Contraception & Infertility Flashcards
What is family planning?
directed at helping couples achieve their fertility goals
How is family planning associated with maternal mortality?
- reduces maternal mortality by preventing unplanned pregnancies, spacing births (at least 12 months), and managing pregnancy timing
- lowers risks of complications like preeclampsia, hemorrhage, and infections
What are the functions of Ovulation Suppression Methods?
- Inhibits ovulation (inhibits release of GnRH from the hypothalamus and LH from the pituitary)
- Thickens cervical mucus (blocks sperm entry)
- Causes atrophy of the endometrium (unfavorable for implantation)
- Most hormonal birth control
What are contraindications for Estrogen Use?
- Migraines with aura
- Thromboembolism (h/o DVT or PE)
- HTN (no matter if controlled or uncontrolled)
- Stroke (CVA)
- Myocardial infarction (MI)
- Smoking cigarettes at age of 35 or older.
List Tier 1 Contraceptives.
- Sterilization
- LARC (Long-acting reversible contraceptive)
- IUD (Intrauterine Device)
- Implant
Describe sterilization
Contraceptive
- utilizes either coagulation, silicone rubber bands and/or clips
- most commonly used method
- considered to be permanent
Describe LNG IUD
- Progesterone only
- T-shaped device inserted into uterine cavity
- Small amount of hormone daily to suppress ovulation
- Thickens cervical mucus
- Keeps uterine lining thin
Describe Copper (Paragard) IUD
- Non-hormonal
- T-shaped device inserted into uterine cavity
- Copper damages sperm prior to fertilization
What are benefits of LNG?
- Reduces menstrual blood loss
- Reduces dysmenorrhea
- Suppresses endometrial thickening, thus decreasing risk of endometrial cancer
What are benefits of Paragard IUD?
- Only contraceptive IUD available that contains NO hormones
- Effective immediately after insertion
- Can be used as emergency contraceptive method
Describe Implants.
- Lasts 3 years
- Progesterone only
- Small, flexible rod placed under skin in upper arm
- May cause irregular and unpredictable menses (most common cause of discontinuation)
List Tier 2 Contraceptives.
- Pill
- Patch
- Ring
- Injectable
Describe Combined Oral
Contraceptives (COCs)
Contraceptive
- Contains Estrogen and Progesterone
- 21-24 days of “active” pills, 3-7 days of placebo
- Stabilizes endometrium for less breakthrough bleeding (BTB)
- Reduces risk of endometrial and ovarian cancer
- Does NOT prevent STIs
- Side effects: nausea, BTB, breast tenderness
BTB = breakthrough bleeding
Describe Progesterone Only Pills (POPs)
Contraceptive
- “Mini Pill”
- No estrogen
- Thickens cervical mucus
- Can be used while breastfeeding
- Same time every day!
Describe Patch
Contraceptive
- Estrogen + Progesterone
- 1 transdermal patch per week
- Must alternate sites (upper body, lower abdomen, buttocks), avoid breast/chest)
Describe NuvaRing
- Estrogen + Progesterone
- Inserted once a month, self administered, into vaginal canal
- Stays 3 weeks then removed for 1, can be continuous
- Suppresses ovulation
- Has local effect
- Discrete, easy, can improve vaginal flora
Describe Emergency Contraception.
- Can be either pills or IUD (Plan B or Ella)
- Used after unprotected sex or if method failed (broken condom)
- May be used up to 5 days after unprotected sex, sooner taken the better
Describe Injectables.
- Progesterone only
- IM injection every 3 months or 12 weeks
- May delay return to fertility (6-12mo)
List Tier 3 Contraceptives.
Barrier methods:
- Condoms
- Spermicide
- Diaphragm
- Sponge, Cervical Caps
Describe Condoms.
- Can breakdown with heat and age, can cause allergy
- Only method to prevent pregnancy AND reduce risk of STI
List Tier 4 Contraceptives.
- Lactational amenorrhea
- Cervical mucus
- Basal body temperature
- Calendar
- Withdraw penis before ejaculation
Describe Lactational
Amenorrhea
Contraceptive
- Temporary for new moms
- Must meet these conditions:
- Before bleeding has returned
- Required exclusive breastfeeding day and night
- Baby is less than 6 months old
What is infertility?
prolonged time to conceive
What are Female Factors Associated with Infertility?
- Hormonal and ovulatory factors
- Tubal and peritoneal factors
- Uterine factors
- Developmental anomalies
- Endometritis
- Vaginal-cervical factors
What are Male Factors Associated with Infertility?
- Undescended testes
- Hypospadias
- Varicocele (varicose vein of the scrotum)
- Low testosterone levels
- Azoospermia: no sperm cells produced
- Oligospermia: few sperm cells produced
List Assisted Reproductive Therapy
(ART)
- Intrauterine Insemination (IUI)
- In Vitro Fertilization–Embryo Transfer (IVF-ET)
- Gamete or zygote intrafallopian transfer (GIFT/ZIFT)
- Oocyte, Sperm, Embryo Donation
- Surrogate Embryo host
IUI - Sperm is placed directly into the uterus
IVF-ET - eggs are harvested from a woman’s ovaries and fertilized with sperm in a laboratory dish
G/ZIFT - Both eggs and sperm are placed directly into the woman’s fallopian tubes
