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REPRO > Fertility Management > Flashcards

Fertility Management Flashcards

week 9

1
Q

What are the surgical contraceptive methods?

A

Vasectomy

Tubual ligation

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2
Q

What are the advantages and disadvantages of a vasectomy?

A

Advantages
No sex interruption
Continuous protection

Disadvanatges
3 month wait to be sterile
Expensive
Irreversible
No STI protection

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3
Q

What are the advantages and disadvantages of Tubal ligation

A

Advantages
No sex interruption
Continuous protection
Decreased risk of ovarian cancer

Disadvantages
Expensive
Irreversible
No STI protection

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4
Q

What are the hormonal contraceptive methods?

A

COC (combined)

POC (progesterone only)

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5
Q

What is POC (hormnal contraceptive)

A

Progesterone Only Hormone

thickens cervical mucous

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6
Q

What are the contracindications of POC?

A

stroke

breast cancer

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7
Q

What is COC

A

Combined Estrogen and Progesterone

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8
Q

What is the action of COC?

A

Supresses follicle stimulation, ovulation and CL formation

Thickens cervical mucous

Disrupts oviduct transport and creates hostile endometrium

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9
Q

Adv and disAvd of COC

A

Adv
Works at 3 levels
Decreases risk of ovarian cancer
Regular and lighter menses

DisAdv
Prescription
Daily use
No STI protection
Nausea, breast tenderness and headaches

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10
Q

Contrainindication of COC

A

CV complications

Breast cancer

Postpartum breastfeeding (blocks PRL)

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11
Q

Adv and DisAdv of Condoms

A

Adv
STI protection
Nonprescription

DisAdv
Interrupts sex
Single-use

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12
Q

What is a Diaphragm used for and what are the disadvantages of it?

A

Prevents movement of sperm in female repro tract

DisAdv
Prescription
Requires fitting
Timing

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13
Q

What is spermicide and what are its Adv and DisAvds

A

What
Prevents movement of sperm through female repro tract

Adv
Some STI protection
Nonprescription

DisAdv
Unpleasant for some
Time-sensitive

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14
Q

What is the action of an IUD and what are its Adv and DisAdvs

A

Prevents implantation of blastocyst

Adv
Effective for years
No sex interruption

DisAdv
Prescription
Painful

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15
Q

What are the natural methods for contraception?

A

Withdrawal

Rhythm method

Breast feeding

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16
Q

What are the barrier/chemical contraceptive methods of contraception?

A

Condom
Diaphragm
Spermicide
IUD

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17
Q

Compare the failure rates of the contraceptive methods.

A

Surgical - lowest failure
hormonal = relatively effective
barrier = high failure
natural = least reliable

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18
Q

What hormones can be targeted for male contraception

A

inhibin: suppresses FSH (unsupported Sertoli cells and no ADP)

ABP: -revent sequestration of testosterone to sertoli cells )

FSH:

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19
Q

What precautions must be made when consideration hormonal targets for males

A

Must avoid disrupting endogenous testosterone levels

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20
Q

What techniques of contractception are used before fertilisation?

A

Male
vasectomy
Abstinence
Condom
Coitus Interruptus

Female
COC, monthly injection, vaginal ring
Abstinence
feae condom
tubal ligation
spermicides, diaphragm

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21
Q

What contraceptive methods are used during transport down the male duct?

A

Abstinence (male and female)
condom (male and female)
coitus interruptus

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22
Q

Clinical infertility vs Sterility

A

Clinical infertility = inability to conceive after 12months of freq unprotected intercourse

Sterility = cannot conceive

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23
Q

Fecundability vs fecundity

A

Fecundability = probability of achieving pregnancy in 1 menstrual cycle

Fecundity = Probability of achieving pregnancy resulting in live birth in 1 menstural cycle.

24
Q

What are the (5) main causes of male infertilty?

A

Poor sperm number/motility/ morphology

Tetes and accessory gland dysfunction

Blocked ejaculatory tracts

Retrograde/ neurological ejaculation disorders

Anti-sperm antibodies

25
Q

What are the 5 main causes of female infertility?

A

Ovulation and ovarian failure

Implantation failure

Failed sperm transport

Blocked oviducts

Anti-sperm antibodies

26
Q

What can cause ovulation and ovarian failure?

A

hormone imbalance, PCOS and hypoplasia

26
Q

What can cause implantation failure?

A

Abnormal endometrium, fibroids/polyps and hormone imbalance

27
Q

What can cause failed sperm transport

A

Vaginal avid and abnormal cervical shape

28
Q

What can cause poor sperm number/motility/ morphology?

A

hormone imbalance and hypogonadism

29
Q

What can cause tetes and Accessory gland dysfunction?

A

Cryptorchidism (a condition in which one or both of the testes fail to descend), varicocele (englagement of veins inside scrotum) and drugs/toxins

30
Q

How is the cause of infertility determined?

A

Primary analysis
Hormone assays
Ultrasound
Test tubual patency
Semen analysis
Blood tests

Secondary analysis
Laparoscopy and endoscopy
Endometrial/ testicular biopsy

31
Q

Hormone assays

A

– detects cycying, ovulation and spermatogenesis

32
Q

Ultrasound use in testing infertility

A

presence of follicles or cysts and endometrial thickness

33
Q

What is looked for in a test of tubal patency?

A

blockages and occlusions (hidden or obscured)

34
Q

what is looked for in a semen analysis?

A

number and morphology of sperm

35
Q

What is looked for in a blood test during the primary analysis of infertilty?

A

anti-sperm antibodies

36
Q

What does a laparoscopy or endoscopy in the secondary analysis of infertility look for?

A

Laparoscopy and endoscopy – uterine and oviduct blockage

37
Q

What terms are used to refer to sperm count?

A

Aspermia

Azoospermia

Oligozoospermia

Normospermia

38
Q

Aspermia

A

NO ejaculate

(accessory gland affected)

39
Q

Azoospermia

A

No Sperm

40
Q

Oligozoospermia

A

Less than 15million/ mL

41
Q

Normospermia

A

Greater than 15million/ mL

42
Q

What are the main types of Assistive Repro Technologies?

A

Artificial insemination (AI)

In Vitro Fertilization (IVF)

Intracytoplasmic sperm injections (ICSI)

Zygote intrafallopian transfer (ZIFT)

Gamete intrafallopian transfer (GIFT)

Cryopreservation of sperm, oocytes or embryo

43
Q

Describe Artificial insemination

A

Most motile/functional perm isolated

Intrauterine insemination by catheter

Synchronised with natural or induced ovulation

44
Q

IVF

A

Oocyte retrieved from ovary

Sperm is capacitated

Natural penetration, fusion and fertilization IN VITRO

Embryo cultured in vitro

Blastocyst transferred to uterus

45
Q

Describe the process of intracytiplasmic sperm injections

A

Fertilization incompetent sperm directly injected into oocyte

Injected oocyte is chemically activated with Ca

46
Q

Describe the process of
Zygote intrafallopian transfer (ZIFT)

A

Like IVF however transferred into oviduct

47
Q

Describe the process of
Gamete intrafallopian transfer (GIFT)

A

Oocyte transferred to oviduct to bypass blockage

48
Q

Suggest the best methods for males with:

a) Suboptimal motility or count
b) Very poor motility or count
c) Immotility

A

a- AI

B- IVF

C- ICSI (directly into oocyte)

49
Q

Suggest the best ART methods for females with:
a) Tubual blockage
b) Tubual blockage AND very poor sperm motility/ count

A

a= GIFT

b= IVF or ZIFT

50
Q

Adv and DisAdv of POC

A

Adv
Don’t get the contraindications associated with Estrogen (COC)

DisAdv
prescription
daily use
decreased protection compred to COC

51
Q

When do most make contraception methods occur?

A

BEFORE fertilisation

(women can do after)

52
Q

Why is there a higher risk of having a child with down syndrome in older mothers rather than older fathers?

A

Cohesive proteins keep sister chromatids apart. These weaken with age =
-incorrect microtubule-centromere attachment
-non-disjunction

53
Q

What is the formula for sperm concentration?

A

mean sperm number X square multiplication factor X dilution

Square multiplication factor = 10^4 (large) or 5x10^4 (small)

dilution factor = 2 for a dilution factor of 1/2

54
Q

What is the formula for the total number of ejaculated sperm?

A

= sperm conc x total ejaculate volume

REPRO (14 decks)

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