Human fertility and infertility - management Flashcards
Ovulation disorders? - most common
PCOS
ovulation disorders - lifestyle factors include?
BMI below 30
Healthy life
style, Exercise
Ovulation induction medications (2)
- how many cycles?
- Clomiphene citrate
- Gonadotrophins (direct FSH)
6 or 7
What intervention method can be considered for PCOS patients?
Laparoscopic ovarian drilling
Sperm problem-Very low count or no sperm (azoospermia) - medical treatment
gonadotrophins
Surgical sperm retrieval to help with problems with the?
donor sperm?
epididymis/testis
- Donor sperm- intrauterine insemination
what is the sperm injection called?
ICSI intracytoplasmic
tubal problem?
surgical approach
- employed in a limited manner
- IVF
Other treatments for endometriosis?
Endometriosis-Ablation or resection of spots, adhesiolysis, cystectomy for endometrioma
uterine surgery may be needed for?
removal polyp/fibroid, adhesiolysis for synechiae
Unresolved Infertility - what is the plan?
IVF
Human Fertilisation & Embryology Authority (HFEA) )(5)
Regulatory authority Licensing Inspections Forms - registration, treatment, outcome Register
What is IVF?
fertilise the egg with the sperm outside the body
Eggs in IVF? What will you give to the women
Own eggs-gonadotrophin induced superovulation
Donor eggs - age (poor ovarian reserve)
- poor quality
- ovarian failure
- genetic cause
Sperm in IVF?
partner vs donor sperm
Partner-
Fresh sample on day of egg collection
Frozen sample (thawed)from surgical retrieval or fertility preservation
Single women
Same sex relationship
Azoospermia(no sperm) Genetic cause
Infection (HIV, HepB,HepC
IVF Process-Key steps (8)
Controlled ovarian stimulation Follicular monitoring Timing ovulation Egg collection Lab fertilization-Insemination/ICSI Incubation/ embryo development Embryo transfer Progesterone support
what is Intracytoplasmic Sperm Injection(ICSI) ?
Injection of egg with single sperm
Embryo Transfer Catheter ?
embryo is loaded and transferred into the uterine cavity
Post embryo transfer - what is given and what steps follow? (4)
Progesterone pessaries
Normal activity
Pregnancy test after 2 weeks
If positive- scan at 7 weeks
Risks of IVF? (4)
- Ovarian hyperstimulation syndrome (OHSS) - overproduction of follicles
- Multiple pregnancy - if implant more than 1 embryo
- Medication side effects
- Procedure related
Long term effects to children born? cancers?
Children born- no difference as per short term data.
Risk of ovarian cancer not confirmed
Absolute risk to women and children low.
IVF expansions (7)
- Donor gametes
- Fertility preservation-gamete/embryo cryopreservation
- Ovarian tissue cryopreservation
- Preimplantation genetic diagnosis
- Assisted hatching
- In vitro maturation
- Surrogacy
