Female Infertility

Question 1

if a woman has normal menstrual cycles, are they likely ovulating?

Answer 1

you betcha

Question 2

name four tests to check for ovulation

Answer 2

midluteal serum progesterone
basal body temp chart
cervical mucus monitoring
urine ovulations predictor kits

Question 3

does temp go up or down with ovulation? why?

Answer 3

up because progesterone makes it bump up

Question 4

what hormone does an ovulation prediction kit test for?

Answer 4

LH surge

Question 5

how is cervical mucus durng the follicular phase?

Answer 5

estrogen makes increase in volume and water content

Question 6

how is cervical mucus during luteal phase?

Answer 6

progesterone makes it more viscous

Question 7

what are two common internal tubal damaging things that can lead to infertility?

Answer 7

chlamydia and gonorrhea infections

Question 8

what is a factor that is external to the follicular tubes that can lead to infetility?

Answer 8

endometriosis

Question 9

what is a developmental abnormality of the uterus that can cause infertility?

Answer 9

septate uterus

Question 10

what are three uterine acquired abnormalities that can lead to infertility?

Answer 10

submucosal leiomyoma
endometrial polyp
intrauterine adhesions

Question 11

what is a submucosal leiomyoma?

Answer 11

fibroid

Question 12

what is intrauterine adhesions?

Answer 12

scar tissue

Question 13

what two medications can be used to stimulate the ovaries?

Answer 13

clomiphene and letrozole

Question 14

what are the three main characteristics for diagnosis of PCOS?

Answer 14

oligo-anovulation/irregular menses
hyperandrogenism
polycystic ovaries on ultrasound

Question 15

what are clinical signs of hyperandrogenism in PCOS?

Answer 15

hirsutism and acne
and
elevated testosterone

Question 16

what two things can be seen in ovary imaging with PCOS?

Answer 16

12 or more follicles or increased ovary volume

Question 17

what is often elevated in PCOS and leads to many fo the changes?

Answer 17

hyperinsulinemia

Question 18

how does hyperinsulinemia change sex hormones?

Answer 18

increases LH, increases ovarian androgen prdxn and lowers sex hormone binding globulin

Question 19

how is the hypothalamus messed up in PCOS? specifically, what happens to LH and FSH levels?

Answer 19

increased LH and decreased FSH

Question 20

what are the four most common associated conditions with PCOS?

Answer 20

insulin resistance
metabolic syndrome
obesity
T2DM

Question 21

what are some random associations with PCOS?

Answer 21

fatty liver
sleep apnea
endometrial cancer
infertility

Question 22

what should be given for insulin resistance in PCOS?

Answer 22

metformin

Question 23

what can be given for cycle regulation in PCOS?

Answer 23

OCPs

Question 24

what can be given for infertility in PCOS?

Answer 24

clomid and letrozole

Question 25

explain three ways that OCPs help PCOS?

Answer 25

lower androgens so decreases hirsutism
regulates cycle
prevents endometrial hyperplasia

Question 26

name four rx options to treat hirsutism in PCOS

Answer 26

OCPs
spiranolactone
finasteride
flutamide

Question 27

what is MoA of spiranolactone to treat hirsutism?

Answer 27

5a reductase inhibitor so blocks androgen receptor and increases sex hormone binding globulin

Question 28

what is role of 5a reductase enzyme in hirsutism?

Answer 28

converts intracellular testosterone to DHT

Question 29

what is MoA of finasteride?

Answer 29

5a reductase inhibitor

Question 30

what is MoA of flutamide?

Answer 30

competitive androgen receptor blocker…blocks T and DHT receptor

Question 31

what commonly happens with PCOS related to weight?

Answer 31

weight gain