Infertility Flashcards

1
Q

Define infertility

A
  • inability to conceive after 12months of regular intercourse without contraception
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2
Q

How often should you advice a couple trying for a child to have intercourse?

A
  • 3 to 4 times per week
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3
Q

Infertility affects____

A
  • 1 in 6 couples
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4
Q

Biggest cause of infertility?

A
  • Womans advancing age
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5
Q

3 main concepts to consider in infertility?

A
  • ovulating
  • tubal blockage?
  • sperm
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6
Q

Normal menstrual cycle length?

A
  • 28-35 days
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7
Q

the menstrual cycle can be broken into 2 phases?

A
  • follicular phase

- luteal phase

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8
Q

The luteal phase of menstrual cycle lasts?

A
  • 14 days
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9
Q

When should progesterone levels be checked in a female?

A
  • day 21 progesterone

- altered to woman’s cycle - 1 week before end of cycle

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10
Q

Define oligomenorrhoea

A
  • cycle lasting > 35 days
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11
Q

Define amenorrhoea?

A
  • absent menstruation
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12
Q

FSH is responsible for what?

A
  • follicular growth
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13
Q

When is LH surge largest?

A
  • peak prior to ovulation
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14
Q

When is progesterone levels highest?

A
  • luteal phase
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15
Q

In an amenorrhoeric woman what investigations should be conducted?

A
  • FSH, LH, E2
  • Testosterone
  • prolactin
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16
Q

What infertility investigations may be conducted for a woman?

A
  • transvaginal USS

- Tubal patency assessment - hysterosalpinogram, laparoscopy, hysterscopy

17
Q

How might tubal patency be assessed?

A
  • hysterosalpinogram
18
Q

Male infertility assessment?

A
  • diagnostic semen analysis
19
Q

Lifestyle advice for infertility?

A
  • stop smoking
  • BMI 18.5-30
  • Reduce alcohol
  • folic acid
20
Q

Define azoospermia?

A
  • no sperm in ejaculation
21
Q

define asthenozoospermia

A
  • % of motile sperm below reference
22
Q

define oligozoospermia?

A
  • total number of sperm < reference
23
Q

define teratozoospermia?

A
  • % of morphologically normal sperm < reference
24
Q

Biggest cause of anovulation?

A
  • PCOS
25
Q

Treatment of PCOS?

A
  • Ovulation induction
  • clomifene citrate
  • gonadotrophic injections
  • laparoscopic ovarian diathermy
26
Q

PCOS diagnostic criteria?

A
  • rotterdam 2/3 criteria
  • oligo/ammenhoria
  • polycystic ovaries
  • signs of hyperandrgoenism
27
Q

Investigations for male infertility?-

A
  • FSH, LH, Testosterone, prolactin

- karyotype

28
Q

Assisted reproduction treatments?

A
  • intrauterine insemination (IUI)
  • In vitro fertilisation (IVF)
  • Intracytoplasmic sperm injection (ICSI)
29
Q

What marks day 1 of the menstrual cycle?

A
  • menstruation
30
Q

Oestrogen causes?

A
  • sexual characteristics
  • thinner mucus
  • promotes fertilisation
31
Q

Progesterone causes?

A
  • thicker mucus

- thickened endometrium

32
Q

The corpus luteum initially secretes___?

A
  • progesterone
  • will continue until the placenta then secretes
  • or if no fertilisation -> corpus albicans