Infertility

Question 1

What % of couples are affected by infertility?

Answer 1

15%

Question 2

Out of couples experiencing infertility, what percentage will require complex treatment e.g., assisted conception?

Answer 2

50%

so ~8% of the population assuming 15% were infertile to begin with

Question 3

List 6 reasons why the number of couples struggling with infertility is increasing

Answer 3

• Women are waiting till they are older to conceive
• Rise in chlamydia infections
• Increase in obesity (+PCOS)
• Increase in male infertility
• Increased awareness of treatments
• Change in couples presenting e.g., same sex, transgender

Question 4

At what age does a woman’s fertility start to decline?

Answer 4

28

Question 5

In the population, what is the % chance of spontaneous pregnancy at...
-6 months
-12 months
-24 months
?

Answer 5

• 6 months: 75%
• 12 months: 90%
• 24 months: 92%

Question 6

What is the definition of infertility?

Answer 6

Failure to achieve clinical pregnancy after 12 months + of regular unprotected sexual intercourse in a couple who have never had a child

Question 7

Why is infertility defined after 12 months of trying to conceive?

Answer 7

Because 90% of couples will have been successful by then

Question 8

What is the difference between primary and secondary infertility?

Answer 8

Primary: couple have never conceived

Secondary: couple have previously conceived but may not have been successful e.g., miscarriage, ectopic pregnancy

Question 9

List 7 factors which increase chances of conception

Answer 9

• Woman <28 y/o
• Previous pregnancy (even if miscarriage or ectopic pregnancy, just proves she can get pregnant)
• Trying to conceive for <3 years
• Unprotected sex 2-3x per week, particularly mid-cycle
• Woman’s BMI 18.5 - 30 m/kg^2
• Both partners non-smokers
• No recreational drugs or excessive caffeine

Question 10

List 6 common causes of secondary infertility

Answer 10

• PCOS
• Tubal disease e.g., infection, iatrogenic
• Fibroids (benign fibrous tissue growths)
• Endometriosis/adenomyosis
• Weight-related (obesity, anorexia)
• Age related

Question 11

What is hydrosalpinx?

Answer 11

A fallopian tube that is blocked with a serous fluid at its ovary-end due to injury or infection

Question 12

What are chocolate cysts and what condition are they found in?

Answer 12

Chocolate cysts = endometriomas = a cyst which contains blood and shed tissue from menstruation, found when endometrial tissue grows inside the ovaries

They are found in endometriosis

Question 13

When is an orchidometer used?

Answer 13

During a testicular examination to measure the testicle size

Question 14

Small testes are seen in obstructive/non-obstructive testicular failure

Answer 14

Non-obstructive e.g., Klinefelter’s syndrome