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Sexual and reproductive health > Contraception > Flashcards

Contraception Flashcards

1
Q

People who are concerned about their fertility should be informed that over 80% of couples in the general population will conceive

A

within a year if woman <40yrs, no contraception and have regular sexual intercourse

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2
Q

what is the cumulative pregnancy rate after 2 years?

A

over 90%

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3
Q

what percent of women aged under 40 years will conceive within 6 cycles of intrauterine insemination?

A

50%

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4
Q

what is the cumulative pregnancy rate in IUI within 12 cycles?

A

75%

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5
Q

male and female fertility decreases with?

A

age

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6
Q

what is the frequency and timing of sexual intercourse?

A

vaginal sexual intercourse every 2 to 3 days

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7
Q

women trying to become pregnant should be informed that drinking no more than?

A

1-2 units of alcohol once or twice per week and avoiding episodes of intoxication

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8
Q

men should be informed that ———- is detrimental to semen quality

A

excessive alcohol

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9
Q

men and women should be advised to avoid?

A

smoking

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10
Q

women who have a BMI of over ——– should be informed that they are likely to take longer to conceive

A

30

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11
Q

men who have a BMI of 30 or over should be informed that are likely to have?

A

reduced fertilty

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12
Q

what is the recommended dose of folic acid supplementation in women intending to become pregnant, before conception and unto 12 weeks gestation?

A

0.4mg

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13
Q

women who are taking anti-epileptic medication or have diabetes what is the dose of folic acid?

A

5mg

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14
Q 
semen analysis should show:
semen volume:
pH; 
Sperm concentration: 
total sperm number: 
total motility (percentage of progressive motility) 
vitality: 
sperm morphology (percentage of normal forms)
A

1.5ml or more
7.2 or more
15 million spermatozoa per ml or more
40% or more motile or 32% or more with progressive motility
58% or more live spermatozoa
4% or more

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15
Q

when do you repeat semen analysis tests?

A

3 months after

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16
Q

total antral follicle count of less than or equal to —– and greater than —— for a high response to predict likely ovarian response to gonadotrophin stimulation in IVF?

A

4 and 16

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17
Q

anti-Müllerian hormone of less than or equal to—— pmol/l for a low response[5] and greater than or equal to ——— pmol/l for a high response to measure ovarian response to gonadotrophin stimulation in IVF

A

5.4, 25

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18
Q

follicle-stimulating hormone greater than ——– IU/l for a low response and less than ———- IU/l for a high response to measure ovarian response to GS in IVF

A

8.9, 4

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19
Q

if cycle is of 28 days then measure serum progesterone level on

A

day 21

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20
Q

if cycle is 35 days long then measure serum progesterone level on

A

day 28

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21
Q

serum progesterone level of 16nm/l

A

repeat, if consistently low refer to specialist

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22
Q

16-30nmol/l progesterone level

A

repeat

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23
Q

what indicates ovulation in regards to serum progesterone level?

A

> 30nmol/l

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24
Q

when do you measure serum progesterone?

A

7 days prior to expected next period

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25
Q

what is the commonest cause of infertility?

A

male factor 30%

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26
Q

which of the following contraceptive do the FSRH recommend should be discontinued after the age of 50 years?

A

depo-provera injections (injectable contraceptives)

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27
Q

delay of return of fertility of up to 1 year for women >40 using which type of contraceptive?

A

deep-provera

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28
Q

non-hormonal methods of contraception <50 years

A

stop contraception after 2 years of amenorrhoea

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29
Q

non hormonal methods of contraception >50

A

stop contraception after 1 year of amenorrhoea

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30
Q

COCP can be continued to —- years

A

50

31
Q

COCP can be switched to non-hormonal or progestegen -only method after —- years?

A

50

32
Q

implant, POP, IUS can be continued beyond —– years

A

50

33
Q

if ammenorrhoeic and using impact, POP, IUS check —– and stop after 1 year if —–>=—-u/; or stop at —– years

A

FSH, FSH, 30, 55 years

34
Q

if not amenorrhoeic and using implant, POP, IUS then consider

A

investigating abnormal bleeding pattern

35
Q

if prescribing HRT then consider —– for additional contraception

A

POP

36
Q

1 missed COCP pill

A

take the last pill (can be two pills in a day), no additional contraception needed

37
Q

if 2 or more pills missed

A

take the last pill even if it means taking two pills in one day and leave out any earlier missed pills and then continue taking pills daily, use condoms or abstain from sex until taken 7 days in a row

38
Q

if more than 2 pills missed in week 1 (days 1-7)

A

emergency contraception should be considered if she had unprotected sex in the pill-free interval or in week 1

39
Q

if 2 or more pills are missed in weeks 2 (days 8-14)

A

after 7 consecutive days of taking the COCP there is no need for emergency contraception

40
Q

if 2 or more pills are missed in week 3 (days 15-21)

A

finish the pills in the her pack and start the new pack the next day (thus omitting the pill free interval)

41
Q

where is the most appropriate place to insert the implant?

A

subnormal, non-dominant arm just overlying the tricep

42
Q

if you can’t find implantable contraceptive?

A

it is radiopaque and therefore easier to locate

43
Q

how does the implantable contraceptive work?

A

main mechanism - preventing ovulation. They also thicken the cervical mucus

44
Q

how long does the implantable contraception take to work?

A

additional contraceptive methods are needed for the 1st seven days if not inserted on day 1-5 of a women’s menstrual cycle

45
Q

what is the main adverse effect of implantable contraception?

A

irregular-heavy bleeding

46
Q

who interacts with efficacy of implantable contraceptive?

A

enzyme inducing drugs such as certain anti-epileptic and rifampicin medication

47
Q

which condition represents an unacceptable risk if implantable contraceptives are to be used?

A

current breast cancer

48
Q

what is an absolute contraindication for someone starting COCP?(3)

A

migraine with aura
breastfeeding <6 weeks postpartum
age 35 smoking 15 cigarettes or more

49
Q

when do you refer to a specialist a couple who has been having regular intercourse for——- months?

A

12 months

50
Q

what is the first line fertility in males?

A

semen analysis

51
Q

what is the first line fertility test in females?

A

mid-luteal progesterone level to confirm ovulation

52
Q

early referral to infertility services in females with the following risk factors? (5)

A 
age above 35 
amenorrhoea 
previous pelvic surgery 
previous STI 
abnormal genital examination
53
Q

early referral to infertility services in males with the following risk factors? (5)

A 
previous surgery on genitalia 
previous STI 
varicocele 
significant systemic illness 
abnorma genital examination
54
Q

the age of consent for sexual activity in the UK is?

A

16 years

55
Q

COCP increased Risk of which cancers?

A

breast and cervical

56
Q

COCP protective against which cancers?

A

ovarian and endometrial cancer

57
Q

Ulipristal may reduce the effectiveness of hormonal contraception. Contraception with the pill, patch or ring should be started, or restarted

A

5 days after having ulipristal

58
Q

levonorgesterol can be taken within —- hours of unprotected sexual intercourse (UPSI)?

A

72hrs, but take as soon as possible as efficacy decreases with time

59
Q

Levonorgestrel mode of action

A

acts both to stop ovulation and inhibit implantation

60
Q

when should levonorgestetrel dose be doubled?

A

for those with a BMI >26 or weight over 70kg

61
Q

ulipristal is a

A

progesterone receptor modulator - inhibits ovulation

62
Q

ulipristal can be taken up to

A

120 hours after intercourse

63
Q

IUD as emergency contraception must be inserted within

A

5 days of UPSI or 5 days after the likely ovulation date

64
Q

how does IUD work as emergency contraceptive?

A

inhibit fertilisation or implantation

65
Q

common adverse effect of POP?

A

irregular bleeding

66
Q

if POP is commenced up to and including day 5 of the cycle it provides

A

immediate contraception otherwise additional contraception should be used for the first 2 days

67
Q

missed POP pills <3 hours

A

continue as normal

68
Q

missed POP pills > 3 hours

A

take missed pill as possible and continue with rest of pack and use extra precautions until pull taking has been re-established for 48 hours

69
Q

for cerazette what period is allowed for missed pills?

A

12 hours

70
Q

injectable contraceptives given every 12 weeks

A

every 12 weeks

71
Q

for a patient with a past history of breast cancer which contraceptive method I best?

A

copper coil

72
Q

postpartum COCP use?

A

after 6 weeks even if breastfeeding

73
Q

what two hormones does the vaginal ring contain?

A

oestrogen and progesterone

Sexual and reproductive health (5 decks)

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