In Vitro Fertalization (8)

Question 0

What is unexplained infertility?

Answer 0

Evaluation fails to identify the problem. Occurs in 10-20% of couples.

Question 1

Define infertility:

Answer 1

Inability to conceive within 12 months without contraception.

Question 2

Etiology of male intertility?

Answer 2

1. Low or no sperm count
2. Problems with quality of sperm
3. Motility issues
4. Genetic mutation of sperm

Question 3

Etiology of female intertility?

Answer 3

1. Failure to ovulation regularly or at all
2. Low supply of egg production follicles
3. Blocked or damaged Fallopian tubes
4. Endometriosis
5. Uterine problems

Question 4

Male factors of infertility?

Answer 4

Environmental lifestyle factors (drugs, smoking, pollution, radiation), systemic pathologies (diabetes, cancer, systemic infection), immature/ abnormal spermatozoa, male accessory gland infection

Question 5

female factors of infertility?

Answer 5

Ovarian, uterine, cervical, endocrine dysfunction

Tubal occlusive disease

Genetic abnormalities

Question 6

When does ovarian reserve peak?

Answer 6

Early fetal life (about 20 weeks of gestation)

Question 7

When does fertility begin to decline and when is there a significant decline in fertility?

Answer 7

Begin to decline: age 27

Significant decline: age 35

Question 8

Name four general classes of treatment for infertility?

Answer 8

Ovulation induction, reproductive tract surgery, intrauterine insemination, assisted reproduction

Question 9

What is the long protocol for the HPO axis down regulation and suppression?

Answer 9

GnRH agonists

Question 10

What is the short protocol for the HPO axis down regulation and suppression?

Answer 10

GnRH antagonists

Question 11

What are the different stages of IVF?

Answer 11

1- patient selection

2- HPO down regulation and suppression

3- controlled ovarian hyperstimulation

4- oocyte retrieval

5- preimplantation embryo culture

6- embryo transfer

Question 12

Name 6 ancillary IVF procedures:

Answer 12

1- assisted embryo hatching

2- intra cytoplasmic sperm injection

3- preimplantation genetic diagnosis

4- oocyte and embryo cryopreservation

5- oocyte and embryo donation

6- gestational carriers

Question 13

How do GnRH agonists work to down regulate the HPO axis?

Answer 13

Flare of LH and FSH initially and then the LH and FSH down regulate and desensitize.

Question 14

What does the HCG trigger mimic?

Answer 14

LH surge

Question 15

Name 2 fertilization techniques:

Answer 15

1- standard oocyte insemination

2- intra cytoplasmic sperm injection (ICSI)

Question 16

Generally speaking, when are eggs transferred to the uterus?

Answer 16

Day 3

Question 17

If you are transferring a blastocysts, what day post fertilization will this occur?

Answer 17

Day 5

Question 18

Under a microscope how can you tell if an egg is fertilized?

Answer 18

You can see 2 pronuclei

Question 19

What imaging technique is used to assist with embryo transfer?

Answer 19

Ultrasound

Question 20

For each of the following ages, what is the number of embryos transferred?

40

Answer 20

40: up to 5

Question 21

Name 4 options for excess embryos:

Answer 21

1- freeze embryos

2- donate for research/ stem cells

3- embryo adoption

4- discard

Question 22

What is the limiting factor in frozen embryo transfer?

Answer 22

Age of the eggs

Question 23

Name 5 reasons a person might need a gestational surrogate:

Answer 23

Absent uterus

Anatomically abnormal uterus

Medical contraindications to pregnancy

Recurrent pregnancy wastage& loss

Repeated IVF failures with good embryos

Question 24

Name the clinical indications for use of PGD:

Answer 24

1- single gene defects
2- balanced translocations
3- advanced maternal age
4- repetitive IVF failure
5- recurrent pregnancy loss
6- embryo selection

Question 25

In human cloning, what is inserted into a donor egg that has been anucleared?

Answer 25

Nucleus of cell from individual you are cloning. It is fused into the cell via electricity.