Infertility Flashcards
what is infertility?
the failure to achieve a clinical pregnancy after 12 months or more of regular sexual intercourse in a couple who have never had a child
what is primary infertility?
infertility in a couple who have never conceived
what is secondary infertility?
infertility in a couple who have previously conceived but the pregnancy was unsuccessful
who is more likely to be affected by anorexia nervosa?
females
what are the clinical features of anorexia nervosa?
low BMI
hair loss
low pulse + BP
anaemia
what are the endocrine features of anorexia nervosa?
low FSH
low LH
low oestradiol
what is the most common endocrine disorder in women?
PCOS
what exacerbates PCOS?
weight gain
what are five clinical features of PCOS?
obesity hirsutism acne cycle abnormalities infertility
what are the endocrine features of PCOS?
high free androgens
high LH
impaired glucose tolerance
what are the diagnostic criteria for PCOS?
chronic anovulation
polycystic ovaries on USS
hyperandrogenism
when is PCOS diagnosed?
when a patient has 2/3 of the diagnostic criteria
what genetic conditions can cause premature ovarian failure?
turner’s syndrome
fragile X
besides genetics, what are some causes of premature ovarian failure?
idiopathic
chemotherapy
radiotherapy
oophorectomy
how does premature ovarian failure present?
hot flushes
night sweats
atrophic vaginitis
what are the endocrine features of premature ovarian failure?
high FSH
high LH
low oestradiol
what are some infective causes of tubal disease?
pelvic inflammatory disease
transperitoneal spread of infection
what are three non infective causes of tubal disease?
endometriosis
surgery
fibroids
what tubal disease can pelvic inflammatory disease often cause?
hydrosalpinx
what is endometriosis?
the presence of endometrial glands outside the uterine cavity
how does endometriosis present?
dysmenorrhoea
menorrhagia
painful defecation
chronic pelvic pain
what can be seen on scans in endometriosis?
chocolate cysts on the ovary
what are the two types of male infertility?
non obstructive
obstruction
name four causes of non obstructive male infertility
klinefelter’s
chemotherapy
undescended testes
idiopathic
how does non obstructive infertility present?
low testicular volume
reduced secondary sexual characteristics
what are the endocrine features of non obstructive infertility?
high LH
high FSH
low testosterone
name three causes of obstructive infertility
congenital absence of vas
infection
vasectomy
is the vas deferens present in non obstructive infertility?
yes
how does obstructive infertility present?
just as fertility problems
what are the endocrine features of obstructive infertility?
all normal
what midluteal progesterone level suggests ovulation has occured?
over 30
what test is done to determine if uterine tubes are patent?
hysterosalpingogram
