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Em NUT2 Semester 2 > Fertility & Pregnancy > Flashcards

Fertility & Pregnancy Flashcards

1
Q

What is the definition of infertility?

A

Lack of pregnancy

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2
Q

__ in 7 UK couples have difficulty conceiving.

A

1 in 7

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3
Q

List 3 factors involved in a successful conception

A
  • Release of a healthy, non-damaged oocyte
  • Production of sperm with adequate motility, DNA integrity, count and morphology
  • Adequate transport of sperm and egg to the fallopian tubes
  • Penetration of sperm into the oocyte
  • Implantation of the embryo into the healthy uterus lining
  • Normal development of the embryo into a foetus
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4
Q

List 2 structural abnormalities that can affect female fertility

A

Cervical stenosis (narrow/closed cervix)
Uterine septum
Uterine fibroids/polyps
Fallopian tube obstruction
Pelvic inflammation
Endo/Adenomyosis
Ovarian cysts

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5
Q

List 2 hormonal issues that may affect female fertility

A

PCOS
Hyper/hypothyroidism
Amenorrhea
Obesity/insulin resistance
Premature ovarian failure

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6
Q

Which 3 organs are oestrogen and progesterone produced in?

A

Ovaries, adrenals, placenta

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7
Q

List 5 signs/symptoms of oestrogen dominance

A

Fibroids / uterine polyps
Endo/Adenomyosis
PCOS
Heavy bleeding and clotting
Fibrocystic breasts
Tender and swollen breasts
PMS and irritability
Headaches
Shorter menstrual cycles
Poor memory
Brain fog
Hypothyroidism
Hair loss
Insomnia
Fatigue
Mood swings
Gallbladder disease
Swelling and bloating
Miscarriages

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8
Q

List 3 signs/symptoms of progesterone dominance

A

Breast tenderness
Water retention
Bloating
Shortness of breath
Dizziness
Drowsiness / lack of concentration
Sense of physical instability
Long luteal phase
Discomfort or pain in the legs
Decreased libido
Anxiety/panic attacks
Weight gain
Insomnia
Light periods

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9
Q

List 3 ways in which you can optimise oestrogen/progesterone ratio

A

Reduce stress
Optimise liver function
Avoid endocrine disruptors
Avoid alcohol
Reduce body weight if obese
Optimise digestion and elimination
Herbs (e.g., Vitex Agnus Castus)

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10
Q

List 2 immunological factors that may cause foetal rejection.

A
  • Tissue type incompatibility (negative maternal response to paternal HLA proteins)
  • Blood clotting defects
  • High uterine NK cells
  • Autoimmunity (immune system rejects the embryo)
  • Anti-sperm antibodies
  • Thyroid antibodies
  • Ovarian antibodies
  • Antiphospholipid syndrome
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11
Q

LIst 3 things that may affect male fertility

A

Congenital defect of testes / ejaculatory tract
Undescended testes
Testicular cancer
Surgery or injury to testes
Ischaemic damage to testes (i.e, sickle cell anaemia)
Infections (STI’s, mumps)
Hypogonadism (reduced sex hormone production)
Obesity (converts testosterone to oestrogen)
Cushings Syndrome
Diabetes mellitus
Haemochromotosis
Scrotal varicocele (increased temperature)
Acute & chronic illnesses
Medications / drugs / chemotherapy
Recreational drugs, alcohol, cigarettes, caffeine, marajuana
Pesticides / endocrine disruptors
Mobile phones
Heavy metals
Heat exposure
Lubricants
Poor diet
Periodontal disease
Ureaplasma infection
Seminal dysbiosis

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12
Q

Which bacterial species should be most dominant in the vaginal and seminal microbiomes?

A

Lactobacillus

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13
Q

List 3 things that can negatively impact the seminal microbiome

A

Antibiotics
Antifungals
STI’s
Prostatitis
Lubricants
Smoking
Alcohol
Obesity
Poor penile hygiene practices

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14
Q

Cervical fluid is important as a fuel source to feed lactobacilli, as it is rich in _________

A

Glycogen

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15
Q

List 3 things that can negatively impact the vaginal microbiome

A

STI’s
Alcohol
Smoking
Poor vaginal / oral health
Increased blood glucose levels
Copper IUD coil
Low antioxidant vitamin status

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16
Q

List 3 ways in which you can positively impact the vaginal microbiome

A

Reduce infections
Improve blood glucose levels
Improve oestrogen balance
Support lactobacilli growth with pre/probiotics

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17
Q

Why is intensive exercise deleterious for fertility?

A
  • It raises cortisol production, lowering progesterone
  • Excessive endorphin secretion interferes with FSH and LH production
  • Can reduce sperm production
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18
Q

Under stress, the body will prioritise the production of cortisol, leading to reduced __________ production in women.

A

Progesterone

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19
Q

How does stress influence FSH and LH?

A

It down regulates their production

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20
Q

Chromosomal abnormalities, poor embryonic development, implantation failure and miscarriage risk increase with maternal _____

A

Age

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21
Q

What is the C677T polymorphism associated with?

A

Decreased fertility in men

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22
Q

List 4 orthodox fertility tests/investigations

A

Ultrasound scans (for structural abnormalities)
Serum FSH, progesterone, oestrogen
Thyroid function
Glucose levels
Anti-mullerian Hormone
Antral follicle count
Sperm sample
Testing for STIs and other infections

23
Q

What is Anti-Mullerian Hormone (AMH?)

A

A serum protein used as a marker of ovarian reserve.

24
Q

What is an antral follicle count (AFC)?

A

An ultrasound scan to check numbers of follicles in both ovaries

25
Q

What 3 things does an orthodox sperm sample test for?

A

Sperm motility, morphology and semen volume

26
Q

List 3 functional fertility tests/investigations

A

Toxic metal profile
MTHFR and COMT variations
Homocysteine
Adrenal stress profile
RBC minerals
Oxidative stress markers
Immune investigations (NK cells, HLA, etc)
Amino acid testing (serum or urine)
Vaginal ecology (microbiome)
Comprehensive hormone panels
DNA fragmentation (sperm)

27
Q

Increased homocysteine levels can indicate an issue with _____________

A

Methylation

28
Q

Name the 3 assisted reproductive technologies (ART)

A

Intrauterine insemination (IUI)
Intracytoplasmic sperm injection (ICSI)
In vitro fertilisation (IVF)

29
Q

Explain intrauterine insemination (IUI)

A

Sperm is placed inside the uterus around ovulation to facilitate fertilisation

30
Q

Explain Intracytoplasmic sperm injection (ICSI)

A

Sperm is injected into the egg in vitro (if fertility issue is due to sperm abnormalities)

31
Q

Explain In vitro fertilisation (IVF)

A

Stimulation of ovaries, egg retrieval, fertilised in vitro with sperm, fertilised embryos transferred into uterus.

32
Q

List 3 risks of IVF

A

Multiple births
Premature delivery
Low birth weight
Ovarian hyperstimulation syndrome
Egg retrieval procedure complications
Ectopic pregnancy
Cancer (from egg growth stimulation drugs)

33
Q

How long does it take for an egg to prepare for ovulation?

A

About 100 days

34
Q

How long does it take for sperm to mature?

A

72-76 days

35
Q

Preconception preparation should start at least ___ months before planned conception

A

3 months

36
Q

Why are organic eggs included in a fertility diet?

A

Contain cholesterol for sex hormone production and choline for neural development

37
Q

Why do the NHS recommend no more than two portions of fish per week?

A

Mercury toxicity risk

38
Q

Why might it be beneficial to consume organic liver 2 x month when on a fertility diet?

A

High in vitamin A, B, iron, copper, choline

39
Q

Name 2 traditional foods to boost fertility

A

Fish
Eggs
Walnuts
Maca
Fresh figs
Saffron (boosts libido, supports nervous system)

40
Q

List 2 things you might do as part of a natural protocol to support fertility

A
  1. Avoid poor food/lifestyle choices
  2. Eat a broad, whole foods, nourishing diet
  3. Optimise body composition (20-25% body fat)
  4. Reduce stress
  5. Minimise exposure to environmental toxins
  6. Optimise sleep
  7. Mindset work
  8. Supportive holistic therapies
  9. Castor oil packs
41
Q

List 2 herbs that you might use for fertility

A

Vitex agnus castus
Ashwagandha
Shatavari

42
Q

Foetal growth is divided into 3 stages. Name them.

A

Blastogenesis stage (2 weeks)
Embryonic stage
Foetal stage (3 months until term)

43
Q

List 3 foods that should be avoided during pregnancy due to risk of toxins/infection.

A

Pate
Soft & blue cheeses
Raw eggs
Raw fish
Green or sprouting potatoes
Undercooked meat
Soft ice cream and ‘squirty’ fresh cream from dispensers

44
Q

Dehydration in pregnancy can cause miscarriage and premature labour. True or false?

A

True

45
Q

Where might you find toxoplasmosis?

A

Cat faeces
Raw/undercooked meat
Soil left on unwashed fruit and vegetables

46
Q

Why should vitamin A be sourced solely from beta-carotene during pregnancy?

A

Because high dose Vit A in retinol form can be teratogenic.

47
Q

Why should intake of fish oils / DHA & EPA be reduced 4 weeks before the baby’s due date?

A

Because they have an anti-coagulant effect which could be detrimental / dangerous during childbirth

48
Q

Excessive pre-pregnancy weight or excessive weight gain during pregnancy can lead to gut flora changes, predisposing the child to ________

A

Obesity

49
Q

List 3 ways in which you might encourage optimal gut flora in infants

A

Probiotic supplementation during pregnancy
Natural childbirth
Breast feeding
Avoidance of antibiotic use
Pets in the home
Avoidance of hyper clean environment
Outdoor activities

50
Q

List 2 possible contributors to morning sickness

A

Rising hCG levels
High oestrogen
Enhanced sense of smell
Poor nutritional status
Poor blood sugar control

51
Q

Define pre-eclampsia

A

Pregnancy-induced hypertension associated with protein ion urine and oedema

52
Q

List 2 signs/symptoms of pre-eclampsia

A

Water retention
Severe headaches
Vision problems
Pain below ribs

53
Q

What is the fourth trimester?

A

The 12 week period after giving birth

54
Q

What causes postpartum mood instability / anxiety?

A

Huge sudden drop in progesterone
Increase in prolactin

Em NUT2 Semester 2 (9 decks)

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