Exam 3 Lecture 3

Question 1

Clear Blue Fertility Mointor

Answer 1

-typically IDs up to 6 fertile days
detects both LG & estrogen
- very accurate
- for women whose natural cycle lasts 21-42 days
- should be off OCs for at leasr 2 cycles
- use first urine sample in AM

Question 2

fertility scope

Answer 2

• detects estrogen in saliva (peaks on ovulation day)
• uses an optical lens
• requires visual interpretation by user
• can be used in women w/ irregular period
• can be affected by eating, drinking, brushing teeth, smoking

Question 3

first response fertility test

Answer 3

• measures FSH on day 3 of cycle (day 1= 1st day of bleeding)
• urine sample
• tests fertility NOT ovulation
• do not use if taken OCs w/in 60 days

Question 4

First response daily digital ovulation test

Answer 4

• measures LH surge
• similar to clean blue
• urine
• test at the same time every day
• do not urinate for at least 2 hours prior to testing
• easy “yes” or “no” display

Question 5

OvWatch

Answer 5

• wrist, biosensing medical device
• detects transdermal hormone induce Cl ion fluctuations
• CL ions surge indicates fertile window
• most expensive
• notifies pt 4 days before ovulation
• do not use if taking OCs
• begin wearing the 1, 2, or 3rd day of menses

Question 6

ovulation induction

Answer 6

stimulate growth, maturation and ovulation of a single follicle

Question 7

controlled ovarian hyperstimulation

Answer 7

stimulate growth and maturation of multiple follicles

Question 8

clomiphene brand name

Answer 8

Clomid or Serophene

Question 9

clomiphene MOA

Answer 9

• inhibit estrogen binding at hypothalamus & pituitary gland preventing normal - feedback
• incr. in FSH/LH release
• promotes follicular growth & maturation

Question 10

nonsteroidal estrogen receptor blocker

Answer 10

clomiphene

Question 11

clomiphene dosing

Answer 11

50mg PO QD for 5 days, starting on day 2-5

Question 12

aromatase inhibitor

Answer 12

lotrozole (Femoara)

Question 13

Letrozole MOA

Answer 13

• inhibits conversion of testosterone to estradiol

- decrease in estrogen stimulates release of FSH/LH

Question 14

lotrozole dose

Answer 14

205-5mg QD for 5 days starting on day 3

Question 15

monitoring with clomiphene & letrozole

Answer 15

monitor with ovulation prediction kits or ultrasound

Question 16

third line infertility treatment

Answer 16

gonadotropin therapy

Question 17

menotropins

hMG( Repronex, Menopur)

Answer 17

FSH & LH

Question 18

Urofollitropins

HP-FSH (Bravelle)

Answer 18

FSH only

Question 19

Follitropin alpha (Gonal-F), follitropin beta (Follistim AQ)

Answer 19

FSH only

Question 20

Lutropin alpha (Luveris)

Answer 20

LH only

Question 21

storage of gonadotropin therapy

Answer 21

powder can be stored in fridge or RT

Question 22

gonadotropin therapy side effects

Answer 22

• male- breast enlargment
• female- N/V, abd pain, breast tenderness, injection site rxn, HA, hot flashes,ovarian hyperstimulation syndrome, multiple gestations, ectopic prego

Question 23

hCG MOA

Answer 23

supplements LH to mimic LH surge

Question 24

hCG side effects

Answer 24

HA, irritability, restlessness, fatigue, edema, gynecomastia, injection site rxns

Question 25

hCG brand names

Answer 25

``` - urine derived: Pregnyl, novarel choriogonadotropin alpha (r-hCG): ovidrel ```

Question 26

female hCG dosing

Answer 26

5000-1000 units once given 3-4 days after last dose of clomiphene or one day after lst dose of gonadotropins - have sex the day after hCG & for the next 2 days

Question 27

Male hCG dosing

Answer 27

for 2* hypogonadism | - 1000-2000 units TIW until serum testosterone are normal (2-3 months); may add gonadotropin & continue hCG

Question 28

hCG therapy is

Answer 28

additive (combined with something else)

Question 29

hCG storage

Answer 29

- urine-derived: store powder at RT; pt must refrigerate after mixed e-hCG: refrigerate pre-filled syringe prior to dispensing; pt may keep at RT

Question 30

hCG therapy indication

Answer 30

- females: ovulation induction with other agents; correct for lack of mid-cycle gonadotropin surge - male: spermatogenesis in men w/ hypogonadism

Question 31

GnRH nasal spray

Answer 31

synarel (nafarelin)

Question 32

GnRH side effects

Answer 32

stimulation: excessive ovarian stimulation & estrogen synthesis suppression: estrogen deficiency

Question 33

GnRH storage

Answer 33

refrigerate injectables | store nasal spray at RT

Question 34

GnRH indications

Answer 34

- women with anovulation due to GnRH deficiency - PCOS - off label in men to increase sperm count

Question 35

GnRH antagonist MOA

Answer 35

competes with natural GnRH for pituitary receprors-> immediate decrease in pituitary secretion of FSH/LH

Question 36

GnRH antagonist dosing

Answer 36

- antagon: 250microg SC QD on day 8-9 of cycle until hCG administration - cetrotide: single or multiple dosing - should be used with hCG

Question 37

indication of GnRH antagonist therapy

Answer 37

- suppress premature LH surge and premature ovulation during controled ovarian stimulation with menotropins

Question 38

OCs, estrogen and progesterone are used

Answer 38

before fertility treatments to help prepare the uterus

Question 39

DA agonists are used in

Answer 39

hyperprolactinemia

Question 40

metformin used in

Answer 40

PCOS associated insulin resistance