Fertilisation

Question 1

Following ovulation, the fimbriae of the fallopian tube sweep of the ovarian surface and pick up the ??? and deposit it in the ???. The ?? of epithelial lining, along with the smooth muscle of the fallopian tube propel the oocyte towards the ????.

A man normally deposits ???? sperm cells into the vagina at the time of ejaculation. Only ??? of these can actually reach the ampulla of the fallopian tube, where fertilization normally occurs. The sperm reach this area within ?? minutes of ejcaulation. The sperm are assisted by contractions of the uterus, cervix and fallopian tubes during female orgasm.

Answer 1

Following ovulation, the fimbriae of the fallopian tube sweep of the ovarian surface and pick up the mature and deposit it in the fallopian tube. The cilia of epithelial lining, along with the smooth muscle of the fallopian tube propel the oocyte towards the uterus.

A man normally deposits 100 million sperm cells into the vagina at the time of ejaculation. Only 50-100 of these can actually reach the ampulla of the fallopian tube, where fertilization normally occurs. The sperm reach this area within 5 minutes of ejcaulation. The sperm are assisted by contractions of the uterus, cervix and fallopian tubes during female orgasm.

Question 2

Sperm mature in the epididymis. However, sperm that are removed from the epididymis are not capable of fertilising the egg until they have undergone further maturation. This process is called ???. This is the process by which spematozoa acquire the ability to penetrate the ???? of the ovum. It is thought the removal or modification of a protective coat from the sperm cell membrane is involved in this process.

The sperm does not need to pass thourgh the uterus for this to occur, as Successful pregnancy can occur with gamete intrafallopian transfer (GIFT), in which spermatozoa and oocytes are placed directly into the ????? of the fallopian tube, and also with direct ????-guided intraperitoneal insemination, in which the sperm are deposited in the peritoneal cavity, near the fimbria

Question 3

Infertility affects what fraction of couples?

Answer 3

1 in 7

Question 4

Define infertility

Answer 4

1 year of unprotected vaginal intercourse in the absence of known causes, in women of reproductive age.

Question 5

Infertility investigation is based around the “Holy triad” of reproductive organs. What are they? In addition, what male component can be added to this?

Answer 5

Ovary

Fallopian tube

Uterus

Sperm!

Question 6

Describe major points you would cover in a history in patient with suspected infertility - this would typically be doing in a GP

Answer 6

• Age of woman > 35 reduces fertility and chance of IVF working
• Parity - number of pgrenanices
  
  • Also check which partners she has been pregant with
• Details of menstrual cycle, length, severity, regular
• Date of last cervical smear
• Past medical history, family history
• Male
  
  • also age
  • occupation
  • trauma to genital region
• Lifestyle factors are really important
  
  • underweight or overweight
  • smoking (On NHS, you have to prove you are not smoking)
  • recreational drugs
  • STIs
  • taxi-driver syndrome - to do with scrotal temperature, sitting down can increase temperature
  • toxins, radiaion
  • tight garments - looser fitting is better

General:

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Question 7

Three main things in fermale for fertilisation to occur.

Working ovary that produce eggs, a uterine tube that is functioning, and a uterus that is receptive to implantation.

Various organs also have a role - name them

Answer 7