaining follicles

A

ovarian reserve

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26
Q

begins with the administration of fertility medications that induce the development of one or more multiple follicles

A

ovulation induction

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27
Q

time just before and after mid cycle during which the endometrium may demonstrate a range of appearances spanning both the proliferative and secretory phases

A

periovulatory period

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28
Q

portion of the menstrual cycle during which endometrial tissue proliferates. It overlaps the menstrual phase and extends through mid-cycle.

A

proliferative phase

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29
Q

portion of the menstrual cycle characterized by an increase in circulating progesterone and during which endometrial tissue is thickest and prepared for embryo implantation

A

secretory phase

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30
Q

less than normal fertility through still capable of achieving pregnancy

A

subfertile

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31
Q

enlarged ovaries with multiple cysts due to abnormally high levels of hcG

A

theca lutein cysts

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32
Q

female factors cause ___ of infertility issues

A

1/3

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33
Q

male factors cause ____ of infertility issues

A

1/3

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34
Q

unexplained infertility issues or a combo between male and female

A

1/3

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35
Q

unknown etiology; hyperechoic/ hypoechoic lesions with shadowing

A

subserosal, intramural, submucosal myoma

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36
Q

congenital anomaly; septum visualized on coronal plane with 3D sonography

A

septate uterus

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37
Q

unknown etiolgy; hyperechoic lesion indenting into endometrial cavity; feeding vessel seen with Doppler; best characterized with saline infusion sonohysterography

A

endometrial polyp

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38
Q

unknown etiology; almost always follows pregnancy loss; absence or discontinuation or endometrial stripe

A

Asherman disease, uterine scarring

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39
Q

blocked or scarred tubes

A

hydrosalpinx or pyosalpinx

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40
Q

scarring around the tubes/ ovaries; infection; prior surgery; echogenic fluid areas surrounding ovary, tubes

A

adhesions

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41
Q

ectopic endometrial tissue; unknown etiology; lesions with low-level internal echoes

A

endometriosis

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42
Q

ovarian hyperandrogenism; unknown etiology; cysts arranged like a string of pearls

A

PCOS

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43
Q

assisted reproductive technology

A

ART

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44
Q

controlled ovarian hyperstimulation

A

COH

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45
Q

embryo transfer

A

ET

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46
Q

gamete intrafallopian transfer

A

GIFT

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47
Q

intracytoplasmic sperm injection

A

ICSI

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48
Q

intrauterine insemination

A

IUC

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49
Q

in vitro fertilization

A

IVF

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50
Q

ovulation induction

A

OI

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51
Q

zygote intrafallopian transfer

A

ZIFT

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52
Q

Gonadotropin-stimulated cycles mean diameter of mature follicles at ovulation

A

16-18 mm

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53
Q

Clomiphene or letrazole stimuated cycles mean diameter of mature follicles at ovulation

A

20-24 mm

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54
Q

Natural cycle mean diameter of mature follicles at ovulation

A

15-25 mm

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55
Q

Infertility impacts ___ in ___ couples.

A

1
8

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56
Q

diagnosis is made when a couple fails to conceive naturally despite 1 year of unprotected intercourse, or in a woman 35 or older that fails to conceive naturally despite 6 months of unprotected intercourse

A

infertility

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57
Q

Most central role of sonography in treatment of infertility

A

monitoring of follicular growth

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58
Q

Zygote develops of __-__ days into a blastocyst that must travel down length of fallopian tube and arrive in uterine cavity __-__ days after fertilization

A

4-5
4-5

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59
Q

The average menstrual cycle is __ days

A

28

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60
Q

produce by hypothalamus; acts on anterior pituitary gland to release FSH; primary follices in ovary begin to grow and mature

A

GnRh

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61
Q

fluid filled cavity that forms within each of a select few primary follicles

A

antrum

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62
Q

Mature follicle turns in ____ follicle

A

Graafian

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63
Q

1st half of menstrual cycle

A

follicular phase

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64
Q

Granulosa cells of the growing ovarian follicle produce the hormone ____

A

estradiol

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65
Q

___ hours after LH and FSH surge, the dominant follicle ruptures and the ovum is expelled from ovarian follicle

A

36

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66
Q

occurs 14 days before beginning of next cycle

A

ovulation

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67
Q

second half of ovarian cycle

A

luteal phase

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68
Q

The ruptured follicle becomes the ______

A

corpus luteum

69
Q

If implantation does not occur, the corpus luteum begins to regress __-__ days after ovulation

A

8-10

70
Q

only structure within the human body that shifts from producing one hormone to another within such a short period of time

A

corpus luteum

71
Q

occurs in endometrial lining of uterus

A

menstrual cycle

72
Q

The menstrual cycle being with :

A

shedding of the old endometrium from previous cycle

73
Q

The endometrium is the thinnest during the ____ phase.

A

menstrual

74
Q

What phase does the endometrium have a triple layer

A

proliferative

75
Q

Sonography appearance of the endometrium during the secretory phase

A

thick and homogenous
hyperechoic double-layered appearance

76
Q

3 stages of follicle development

A

primordial
early growing
antral

77
Q

4-5 days preceding ovulation the dominant follicle grows __-__ mm daily

A

1-2

78
Q

The rise in serum estradiol is directly proportional to growth in diameter of ______

A

single dominant follicle

79
Q

mean diameter of dominant follicle during natural cycle

A

15-25 mm

80
Q
A
81
Q

quantity of eggs that a female has

A

ovarian reserve

82
Q

What is considered a low AFC count?

A

3-4

83
Q

The AFC is most predictive if measured during the _______

A

early follicular phase

84
Q

common etiology of anovulation

A

PCOS

85
Q
A
86
Q

most commonly used diagnostic procedure for evaluating intracavitary lesions

A

saline infusion sonogram

87
Q

physiologic at mid-cycle, extending from cervical os to uterine cavity produced in response to elevated periovulatory level of estradiol

A

cervical mucus

88
Q

_______ can prevent sperm from ascending into uterus

A

cervical factor infertility

89
Q

two layers of endometrium

A

basal
functional

90
Q

Normal reproductive years thickness of endometrium

A

3-16 mm

91
Q

shedding of uterine lining; thin, echogenic interface with myometrium

A

menstrual phase

92
Q

endometrium thickens and fertile window occurs

A

proliferative phase

93
Q

echogenicity and thickness of endometrium increase; homoegenous, hyperechoic, thick, double layer

A

secretory phase

94
Q

What does an endometrial thickness of less than 7 mm indicative of?

A

poor implantation rates in in vitro fertilization

95
Q

allows characterization of intracavitary abnormalities, helps distinguish endometrial lesions from myometrial lesions

A

SIS

96
Q

appear as hyperechoic filling defects; emanated from endometrial layer of uterus

A

polyps

97
Q

arise from myometrial layer, often round in shape

A

myomas

98
Q

2 types of myomas

A

intracavitary
submucosal

99
Q

pillars of linear filling defects within cavity, often connect anterior and posterior aspects of cavity

A

intrauterine synechaie

100
Q

structural mullerian anomaly

A

septate uterus

101
Q

presence of endometrial tissue within myometrium; diffuse or focal form

A

adenomyosis

102
Q

preferred imaging procedure to evaluate tubal patency

A

hysterosalpingogram

103
Q

most common abnormality associated with male infertility

A

varicoceles

104
Q

reduced testicular volume

A

12 mL or less

105
Q

Normal testicular volume

A

15-25 mL

106
Q

classic “bag of worms” appearance of multiple tubular veins superior to testes

A

varicoceles

107
Q

Varicocele diagnosis

A

3 or more veins 3 mm or greater in diameter

108
Q

prewashed sperm placed directly in woman’s uterus at time of ovulation

A

intrauterine insemination

109
Q

preceded by COH and retrieval of ova from mature follicles

A

in vitro fertilization

110
Q

fertilization takes place outside of the body

A

in vitro

111
Q

involves injection of one sperm into cytoplasm of egg

A

intracytoplasmic sperm injection

112
Q

performed within first few days of menstrual flow, determine appearance of uterus and ovaries prior to initiation of stimulation

A

baseline sonogram

113
Q

____ plays central role in process of ART

A

COH

114
Q

use of clomiphene citrate or letrozole

A

ovulation induction

115
Q

goal is to develop a single mature follicle that will ovulate

A

ovulation induction

116
Q

Mean OI mature follicle

A

20-24 mm

117
Q

mean diameter gonadotropin cycle follicles

A

16-18 mm

118
Q

mean diameter CC or L-stimulated cycle follicles

A

20-24 mm

119
Q

Natural ovarian mean diameter cycle follicles

A

15- 25 mm

120
Q

occurs when a sufficient number of follicles reach an optimum size in the hyperstimulated ovaries

A

follicle aspiration

121
Q

transferred either as cleavage-stage embryos 3 days after egg retrieval or as blastocysts 5 or 6 days after egg retrieval

A

embryo transfer

122
Q

visualized by 5 weeks after LMP

A

gestational sac

123
Q

visualized by 5.5 weeks after LMP

A

yolk sac

124
Q

Fetus visualized with heartbeat

A

by 6.5 weeks

125
Q

Fertility patients are usually referred to OB at __-__ weeks

A

10-12

126
Q

Ovaries markedly enlarged ( greater than 10 cm diameter)

A

severe OHSS

127
Q

Infertility is the failure to produce a pregnancy with unprotected intercourse after:

A

12 months

128
Q

Sonographic assessment of the male ____ may help to assess and diagnose infertility in a couple.

A

scrotal anatomy

129
Q

Clomiphene citrate and letrozole are known as:

A

ovulation induction agents

130
Q

Fertilization of one egg by one sperm creates a:

A

zygote

131
Q

What is the fluid-filled cavity that develops within primary follicles and is sonographically visible?

A

antrum

132
Q

The second half of the ovarian cycle is the:

A

luteal phase

133
Q

The endometrium is thinnest during the:

A

menstrual phase

134
Q

The dominant follicle grows approximately ____ daily, in the 4 to 5 days preceding ovulation.

A

1 to 2 mm

135
Q

When determining the antral follicle count (AFC) for an infertility patient, only follicles between ____ are tallied.

A

2 and 10 mm

136
Q

The syndrome associated with irregularly timed menstrual cycles, elevated androgen levels often manifested by increased hair growth, hair loss, and acne is:

A

polycystic ovarian syndrome

137
Q

Normal endometrial thickness varies from ____ through the menstrual cycle during the reproductive years.

A

3 to 16 mm

138
Q

Polyps, myomas, synechaie, retained products of conception, endometrial hyperplasia, and carcinoma can best by viewed by using:

A

SIS

139
Q

Distortion of the uterine cavity, interference of uterine/ endometrial blood flow, and tubal ostia occlusion are mostly related to:

A

submucosal fibroids

140
Q

The preferred imaging method to ensure fallopian tube patency is:

A

HSG

141
Q

The prevailing reason for male infertility is:

A

varicoceles

142
Q

A baseline scan is performed when:

A

within the first few days of menstrual flow

143
Q

Intracytoplasmic sperm injection (ICSI) is:

A

the injection of one sperm into the cytoplasm of one egg

144
Q

For many etiologies of infertility, the first step in treatment is:

A

OI

145
Q

In an embryo transfer procedure, the embryo along with its surrounding culture media appears:

A

echogenic once released from the catheter

146
Q

The stage of an embryo at 2 or 3 days after fertilization is known as:

A

zygote

147
Q

Am embryologist uses a container responsible for moving embryos into the uterine cavity. The container is a:

A

transfer catheter

148
Q

EV sonography is utilized to detect a gestational sac;

A

by 5 weeks after a woman’s last menstrual period

149
Q

Most fertility centers will follow patients through their first trimester with the first sonogram often being scheduled at approximately ___ weeks EGA..

A

6

150
Q

Serious complications of ovarian stimulation techniques used in assisted reproduction are ___ and ____.

A

OHSS
multifetal gestations

151
Q

____ is frequently linked with timed intercourse, intrauterine insemination, or in vitro fertilization embryo transfer

A

COH

152
Q

The normal ovarian/menstrual cycle last ___ days, beginning on the first day of a woman’s menses, and extending to the ___ day of her next menses/

A

28
first

153
Q

Day 14 of the menstrual cycle is usually when _____ occurs.

A

ovulation

154
Q

The corpus luteum begins to degenerate about ____ days after ovulation if fertilization does not occur.

A

8-10

155
Q

A surge in ____ causes the dominant follicle to rupture, at which time the ______ will erupt from the ovary.

A

LH
Graafian follicle

156
Q

The mean diameter of a dominant follicle, at the time of ovulation, is ____ mm.

A

15-25

157
Q

_____ acquisition can provide automated counting of follicles.

A

3D volume

158
Q

A “string of pearls” is associated with ____ and increased ovarian surface area/

A

PCOS

159
Q

The endometrium consists of a _____ layer and a _____ layer.

A

functional
basal

160
Q

IUI is _______

A

intrauterine insemination

161
Q

A cause of female infertility known for uterine scarring and usually related to pregnancy loss showing absence or discontinuation of endometrial stripe is ______

A

Asherman syndrom

162
Q

Sonography of the endometrium is able to assess _____, ____ flow, ______ movements, presence of intracavitary lesions, and the presence of intracavitary fluid.

A

thickness
blood
perstaltic

163
Q

Adenomyosis is the presence of endometrial tissue within the _____.

A

myometrium

164
Q

Semen analysis includes sperm _____, ______, and ______.

A

density
motility
morphology/shape

165
Q

The classic appearance of mutliple tubular veins superior to the testes which can contribute to infertility is described as _____.

A

varicoceles

166
Q

Once follicles are considered to be mature, _____ or ______ is administered to induce ovulation.

A

clomiphene citrate
letrozole

167
Q

An endometrial thickness of less than ___ mm is useful in predicting poor implantation rates in in vitro fertilization cycles.

A

7

168
Q

Varicocele is determined by ___ or more veins measuring ___ mm or greater with or without the Valsalva technique

A

3
3

169
Q
A

OB 1 (16 decks)

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