Infertility Flashcards
Define infertility
- inability to conceive after 12months of regular intercourse without contraception
How often should you advice a couple trying for a child to have intercourse?
- 3 to 4 times per week
Infertility affects____
- 1 in 6 couples
Biggest cause of infertility?
- Womans advancing age
3 main concepts to consider in infertility?
- ovulating
- tubal blockage?
- sperm
Normal menstrual cycle length?
- 28-35 days
the menstrual cycle can be broken into 2 phases?
- follicular phase
- luteal phase
The luteal phase of menstrual cycle lasts?
- 14 days
When should progesterone levels be checked in a female?
- day 21 progesterone
- altered to woman’s cycle - 1 week before end of cycle
Define oligomenorrhoea
- cycle lasting > 35 days
Define amenorrhoea?
- absent menstruation
FSH is responsible for what?
- follicular growth
When is LH surge largest?
- peak prior to ovulation
When is progesterone levels highest?
- luteal phase
In an amenorrhoeric woman what investigations should be conducted?
- FSH, LH, E2
- Testosterone
- prolactin
What infertility investigations may be conducted for a woman?
- transvaginal USS
- Tubal patency assessment - hysterosalpinogram, laparoscopy, hysterscopy
How might tubal patency be assessed?
- hysterosalpinogram
Male infertility assessment?
- diagnostic semen analysis
Lifestyle advice for infertility?
- stop smoking
- BMI 18.5-30
- Reduce alcohol
- folic acid
Define azoospermia?
- no sperm in ejaculation
define asthenozoospermia
- % of motile sperm below reference
define oligozoospermia?
- total number of sperm < reference
define teratozoospermia?
- % of morphologically normal sperm < reference
Biggest cause of anovulation?
- PCOS
Treatment of PCOS?
- Ovulation induction
- clomifene citrate
- gonadotrophic injections
- laparoscopic ovarian diathermy
PCOS diagnostic criteria?
- rotterdam 2/3 criteria
- oligo/ammenhoria
- polycystic ovaries
- signs of hyperandrgoenism
Investigations for male infertility?-
- FSH, LH, Testosterone, prolactin
- karyotype
Assisted reproduction treatments?
- intrauterine insemination (IUI)
- In vitro fertilisation (IVF)
- Intracytoplasmic sperm injection (ICSI)
What marks day 1 of the menstrual cycle?
- menstruation
Oestrogen causes?
- sexual characteristics
- thinner mucus
- promotes fertilisation
Progesterone causes?
- thicker mucus
- thickened endometrium
The corpus luteum initially secretes___?
- progesterone
- will continue until the placenta then secretes
- or if no fertilisation -> corpus albicans
