Fertility

Question 1

What is the life stages of fertility for women?

Answer 1

Premenarche, fertility (at menarche) and gradual decline in fertility until perimenopause and then menopause

Question 2

What are the life stages of fertility for men?

Answer 2

Preadolescene, puberty and gradual decline in fertility

Question 3

What is adolescence?

Answer 3

Puberty and psychological development.

Question 4

Premenarche

Answer 4

Before first period

Question 5

What is puberty?

Answer 5

Start of ability to procreate with egg release or sperm production

Question 6

What is adrenarche?

Answer 6

Adrenal development toward puberty.

Question 7

What is thelarche?

Answer 7

Breast development to puberty.

Question 8

What is pubarche?

Answer 8

Pubic hair development to puberty.

Question 9

What is menarche?

Answer 9

First menstrual period.

Question 10

What is menopause?

Answer 10

Time of last menstrual bleed being over 12 months.

Question 11

What is clicteric?

Answer 11

Any Period of time before menopause such as 10 years

Question 12

What is perimenopause?

Answer 12

12 months before menopause

Question 13

What cell does FSH act on in males?

Answer 13

Sertolli cells for spermatogenesis.

Question 14

What occurs in preadolescence?

Answer 14

Intermittent very low levels of gonadotrophin hormone is released from the hypothalamus which is immature. Therefore there is no spermatogenesis, no maturation of the ovarian follicle.

Question 15

Which factors affect onsent of menarche?

Answer 15

Body weight, periods of light and darkness, diet and nutrition and socioeconomic class.

Question 16

What weight does adolescent spurt occur?

Answer 16

At 30kg

Question 17

What weight does menarche occur?

Answer 17

At 46kg

Question 18

What is precoscious puberty?

Answer 18

Menarche before 9 years old, which is indicative of cerebral tumour or epiphyseal fusion or congeital adrenal hyperplasia.

Question 19

What is epiphyseal fusion?

Answer 19

Chondrocytes for endochrondral proliferation are exhausted so oestrogen levels induce sensescence of bone growth.

Question 20

What is delayed puberty?

Answer 20

Menarche after 16 years old and is indicative of congenital abnormality affecting gonads, malnutrition or chromosomal abnormality.

Question 21

What is the pattern of development for puberty?

Answer 21

Growth spurt at 11 years old along with Tanner stages 1-4 of breast and pubic hair development at the same time. At 13 years old, menarche with ovulation at 14.

Question 22

What increases the likelihood of pregnancy?

Answer 22

Having unprotected sex frequently- after 12 months, it is 100%.

Question 23

What is subfecund?

Answer 23

When a couple has unprotected sex and after 12 months, they don’t conceive.

Question 24

What decreases pregnancy rate?

Answer 24

Smoking, pathology and higher female age.

Question 25

What is the average length of menstruation?

Answer 25

3-5 days and a 28 day cycle.

Question 26

What is oestradiol production?

Answer 26

Production of oestrogen which occurs in granulosa cells of the ovarian follicle. 95% of this is derived from thecal cells that produce androgens.

Question 27

What affects germ cell depletion?

Answer 27

Smoking that affects gamete production in 30s and maternal smoking that has the greatest impact beginning from initial gamete production.

Question 28

How does the menstrual cycle vary with age?

Answer 28

More anovulation which ends after puberty and a decrease at age 16. More irregular cycles after 20 and more regular cycles from 30 onwarda. These switch in the 40s.

Question 29

What is an anovulatory cycle?

Answer 29

Egg isn’t released during ovulation.

Question 30

How do older oocytes affect pregnancy?

Answer 30

Less likely to fertilise or implant into the ovary, more likely to miscarry or have a child with chromosomal abnormality.

Question 31

What is amanoorhea?

Answer 31

Lack of period.

Question 32

What is POF?

Answer 32

Premature ovarian failure- Occurs in women under 45. Amonorrhea longer than 6 months, high levels of FSH, low oestrogen and anovulation. It may be X linked gene and the ovaries have apoptotic defects unresponsive to hormone stimulation. It is a secondary effect of chemotherapy and hypogonadism.

Question 33

How has age of first pregnancy change?

Answer 33

More women 35+ are having children, less women under 25 having children due to IVF availability.

Question 34

Which menopausal symtpoms are related to oestrogen?

Answer 34

Osteoporosis, increased coronary embolism risk, hot flushes due to vasomotor changes, more menstrual irregularities.

Question 35

Which menopasual symtpoms are unrelated to oestrogen?

Answer 35

Histruitism, mood swings, depression, forgetfulness, inability to concentrate, general wellbeing

Question 36

What is hirsutism?

Answer 36

Development of male associated features such as facial hair growth in females that occurs after menopause.

Question 37

What are the long term effects of menopause?

Answer 37

Osteoporosis., Alzheimer’s and ischaemic heart disease has greater effect with use of HRT.

Question 38

What is the benefits of HRT?

Answer 38

Reduces colon cancer, osteoporosis, relief of menopausal symptoms- cardiac disease in younger.

Question 39

What are the risks of HRT?

Answer 39

Uterine and breast cancer, stroke, ischaemic heart disease in older women and Alzhiemer’s.

Question 40

What are the types of HRT?

Answer 40

Combined with oestrogen and progesterone as a pill, cream or patch- this is to prevent endometrial hyperplasia and cancer. Unopposed oestrogen for women who had hysterectomy.