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HLTH3310 > Fertility and Contraception > Flashcards

Fertility and Contraception Flashcards

1
Q

What is contraception and the types

A
  • Contraceptive: Family planning / birth controlmethods, range of devices, procedures and medications which assist women toprevent pregnancy
  • Hormonal: Chemicals are added to the body, prevent ovulation, change cervical mucus to make it impenetrable to sperm, slow down / kill sperm, reduce of endometrial lining (fertilised egg can’t implant)
  • Barrier: Physical barrier between semen and vagina / uterus
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2
Q

What is the pill

A
  • Oral contraceptive taken daily, at same time to ensure constant hormone levels, contain synthetic estrogen and progesterone, prevents ovulation, thin uterine lining
  • Progesterone (thickens cervical mucus), estrogen (prevents pituitary from releasing LH / FSH, inhibited follicle maturation and no ovulation)
  • Side effects include moodiness, headaches, nausea, blood clots (estrogen), heart attack & stroke
  • Placebo pills cause hormone levels to fall, no negative feedback, follicles mature, after 2 days progesterone levels fall low enough for menstruation to occur
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3
Q

What is the mini pill

A
  • Contains only synthetic progesterone and does not contain estrogen = progestin only pill, pill is taken continuously without any breaks between packets
  • Thickens cervical mucus which prevents passage of sperm into uterus, may prevent ovulation
  • Thins endometrial lining so no implantation, usually no menstruation
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4
Q

What is the morning after pill

A
  • Emergency contraception, can be taken up to 5 days after unprotected intercourse but effectiveness decreases after 24h
  • Same hormones as in birth control pill but higher dosage, high amount of hormone prevents ovulation
  • Will not stop an existing pregnancy
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5
Q

What is the vaginal ring

A
  • Clear soft flexible circular ring inserted in vagina around cervix and left for 3 weeks
  • Releases progestin and estrogen, hormones from ring absorbed through vaginal wall
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6
Q

What is the combined contraceptive patch

A
  • Bandage like hormone patch, changed weekly, no patch in 4th week, releases progestin and estrogen into blood, hormones absorbed through skin
  • Can cause skin irritation less effective in obese people
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7
Q

What are contraceptive implants

A
  • Soft rod placed under skin in upper arm, slow release of hormones into system
  • Prevents pregnancy for >3 years but can be removed any time
  • Risk that implant moves and can be ”lost” in muscle
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8
Q

What is the 3 month shot

A
  • Long acting hormone injection, given every 3 months in muscle of arm or buttocks, not reversible – if rejection occurs hormones cannot be taken out
  • Constant levels of progestin from muscle into blood
  • Can take a long time to get pregnant after one shot
    Side effects include irregular menstrual bleeding or no menstruation
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9
Q

What is the IUD (hormonal)

A
  • > 5 years, plastic T shaped hormone reservoir
  • Releases synthetic progestin, changes cervical mucus
  • Reduced uterine lining, stops or slows sperm and oocyte, can be removed at any time
  • Side effects include missed periods (amenorrhea)/little menstruation, spotting
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10
Q

What is the IUD (copper)

A
  • > 10 years, interferes with sperm, fertilisation and prevents implantation
  • Side effects include heavy or irregular menstruation
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11
Q

What are spermicides

A
  • Chemicals administered to vagina before intercourse (most 10min before)
  • Come in jelly, foam, film
  • Suppository, immobilises/ kill sperm
  • Key ingredient is nonoxynol9
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12
Q

What is the diaphragm

A
  • Soft silicone dome that covers cervix with a flexible rim that holds spermicide
  • Held in place by pelvic muscles
  • Prevent sperm from passing through cervix into uterus
  • Sperm die off quickly in the vagina (spermicide)
  • Needs to be left in for 6h after intercourse, can be used for up to 24 hours
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13
Q

What is the cervical cap

A
  • Similar todiaphragm (smaller)
  • Soft latex or silicone cup holding spermicide
  • Fit cover cervix only
  • Used for up to 42 hours
  • Needs to be left in for 6h after intercourse
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14
Q

What is the female condom / condoms

A
  • F: Soft loose pouch that is inserted in the vagina, prevents sperm from entering uterus, made of nitrile, flexible rings at each end hold it in place, one time use only, can be put in 8h before sex
  • M: Thin covering out of latex or polyurethane, unrolled over erect penis, best method to protect from STIs, incorrect handling can lead to rapture of condom
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15
Q

What is female tube litigation / a vasectomy

A

FTL:
- Permanent
- Fallopian tubes are blocked, clipped or shut to prevent oocyte from getting fertilised or reaching uterus
V:
- Permanent
- Vas deferens is sealed, tied or cut
- Can still ejaculate, no sperm will be present (only seminal fluid)
- Sperm produced but cannot leave testes (eventually deteriorates)
- Testosterone still produced and sex drive normal, male sex characteristics

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16
Q

What is the temperature methods

A
  • Before ovulation, during follicular phase
  • Basal temperatures low, after ovulation, when there is increased progesterone secreted from the corpus luteum, temperatures become elevated
  • Can see difference between pre-ovulation / post-ovulation temperatures when they are plotted on a graph
  • Temperature will drop if fertilisation does not occur
17
Q

What is the calendar methods

A
  • Predicting fertility based on menstrual cycles
  • Prediction of fertile and infertile days based on previous menstrual cycle
  • Abstinence during calculated fertile time
18
Q

What is the withdrawal / pullout method

A
  • Man withdraws penis out of vagina before ejaculation, depends on male self knowledge and self control
  • Pre-ejaculatory fluid can contain sperm
19
Q

How does oral chemical affect plasma concentration

A
  • The pill, with oral intake of chemicals at first spike in plasma drug levels
  • Drug levels in plasma decline over time, drug becomes ineffective at suboptimal plasma concentration
  • Second tablet has to be taken before plasma levels drop to suboptimal levels
  • Decrease in plasma drug concentration determines when next tablet has to be taken
  • Most drugs coated/in capsules & chemically modified -> get reabsorbed slower but also maintain their effective levels longer
  • Companies invest in chemical modifications of drugs to make their administration convenient – e.g. 1 tablet a day (not e.g. 1 every 3.2hours)
20
Q

How do depot chemicals affect plasma concentration

A
  • Vaginal ring, depot chemicals
  • Aim to have therapeutical drug level maintained
  • Aim to avoid toxic levels and high concentrations to avoid side effects
  • Aim to avoid suboptimal/ineffective concentrations, less fluctuation of chemical levels in blood
  • Release high dosages of chemicals more constantly than orally administered ones
21
Q

Talk about male hormonal contraception studies

A
  • Studies started in 1970 and none approved yet, involve intramuscular administration of testosterone enanthate (TE)
  • Causes suppression of spermatogenesis and suppression of sperm concentration to very low levels, azoospermia or severe oligospermia
  • Common side effects include acne, altered libido, night sweats, increased weight, and mood changes
22
Q

Describe different fertility measures and factors influencing

A
  • Crude Birth Rate: Number of livebirthsoccurring among population during a given year,
  • Fertility Rate: Number of children born to women of child bearing age
  • Total Fertility Rate: Number of children a women in a particular population is expected to have based on current birth rates, 2.1 is rate required to achieve a replacement level in population
23
Q

What is infertility

A
  • Inability to conceive after 12 months of having sexual intercourse with average frequency without the use of any form of birth control
  • Significant social and medical problem affecting couples worldwide
  • Average incidence of infertility ~15% globally and unexplained infertility constitutes ~10% of all cases
  • Male and female factors equally responsible for infertility, in~20% combination of female and male factors results in infertility
24
Q

What is inference

A
  • Condition that interferes with ovulation, fertilisation or implantation may result in infertility
25
Q

What are factors influencing fertility

A
  • Education or literacy rates
  • Culture and religion
  • Personal choices
  • Standard of living / wealth
  • Mortality / infant mortality
  • Health issues, political policy and environment
  • Frequency of intercourse
  • Timing of intercourse (sperm viable up to 5 days, oocyte only 1d
  • Infections / nutrition
  • Age of woman (fertility rate decreases ~50% after 40 and miscarriage rate increases, menopause)
  • Age of man (increased age affects coital frequency and sexual function)
  • Toxic substances (lead, pesticides, alcohol, smoking, problematic for sperm count & foetal development)

HLTH3310 (12 decks)

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