Human Fertility and Infertility - Management Flashcards
What are the 4 key areas for problem based management?
Egg, sperm, tubes and other
What is the non-pharmacological management for ovarian disorders?
Optimise body weight (keep BMI to about 25), healthy life style and exercise
What is the pharmacological management for ovarian disorders?
Ovulation induction - Clomiphene citrate and Gonadotrophins
What is the surgical management for ovarian disorders?
Laparoscopic ovarian drilling - polycystic ovaries
What is the management for sperm problem?
Medical - gonadotrophins
Surgical sperm retrieval - epididymis/ testis
Donor sperm - intrauterine insemination
ICSI - intracytoplasmic sperm injection
What is the management for tubal problem?
Role of surgery is limited to mild tubal disease
IVF
What are the treatment for endometriosis in infertility?
Ablation or resection of spots, adhesiolysis, cystectomy or endometrioma
What is uterine surgery used for?
Removal of polyp/ fibroid, adhesiolysis for synechiae (scar tissue)
What is the management for unresolved infertility?
IVF - in vitro fertilisation
Describe eggs in IVF
Own - gonadotrophin induced superovulation
Donor
Describe sperm collection for IVF
Partner - fresh sample on day of collection or frozen sample from surgical retrieval or fertility preservation
Donor
What are the key steps of IVF process?
Controlled ovarian stimulation
Follicular monitoring
Timing ovulation
Egg collection
Lab fertilisation
Incubation then embryo transfer
Progesterone support
What are the fertilisation techniques in IVF?
Insemination - most common
If low sperm count then ICSI
How long can embryos be frozen for?
About 10 years
Describe post embryo transfer
Progesterone pessaries
Normal activity
Pregnancy test after 2 weeks
If positive then scan at 7 weeks
