Fertility Flashcards
What does natural conception rely on?
Functioning hormonal axis and gonads – Ovarian reserve – Regular ovulation – Normal sperm production – Fertilization- egg and sperm interaction – Normal uterine cavity for implantation
What is the WHO definition of infertility?
Clinical definition (WHO)- Inability to conceive over a
12 month period despite exposure to regular ,
unprotected intercourse. Represents a prognosis
based approach and provides practical guidance on
when to initiate investigations.
When should a couple be referred to an infertility clinic?
No conception after one year of regular unprotected intercourse
Known cause for infertility
What are the casues of female fertility?
Ovulatory dysfunction Diminishing ovarian reserve Endometriosis Uterine factor Tubal factor
What erection and ejaculation problems might cause infertility?
Prostate surgery Damage to nerves Ejaculation problems Timing of intercourse Medication
What sperm production problems may cause infertility?
Genetic casues Failure of testes to decend Infections Torsion Varicocele Drugs Radiation Sperm antibodies Heat
What questions should be answered when investigating infertility?
Are eggs avaliable?
Are sprem avaliable?
Any other factor?
What investigations can be used to work out if eggs are avaliable?
Ovarian reserve test: blood test and scan
Blood test: FSH, D1-D5 of cycle
US: antral follicular count
Describe how ovulation diagnosis occurs?
Progesterone levels taken at appropriate time - day 21 only if 28/30 day cycle
– Levels > 20nmol/l show satisfactory ovulation
How to check fallopian tube patency?
Hysterosalpingogram
How to check fallopian tube patency when there is pelvic infection or gynaecological?
Laparoscopic dye test
What are the treatments for a low sperm count?
- Medical treatments- gonadotrophins
– Surgical sperm retrieval- epididymis/testis
– Donor sperm- intrauterine insemination
– ICSI (intracytoplasmic sperm injection)
Describe in-vitro fertilisation
Fertilising egg with sperm outside of the body
When might a donor sperm be used?
Single women
Same sex relationship
Azoospermia(no sperm)
Genetic cause
Infection (HIV, HepB,HepC)
Describe the key steps in the IVF process.
– Controlled ovarian stimulation – Follicular monitoring – Timing ovulation – Egg collection – Lab fertilization-Insemination/ICSI – Incubation/ embryo development – Embryo transfer – Progesterone support
