Female Factor Infertility Flashcards
Describe the different catogeries of ovulation disorders
Group 1: Hypothalamic pituitary failure (hypothalamic amenorrhoea of hypogonadotrophic hypogonadism)
Group 2: Hypothalamic - pituitary ovarian dysfunction (predominately polycystic ovary syndrome)
Group 3: Ovarian failure
What is the most common cause of group 1 ovulation disorders and what is the treatment?
Low body weight/excessive exercise = Advice to increase BMI to 19 and/or reducing exercise
Can be offered pulsatile administration of gonadoptrophins
What are the treatment options for women with type 2 ovulatory disorders (Usually PCOS)?
BMI over 30 - lose weight
Clomifene citrate
Metformin
What is the scanning protocol for women taking clomifene citrate and why is this the case?
Ultrasound monitoring during the first cycle of treatment to ensure that they are taking a dose that minimises the risk of multiple pregnancy
How long should clomifene citrate treatment be continued for?
No longer than 6 months
What are the other options for women with type 2 ovulation disorders that have not responded to clomifene citrate?
Laparoscopic ovarian drilling
Combined treatment with clomifene citrate and metformin
Gonadotrophins (not in PCOS due to high risk of OHSS)
What medication can be used for women with hyperprolactinaemia causing amenorrhoea?
Dopamine agonists such as bromocriptine
What should be done for women with hydrosalpinges?
Salpingectomy by laproscopy before IVF treatment
What surgical options are available to women with endometriosis?
Surgical ablation or resection of endometriosis plus laproscopic adhesiolysis (removing adhesions)
What treatment is recommened for women with ovarian endormetriomas?
Laparoscopic cystectomy
