Class 11: EP, Infertility, Contraceptives Flashcards
what is the only form of contraception where ultrasound is useful?
IUD
IUDs prevent implantation in the uterus. T/F?
true
2 types of IUD?
- copper T/paragard T380A
- progestasert
how does the paragard IUD work?
releases copper and kills sperm
how does the progestasert IUD work?
releases progesterone, thickens cervical mucous so sperm can’t reach the egg; high progesterone levels can also block ovulation
risks for IUD?
PID
EP
pregnancy with IUD
uterine perforation
U/S appearance of IUD?
echogenic & central in UT
shadowing with entrance & exit echoes
which phase of the menstrual cycle may an IUD not be seen in?
secretory phase
what is infertility?
failure to conceive after 1 year of trying
factors for male infertility (3)
- decreased sperm count or motility
- urethral strictures or STD
- varicoceles
what is a varicocele?
dilated scrotum veins
factors for female infertility? (6)
- older maternal age
- infection
- surgery
- disease
- congenital anomalies
- hormonal imbalance
another name for ovulation induction therapy
assisted reproductive therapy (ART)
purpose of ovulation induction therapy
stimulate the early growth of follicles for harvest
drugs used for ovulation induction therapy
clomid & perganol
what drug may be used to induce ovulation for ovulation induction therapy?
HCG
what are 3 parameters to predict follicular development?
- increased basal body temperature
- watery cervical mucous
- high estrogen levels
4 side effects of ovulation induction therapy?
- multiple pregnancies
- ovarian hyperstimulation syndrome (OHS)
- ectopic pregnancy
- heterotropic pregnancy
what is a heterotropic pregnancy
2 pregnancies with 1 IUP & 1 EP
what is OHS?
when multiple follicles are induced, it may lead to theca lutein cysts (bilateral), enlarged ovaries, and edema of stroma
3 methods of ART?
- in-vitro fertilization with embryonic transfer
- gamete intrafallopian transfer
- zygote intrafallopian transfer
what is the process for IVT-ET
ova & sperm are extracted and fertilized in a test tube, wait for cell division, when morulas become embryos, they’re implanted in the uterine cavity
2 methods of retrieval for IVT-ET
- laparoscopy
- US guided retrieval
what is GIFT?
gamete intrafallopian transfer
sperm & ova are placed in fallopian tube to fertilize
indications to use GIFT?
- endometriosis
- cervical stenosis
- oligospermia
- immunologic infertility
- unexplained infertility for > 2 years
what is ZIFT?
zygote intrafallopian transfer
extract sperm & ova to fertilize in laparscopy dish & wait for zygote
then transfer zygote into fallopian tube
what defines an ectopic pregnancy?
the implantation of ovum outside the endometrial cavity
what is the leading cause of maternal death in 1st trimester?
ectopic pregnancies
most common location for an ectopic pregnancy?
ampulla of fallopian tube
which part of the fallopian tube is the most dangerous for an EP to occur?
interstitial part
5 other locations for an ectopic pregnancy besides FT?
- ovaries
- abdomen
- interligamentous
- cervix
- rudimentary uterine horn
8 causes of ectopic pregnancy?
- any mechanical obstruction in FT
- hx of EP
- PID w salpingitis
- tubal ligation
- FT abnormality
- UT & adnexal masses/adhesions
- IUD
- transmigration
2 types of transmigration?
- internal
- external
what is internal transmigration?
fertilized ovum migrates across the uterus to implant into opposite FT
what is external migration?
fertilization occurs in cul de sac, then fimbrae from opposite FT picks up fertilized ovum & implants in opposite FT
what proves transmigration occured?
seeing corpus luteum cyst on contralateral ovary
are HCG levels higher or lower in an ectopic pregnancy compared to a normal pregnancy?
lower than a normal pregnancy
3 other procedures besides U/S that can detect ectopic pregnancy?
- D&C
- culdocentesis
- laparoscopy
what is the gold standard in detecting EP?
laparoscopy
during D&C, getting chorionic villi indicates ___ pregnancy
intrauterine pregnancy
during D&C, getting only decidual tissue indicates ___ pregnancy
ectopic
which cul de sac is culdocentesis performed?
posterior cul de sac
what does culdocentesis help diagnose?
a ruptured ectopic pregnancy
what drug can help treat an ectopic pregnancy?
methotrexate
methotrexate can be used up to ___ weeks from LMP
6 weeks from LMP
treatment options for tubal pregnancy? (2)
- total salpingectomy
- salpingostomy
2 treatment options for interstitial pregnancy?
- hysterectomy
- wedge resection of uterus
treatment option for abdominal pregnancy?
always surgical
