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Repro > Contraception and infertility > Flashcards

Contraception and infertility Flashcards

1
Q

What is contraception?

A

Any method to prevent pregnancy

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2
Q

How does contraception work?

A
  • blocks transport of sperm to avoid fertilisation of oocyte
  • disrupts the HPG axis to interfere with ovulation
  • inhibiting implantation of the conceptus into endometrium
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3
Q

Where does the coil sit?

A

sits in the neck of the womb through the internal and external os

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4
Q

What is sub fertility?

A

Failure of conception in a couple having regular, unprotected sex for one year

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5
Q

What is regular sex?

A

2-3 times a week

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6
Q

What is primary infertility?

A

never been pregnant

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7
Q

What is secondary infertility?

A

has been pregnant in the past (including ectopic pregnancy and termination of pregnancy) are struggling to conceive again

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8
Q

What are the main causes of sub fertility?

A
  • male problems (pre-testicular, testicular, post-testicular)
  • ovulatory disorders
  • tubal damage
  • uterine or peritoneal disorders
  • unknown reasons
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9
Q

What are some pre-testicular causes?

A

Endocrine problems affecting the HPG axis - hypothyroidism, diabetes, hyperprolactinoemia, hypothalamus dysfunction

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10
Q

What are some testicular causes?

A

Affecting sperm production and storgae

  • genetic
  • congenital
  • infective
  • antispermatogenic agents
  • vascular
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11
Q

What are the genetic factors causing subfertility?

A

-Kleinfelter syndrome
-Y chromosome deletion
This decreases sperm production

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12
Q

What are the infective causes of subfertilty?

A

STI’s (affect more women)

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13
Q

What vascular causes of sub fertility?

A

testicular torsion and varicoele

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14
Q

What anti spermatogenic agents affect sub fertility?

A

Chemotherapy and drugs

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15
Q

What are the post-testicular causes of sub fertility?

A
  • Obstructive causes like congenital (structure) or vasectomy)
  • Coital problems like ejaculatory failure and erectile dysfunction
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16
Q

What factors affect women with sub fertility?

A

ovulatory disorders, uterine/peritoneal disorders, tubal damage

17
Q

What ovulatory disorders can a woman have?

A
  1. hypothalamic-pituitary failure
  2. hypothalamic-pituitary-ovarian dysfunction
  3. Ovarian failure
18
Q

What cause is most common?

A

hypothalamic-pituitary-ovarian-dysfunction

19
Q

What care uterine and peritoneal disorders affecting sub fertility?

A

Physical reasons why implantation is not possible once fertilisation has occured

  • Uterine fibroids
  • endometirosis
  • PID
  • Ashermans syndrome
  • Abdominal surgery
  • abnormal structure of the uterus from issues of the mullerian ducts incorrectly developing (agenesis)
20
Q

What tubal damage can affect sub fertility?

A
  • cause disruption of the transport of the ovum from the ovary to the uterus
  • endometirosis
  • iatrogenic pelivc surgery
  • chlamydia
  • ectopic pregnancy
21
Q

What investigation are important in men?

A
  • semen analysis
  • hormone levels (LH, FSH, testosterone)
  • ultrasound of testes
  • exclude STI
  • karyotyping
22
Q

What are you looking for in a sememn analysis?

A

sperm motility
sperm count
liquification studies

23
Q

What investigations would you do in women?

A
  • hormones (LH, FSH, progesterone, androgens)
  • blood tests (prolactin and thyroid function)
  • exclude STI
  • Peliv USS
  • tests to check tubal patency
24
Q

How would you determine the potency of fallopian tubes?

A

do a hysterosalpinogram

25
Q

What would a doctor advise a couple who can’t get pregnant?

A
  • stop smoking
  • reduce alcohol
  • reduce stress levels
  • healthy diet and lose weight
  • regualr sex
26
Q

When would you refer a couple to a fertility clinic?

A

A women of reproductive age who has not conceived after 1 year of unprotected vaginal sex in the absence of any known cause of infertility

27
Q

When would you give an early referral to a fertility clinic?

A
  • if the woman is older than 36 yrs

- known clinical cause of infertility

28
Q

What kind of treatment can be given?

A
  • treatments to restore fertility
  • surgical treatments to restore fertility
  • assisted reproduction techniques
29
Q

What treatments can restore fertility?

A
  • GnRH agonist

- drugs to stimulate follicular development and ovulation

30
Q

What surgical treatments can restore fertility?

A

-laproscopy to remove endometriosis and fibroids

31
Q

What is ART?

A

artificial semination / IVF (anything that deals with conception other than vaginal intercourse)

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