Contraception/Infertility Lectures

Question 1

Most effective form of contraception (less than 1% pregnancy rate)

Answer 1

Long acting reversible contraception (LARC)

Question 2

Where do you put Nexplanon

Answer 2

arm

Question 3

How many IUDs available in US?

Answer 3

4

Paragard
Mirena
Skyla
Liletta

Question 4

Is there hormonal exposure in the copper IUD (paragard)

Answer 4

NO

can last 10 years

Question 5

Side effects of copper IUD

Answer 5

Menses may be heavier with unschedules bleeding

Question 6

Are IUDs that do have hormonal exposure estrogen or progestin?

Answer 6

Progestin

efficacy for these= 3-5 years

Question 7

How is Medroxyprogesterone acetate (Depo) administered?

Answer 7

Injection every 12 weeks

Question 8

Increase risk of breast ca
Increase risk of thrombosis
Increase risk of AMI

Answer 8

risks of estrogen

Question 9

Can you still get pregnant with sterilization

Answer 9

Yes.

Question 10

• inhibits secretion of pituitary gonadotropins via negative feedback mechanism which prevents follicular maturation and ovulation
• alters endometrium (thinning) which may affect implantation by producing unfavorable environment for fertilization
• thickens cervical mucus which inhibits sperm passage/penetration

Answer 10

MOA of hormonal contraception

Question 11

How long must you try to conceive for before the term infertile should be used

Answer 11

12 months women under 35

6 months women over 35

Question 12

How many follicles are girls born with?

Answer 12

1-2 million

300,000 at onset of puberty

Question 13

• Ovulatory disorders (PCOS, lactational amenorrhea, Cushings, CAH, Turners, etc)
• Endometriosis
• Pelvic adhesions
• Tubal blockage
• Hyperprolactinemia
• Other tubal abnormalities

Answer 13

Causes of female infertility

Question 14

Vitals (BMI!!)
General-signs of androgen excess
Neck-thyroid
Breast-galactorrhea
Pelvic exam

Answer 14

Physical exam pieces when examining infertility

Question 15

FSH
TSH
Prolactin
Pelvic ultrasound

Answer 15

Labs that can be looked at when female is infertile

Question 16

Hypothalamic pituitary dz (secondary hypogonadism)
Testicular dz (primary gonadal disorder)
Disorders of sperm transport
Idiopathic

Answer 16

Causes of male infertility

Question 17

measurement of semen volume and pH
microscopy for debris and agglutination
asssessment of sperm concentration, motility, and morphology
sperm leukocyte count
search for immature germ cells

*examined after 2-7 days of abstinence

Answer 17

Semen analysis

Question 18

Drug therapy

Procedures (intrauterine insemination, IUI, or in vitro fertilization, IVF)

Answer 18

Therapeutic interventions for infertility