Female infertility problems Flashcards
What is polycystic ovarian syndrome?
2 out of 3 of:
abnormal cycles
excess androgens: hirstium, acne
polycystic ovaries on USS
What is the management of PCOS?
lose weight stop smoking alcohol rubella immunisation folic acid 400mg
What drugs can be given to help ovulation induction?
Clomifene citrate - stops oestrogen negative feedback
Gonadotrophin injections - stimulates ovaries
Laprascopic ovarian diathermy
What is the link with PCOS and insulin resistance?
insulin acts as a co-gonadotrophin to LH as it lowers your sex binding gloublin levels so increased testosterone levels leads to hyperandrogenism
What are the risks of ovarian induction?
ovarian hyperstimulation -> multiple pregnancies
ovarian cancer
What is premature ovarian failure?
menopause before 40years
What can cause premature ovarian failure?
family history turners syndrome XXgondal agensis fragile X syndrome autoimmune ovarain failure pelvic radiation
What is the treatment for premature ovarian failure?
hormone replacement therapy
egg/embry cryopreservation prior to chemo/radiotherapy if POF is anticipated
What is a hydrosalphinx?
fallopian tube is blocked and fills with serous or clear fluid near the ovary due to a pelvic inflammatory disease
What are the signs of a hydrosalphinx?
abdo/pelvic pain vaginal discharge dysparenuria cervical excitaion menorrhea infertility ectopic pregnancy
What is endometriosis?
presence of endometrial glands outside the uterine cavity
What can cause endometriosis?
retrograde menstruation
altered immune function
abnormal cellular adhesion molecires
genes
What are the signs of endometriosis?
dysmenorrjea dysparenuria menorrhagia painful defecation pelvic pain uterus fixed or retroverted chocolate cysts in ovary infertility
What are the biological signs of premature ovarian failure?
high FSH
high LH
low oestradiol
What are the investigations for infertility?
endocervical swab for chlamidya bloods for rubella test for tubual pregnancy midluteal progesterone level test tubal patency - hysterosalpingiogram or laparoscopy hysteroscopy when endometrial pathology pelvic ultrasound for pelvic abnormality
