Implantation disorders

Question 1

What 3 characteristics are measured in cleavage stage embryo grading?

Answer 1

cell number, cell size (in accordance with cleavage stage) and degree of fragmentation

Question 2

Is an embryo graded 4,1,2 likely to be implanted?

Answer 2

No

Question 3

If an embryo has a grading 8,4,4 what does this mean?

Answer 3

tip top best embryo 10/10 lets gooo

Question 4

What do grades 1-4 denote in blastocyst grading?

Answer 4

1-4 denote level of expansion (or size of blastocoele)

Question 5

What do A-D denote in blastocyst grading?

Answer 5

A-D is a grading system used for both ICM and trophectoderm. A = primo, D = degrading

Question 6

What factors define repeated implantation failure?

Answer 6

failure to acheive clinical pregnancy after transfer of at least 4 embryos, in at least 3 transfer cycles. Embryos transferred were good quality, and the women were less than 40.

Question 7

what defines failed implantation?

Answer 7

failure to reach a stage in which there is evidence of intra uterine pregnancy (via ultra sound)

Question 8

What type of condition is uterine septa?

Answer 8

congenital endometrial condition

Question 9

What is uterine synechia?

Answer 9

Uterine lining is all joined together

Question 10

What tests can be performed to investigate PCOS?

Answer 10

free androgen and SHBG tests. more than 5.5% free androgen = PCOS

Question 11

What tests can be performed for suspected thyroid issues?

Answer 11

Thyroid peroxidase (TPO) antibody test, TSH in bloodstream

Question 12

What might a positive test for lupus anticoagulant reveal?

Answer 12

abnormal clotting, potential thrombophilia

Question 13

What might a HbAC1 test reveal (glycoslyated heamoglobin test)

Answer 13

diabetes

Question 14

What factors are being investigated during a hysterosalpinography?

Answer 14

uterine, endometrial or tubal factors for implantation failure

Question 15

If a hysterosalpinography indicates tubal issues, what is the next step?

Answer 15

laparoscopy

Question 16

When would a parental karyotype be carried out?

Answer 16

If there is no other known cause for implantation failure, and there are strong indications that there is a genetic problem.. eg previous miscarriage fetus karyotype indicates genetic issue

Question 17

What are the disease characteristics of APS?

Answer 17

vascular thrombosis and / or pregnancy morbidity (repeated miscarriage)

Question 18

What are the three tests performed in suspected APS?

Answer 18

antibodies againts beta-2 glycoprotein, antibodies against cardiolipin, lupus anticoagulant

Question 19

What is the treatment for a woman with APS?

Answer 19

Aspirin daily from first confirmed pregnancy test.

Question 20

When can you aspirate fluid pockets in endometrium?

Answer 20

When the fluid pockets have been identified on the day of egg retrieval, and have a diameter of over 3mm

Question 21

What treatment might be used in the case of endometriosis causing implantation failure?

Answer 21

GnRH analogues

Question 22

What is the limitation to endometriosis implantation failure treatment?

Answer 22

After 3 months it will start to harm fertility