Infertility Flashcards
What is infertility?
The inability of a couple to conceive after 12 months of regular, unprotected, sex.
What is primary infertility?
A couple has never conceived together - either of the 2 can have children with another partner and still be classed as primary infertility.
What is secondary infertility?
A couple have previously conceived together but cannot fall pregnant again.
What is described as day 1 of the ovulatory cycle?
The first day of bleeding.
What are the 2 phases of the menstrual cycle?
Follicular phase
Luteal phase
Which phase of the menstrual cycle is always a consistent 14 day period?
Luteal phase
How long should a normal period last?
3-8 days
What is oligomenorrhoea?
A menstrual cycle lasting over 35 days.
What is amenorrhoea?
Absence of menstruation
What triggers ovulation?
The LH surge.
This occurs 35 hours before ovulation.
What hormones control the first (follicular) phase of menstruation?
FSH and oestrogen
Which hormone controls the second (luteal) phase of menstruation?
Progesterone
What indicates ovulation is occuring as intended?
Progesterone level at day 21/1 week before period.
Why is rubella vaccination of mother important?
As virus can cross the placenta, attacking the developing baby.
Results in severe abnormalities.
What is azoospermia?
No sperm in semen sample.
What is asthenozoospermia?
Poor semen swimming observed in semen sample.
What is oligozoospermia?
Low sperm number observed in semen sample.
What is teratozoospermia?
Poor sperm morphology in semen sample.
What are the first-line tests for a couple with infertility issues?
Semen analysis
USS of women
How does PCOS appear on USS?
Lots of dark circles - these are follicles. Patient has oversized ovaries.
What is the name of the test used to determine uterine tube patency?
Hysterosalpingogram
What lifestyle advice is recommended in parents attempting to conceive?
Smoking cessation BMI = 18.5-30 Reduce/Stop alcohol consumption Moderate caffeine Cessation of recreational drugs (including methadone) Take folic acid supplementation
What is responsible for 85% of ovulatory problems?
Polycystic ovarian syndrome
What medication is first-line for ovulation induction?
Clomifene citrate
Can also give tamoxifen.
At which stage in the ovulatory cycle should clomifene citrate be taken?
Take for first 5 days.
It is effective in 80% of cases.
What medication is second-line in ovulation induction?
Gonadotrophin injection.
Monitor closely as can have side-effects.
What is third (and last)-line in ovulation induction?
Laparoscopic ovarian diathermy
If semen sample is abnormal, what tests should be performed?
LH/FSH
Testosterone
Prolactin
Genetic testing
What genetic conditions are linked to azoospermia?
Klinefelter’s syndrome
Cystic fibrosis
How is abnormal sperm circumvented to achieve conception?
IVF
How is tubal disease treated?
No treatment.
Try IVF.
How many IVF cycles are funded by the NHS?
3
