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Fertility Problems. Flashcards

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1
Q

Why is the study of human infertility becoming more important?

A

Because infertility rates are rising.

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2
Q

What is the official definition of infertility?

A

12 months of unprotected sex without a pregnancy.

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3
Q

What is the definition of sterility?

A

There is no chance of having children.

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4
Q

If a couple is trying to have a baby and the female is under 44, is it more likely that this couple is sterile or infertile?

A

If the female is under 44 then the couple is more likely to be infertile.

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5
Q

What do most experts estimate that the fertility rate is amongst humans?

A

Around 30 to 50%.

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6
Q

When should couples seek medical advice, if they are not getting pregnant?

A

If they have been trying to have a baby with no result for over a year.

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7
Q

Are there couples that should seek medical advice, if they have been trying to get pregnant for less than a year?

A

Yes.

If the female partner is older than 37.

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8
Q

Women over what age may need help in order to conceive?

A

Over 40.

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9
Q

When should should an individual warn their partner and seek medical advice?

A

If they know that they have a condition that is likely to stop them from having children.

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10
Q

Fertility decreases with what?

A

Age.

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11
Q

Biological causes of infertility are caused by what 2 aspects?

A

The environment and body issues.

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12
Q

What are the 5 most common causes of infertility?

A

Ovulation problems.

Tubal infertility.

Sperm problems.

Unexplained infertility.

Age related factors.

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13
Q

What are the 5 less common causes of infertility?

A

Uterine problems.

Endometriosis.

Previous tubal ligation.

Previous vasectomy.

Immunological problems.

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14
Q

What are the 4 most common causes of infertility in women?

A

40% are ovulatory disfunction.

40% are tubal and pelvic pathology.

10% are unusual problems.

10% are unexplained.

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15
Q

What are the 5 most common causes of infertility in men?

A

Semen disorders.

Testicular failure.

Undescended testicles.

Systemic disease.

Unexplained.

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16
Q

Male problems cause what percentage of infertility in couples?

A

Around 35%.

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17
Q

What are common semen disorders in men?

A

The sperm may not separate properly.

They may be misshapen.

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18
Q

If there is a problem with only 1 hormone for oogenesis, can this lead to infertility in women?

A

Yes, the whole process will stop.

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19
Q

What is an ectopic pregnancy?

A

When the fertilised egg hatches in the oviducts.

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20
Q

What can a hard zona pellucida cause?

A

The sperm may not be able to penetrate it and this results in no fertilisation.

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21
Q

Many ovulatory problems are a result of problems in what gland?

A

The thyroid.

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22
Q

Why is the thyroid so important for ovulation?

A

Because ovulation is under hormonal control and many of these hormones originate in the thyroid.

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23
Q

What is prolactin?

A

A natural contraceptive.

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24
Q

When is prolactin normally produced?

A

When a woman is breast feeding.

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25
Q

What will an overproduction of prolactin cause?

A

It will inhibit oestrogen and progesterone.

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26
Q

What are androgens?

A

Hormones such as testosterone.

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27
Q

If androgens are present in women, what effect will they have?

A

These will disrupt hormone balance and ovulation.

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28
Q

Can stress lead to ovulatory problems?

A

Yes.

Things such as a bad job, or stressful lifestyle can lead to ovulatory problems.

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29
Q

Is stress an under estimated cause of fertility?

A

Yes.

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30
Q

What is aovulation?

A

When some women can not be develop and release a mature egg every month.

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31
Q

What are irregular menstrual cycles?

A

When some women have no menstrual periods for a long time.

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32
Q

How can irregular menstrual cycles be cured?

A

Birth control pill or hormone replacement therapy.

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33
Q

What is polycistronic ovarian syndrome?

A

When the follicles develop but do not ovulate.

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34
Q

How does polycistronic ovarian syndrome affect the ovaries?

A

It causes multiple follicles to develop in the ovaries.

They form a ring around the ovary that stops oocytes being released.

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35
Q

How does polycistronic ovarian syndrome affect hormones?

A

It causes a higher level of testosterone and oestrogens.

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36
Q

Which infertility disease has symptoms that may include excessive hair growth or loss, obesity, diabetes and hypertension?

A

Polycistronic ovarian syndrome.

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37
Q

How can polycistronic ovarian syndrome be cured?

A

By hormone replacement therapy.

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38
Q

What will lead to a decrease in the number of primary oocytes in women?

A

Time.

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39
Q

At age 25 what percentage of women will manage to get pregnant?

A

Around 60%.

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40
Q

At age 45 what percentage of women will manage to get pregnant?

A

Around 2%.

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41
Q

How can older women get primary oocytes?

A

By freezing their eggs or by receiving an egg from a donor.

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42
Q

What are cervical causes of infertility in women?

A

When the sperm cannot get past the cervix.

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43
Q

How can the amount of mucus be a cervical cause of infertility?

A

Inhospitable mucus is when it is too thick and the sperm will not be able to move to the egg.

If there is not enough mucus, then the sperm cannot swim up the cervix.

If the pH of the mucus is wrong.

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44
Q

What is cervical narrowing?

A

Infertility that is cause by a defect of the cervix that the woman is born with.

These defects will not allow the sperm to go past a certain point.

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45
Q

How can sexually transmitted diseases damage the cervix?

A

They can lead to scarring which damages the cervix and stops the sperm from swimming up it.

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46
Q

How can a woman’s immune system cause infertility?

A

it may recognise the sperm as a foreign intruder and kill it.

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47
Q

Immunological problems tend to be associated with what form of infertility?

A

Miscarriages.

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48
Q

What can the embryo secrete that suppresses the female immune system?

A

Early pregnancy factor (EPF).

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49
Q

How does EPF stop the female immune system from killing it?

A

Because the embryo is non self and may be killed by the immune system.

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50
Q

What are uterine polyps?

A

Growths in the uterus.

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51
Q

What can uterine polyps cause to develop?

A

An imperfect uterine endometrium.

52
Q

What will scars within the uterine wall inhibit from developing?

A

The uterine endometrium from growing.

53
Q

What are congenital malformations?

A

When women are born with problems with their uterus.

54
Q

Inadequate developing of the uterine lining is usually associated with what?

A

Improper hormone regulation and is a major cause of uterine problems.

55
Q

What is endometriosis?

A

When the endometrial lining develops in an unusual location.

56
Q

Where can the endometrial lining develop if endometriosis occurs?

A

On the ovary, oviduct or the endometrial surface.

57
Q

Endometriosis occurs in what percentage of women?

A

In 5-10% of women.

30-40% of infertile women have it.

58
Q

Mild cases of endometriosis will cause what?

A

Severe lower abdominal pain and pelvic pain.

Infertility.

Sometimes there are no symptoms.

59
Q

Mild cases of endometriosis can be treated with what?

A

Ovarian stimulation followed by insemination.

60
Q

Severe cases of endometriosis will cause what?

A

Blocked or damaged tubes due to cysts.

Damaged eggs in the ovary.

Decreased quantity and quality of eggs in the ovary.

61
Q

Severe cases of endometriosis can be treated with what?

A

By insemination or IVF.

62
Q

What is tubular Factor Infertility?

A

When both ovarian tubes are completely blocked or only one is blocked by scarring.

63
Q

What can cause the scars that lead to tubular factor infertility?

A

Pelvic surgery or a pelvic infection.

64
Q

What can correct tubular factor infertility?

A

By surgery or in-vitro fertilisation.

65
Q

What is pelvic inflammatory disease?

A

The invasion of the pelvic area by gonorrhoea or chlamydia.

This can permanently scar the inner lining of the tubes.

66
Q

How can blocked ovarian tubes be corrected?

A

By cutting the block out and then stitching the tube back together.

67
Q

What is tubal reversal surgery?

A

When women get their ovarian tubes cut and need this surgery to get it reversed.

68
Q

What is the chance of tubal reversal surgery working?

A

75%.

If it is done within 5 years of the original surgery.

69
Q

What end of the tube needs to be present and undamaged after tubal reversal surgery?

A

The fimbriated end.

70
Q

What 5 conditions must be considered after tubal reversal surgery?

A

Sperm quality of male partners.

Tubal status.

Status of pelvic conditions.

Female age.

Quality and quantity of eggs.

71
Q

What 9 factors often lead to male infertility?

A

Low sperm count.

Abnormal sperm morphology.

Low sperm motility.

Poor quality sperm.

Sometimes cause by a swollen vein in the scrotum called a varicocele.

Stress is also a major cause.

Heating the genitals.

Dugs and alcohol.

Smoking.

72
Q

Males cause what percentage of infertilities in couples?

A

35%

73
Q

What is ICSI (intracytoplasmic sperm injection)?

A

When sperm is injected into the oocyte.

74
Q

What will determine whether the sperm works or not?

A

Whether the sperm can fertilise an egg.

75
Q

What are vasectomy reversals?

A

The re-joining of the vas defron tubes.

Reverse vasectomys tend to be very successful if performed upto 10 years after the vasectomy.

76
Q

What percentage of the causes of male fertility are unknown?

A

20%.

77
Q

What are 10 of the environmental causes of infertility?

A

Coffee.

Cigarettes.

Plastics.

Pesticides.

Alcohol.

Vehicle exhausts.

Chemicals.

Geographic locations.

Food additives.

Phytoestrogens.

78
Q

What occupation is 10 times higher than average for infertility?

A

Farming.

79
Q

Why does farming cause so much infertility?

A

The handling of pesticides and herbicides.

80
Q

What will cause an increase of autoimmune antibodies?

A

Pesticides.

81
Q

What are phytoestrogens?

A

Plant compounds that have oestrogenic properties and can mimic oestrogen.

82
Q

Smoking can lower a mans sperm count by what percentage?

A

13-17%.

83
Q

How can smoking affect sperm?

A

It decreases sperm count and increases the amount of deformed sperm.

84
Q

What percentage of women who are non smokers conceived in their 1st cycle?

A

38% of female non smokers compared to 28% of non smokers.

85
Q

What compounds are released by car exhausts can cause a significant reduction in fertility in animals and were lowered even further when animals were exposed to this compound and lead simultaneously.?

A

BAP.

86
Q

Coffee increases what?

A

Miscarriages.

87
Q

How many cups of coffee do women need to drink per day to to increase the risk of infertility?

A

More than 1 cup of coffee per day and it is higher if they drink more than 3 cups per day.

88
Q

Exposure of women to chemical solvents can increase the chances of what?

A

Spontaneous abortion.

89
Q

Use of what drug in males is linked to abnormal development of embryos?

A

Cocaine.

90
Q

How can cocaine lead to abnormal development of embryos?

A

Cocaine binds to the sperm and finds a way into the embryo.

91
Q

What about drug use will bring about infertility?

A

It is not usually the drug use, but the decreased health that occurs with drug use.

92
Q

How is recycled water leading to infertility?

A

Many of the oestrogen mimicking compounds that are found in birth control pills are not recycled and are passed into the water system.

They are then drunk by people trying to get pregnant.

93
Q

How are oestrogen mimicking compounds in water affecting men?

A

The exposure to oestrogen causes an increase in testicular cancer and low sperm counts.

94
Q

What is usually the 1st step to be taken when a couple is having problems conceiving a child?

A

Artificial insemination.

95
Q

What is artificial insemination?

A

The insertion of sperm into the oviduct.

96
Q

Artificial insemination is effective in what cases?

A

For women under 40 unless they have:

Tubal blockage/damage.

Poor egg quality.

Ovarian failure.

If the problem lies with male infertility.

97
Q

When is AI unlikely to work?

A

In women over 40.

If the man has low sperm count.

98
Q

If AI is unlikely to work, what can couples use?

A

IVF.

99
Q

How does the process of AI work?

A

A female receives hormones that induce ovulation.

Semen is collected from the male and washed/concentrated before being injected into the cervix or uterus.

100
Q

The success of AI is dependent on what 4 factors?

A

The age of the woman.

The method used to cause ovulation.

The quality/numbers of the sperm used.

The duration and cause of infertility.

101
Q

What is in vitro fertilisation?

A

It involves taking eggs from the woman and fertilising them in a petri dish before inserting the fertilised egg back into the uterus.

102
Q

How many days after IVF has taken place in the lab will the egg be inserted into the uterus?

A

3-5 days later.

103
Q

What fertility problems can IVF not cure?

A

Blocked fallopian tubes.

Severe male infertility.

Females over 38.

Reduced ovarian reserve.

Severe endometriosis.

104
Q

Variations in IVF are based on what?

A

Where the fertilisation takes place.

105
Q

What is gamete intrafallopian transfer (GIFT)?

A

When sperm is injected into the oviduct after the oocyte has ovulated.

After this has occurred, fertilisation will occur normally.

106
Q

GIFT is useful in what scenarios?

A

This method bypasses the cervix, therefore if the cervix opening is narrow or the mucus will not let a sperm pass through, then this method will work.

107
Q

What is Zygote intrafallopian transfer (ZIFT)?

A

It involves inserting an externally fertilised egg into the oviduct.

The egg will then travel down the oviduct and be implanted in the uterus.

108
Q

Why do they not transplant the egg directly into uterus directly in ZIFT?

A

Because scientists like to make IVF as natural as possible to reduce the number of retarded IVF babies.

109
Q

What is ICSI (intracytoplasmic sperm injection)?

A

Removing eggs from the woman with a specialised pipette and then fertilising them with a single sperm which is selected using a sharp needle which is used to insert it into the zona pellucida.

The eggs are then checked the next day to make sure that normal fertilisation has occurred.

110
Q

When is ICSI used?

A

When the male has an extremely low sperm count or very poor sperm morphology.

This method can also be used if the woman has a very low number of eggs.

111
Q

What is assisted hatching?

A

Sometimes , the embryo cannot hatch out of the zona pellucida because the embryo is not strong enough to erode the zona pellucida.

To correct this, scientists can remove the egg and then erode the zona peullucida. The embryo will then hatch and be introduced into the uterus for implantation.

112
Q

On what day of embryogenesis does the egg usually hatch out of the zona pellucida?

A

Day 5/6.

113
Q

What does the embryo use to break down the zona pellucida?

A

Tripsin.

114
Q

What doe scientists use to break down the zona pellucida in assisted hatching?

A

An acid like solution.

115
Q

Assisted hatching combined with what has shown higher pregnancy rates than IVF alone?

A

IVF.

116
Q

Can assisted hatching damage the embryo?

A

Yes.

117
Q

What is cryopreservation?

A

It involves removing oocytes and then freezing them for use at a later date. This allows women to bypass the age problem that is associated with infertility.

118
Q

For which group of women is cryopreservation very popular?

A

Women who want to have children later in life.

119
Q

What is a major problem with cryopreservation?

A

It provides extra embryos.

This is good for stem cells as couples will often donate their unused embryos for research rather than discard them.

Other embryos have also been donated to infertile couples.

120
Q

There are also 2x higher incidents of retardation in children born via what methods?

A

via ICSI and IVF as opposed to natural births.

121
Q

A high number of babies born via artificial reproductive therapy have what syndrome?

A

Beckwith-Weidderman syndrome.

122
Q

How does artificial reproductive therapy affect birth weights?

A

There is an excess of low and very low birth weights of children born using artificial methods and some of the children are infertile.

123
Q

What could be the future problem of breeding infertile couples?

A

Infertile genes are being passed on to the next generation, this is bad for evolution and natural selection.

124
Q

How much can hormonal treatments cost?

A

$2000-$5000.

125
Q

What can IVF cycles cost?

A

$6000 and $10,000 and adding ICSI can be another $1000 +.

126
Q

What can it cost to freeze eggs?

A

$3000-$5000.

127
Q

What are the ethical issues with ART?

A

only the rich are able to do ART.

Are we allowed to genetically engineer a child and produce a designer baby.

Should there be a maximum age for conceiving a child?

Some forms of ART have been linked to an increased risk in cancer.

Who owns the embryos, is it the man or the woman?

Developmental Biology. (21 decks)

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