Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Gynaecology > Infertility > Flashcards

Infertility Flashcards

1
Q

What percentage of couples will conceive within a year of regular unprotected sex?

<40 woman

A

85%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When should you start investigations for infertility?

A

12 months of regular unprotected
Intercourse

6 months if woman >35

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Oocytes at puberty and menopause

A

400,000 at puberty

<1000 at menopause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Causes of infertility

A 
Sperm problems (30%)
Ovulation problems (25%)
Tubal problems (15%)
Uterine problems (10%)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

General lifestyle advice for couples trying to get pregnant

A

400mcg folic acid daily
Aim for healthy BMI
Avoid smoking and drinking excessive alcohol
Reduce stress as this may negatively affect libido
Intercourse every 2-3 days
Avoid timing intercourse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Causes of anovulation

A

PCOS
Weight-related <18, >30
Ovarian failure
Hyperprolactinaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Tubal disease causing infertility

A

PID
Pelvic surgery
Endometriosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Female history for infertility

A 
Age
Duration, type of infertility
Menstrual cycle 
Tubal surgery/ PID
Menorrhagia, dysmenorrhea, pelvic pain
Pelvic surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Examination of female factor infertility

A 
BMI
Body hair distribution 
Galactorrhea
Secondary sexual characteristics 
Bimanual pelvic examination
Adhesion or masses
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

When should LH, FSH be measured?

A

Day 2

Follicular phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

When should progesterone be measured?

A

D12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Investigations for female factor infertility

A 
Follicular phase
Luteal phase
Rubella states
Tests of tubal patency: hysterosapingography 
Chlamydia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Male history for infertility

A 
General health
Alcohol/smoking
Previous surgery 
Previous infections
Sexual dysfunction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Male factor infertility examination

A 
Examination not essential 
Scrotum- varicocele
Testicular size
Testicular position: torsion
Prostate for chronic infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Semen analysis

A
  • Semen analysis x2 (3 months)
    • Semen volume 1.5ml or more
    • PH 7.2 or more
    • Sperm concentration: 15million/ ml
    • Total number: >39/ ejaculate
    • Total motility: 40% or more motile, 32% or more with progressive motility
    • Vitality: 58% or more live spermatozoa
    • Sperm morphology: 4% or more
    • High scrotal temperature, drinking and smoking can affect so repeat after 3 months/ correcting factors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Female hormone testing

A 
LH/FSH D2-5
Progesterone D21
Anti-mullerian hormone
TFT
Prolactin
17
Q

High FSH

A

Poor ovarian reserve

18
Q

High LH

A

PCOS

19
Q

High progesterone day 21

A

Indicates ovulation has occurred

Corpus luteum formed

20
Q

Most accurate marker of ovarian reserve

A

Anti-Mullerian hormone
Most accurate marker of ovarian reserve
High level, good ovarian reserve

21
Q

Management of anovulation

A 
Clomifene
Letrozole
Gonadotropin 
Ovarian drilling
Metformin 
Dopamine agonists for hyperprolactinaemia
22
Q

Management of tubal factors

A

Tubal cannulation during a hysterosalpingogram
Laparoscopy to remove adhesions or endometriosis
IVF

23
Q

Management of uterine factors

A

Surgery may be used to correct polyps, adhesions or structural abnormalities affecting fertility

24
Q

Management of sperm problems

A 
Surgical sperm retrieval 
Blockage along vas deferens
Intra-cytoplasmic sperm injection
Donor insemination with sperm from a donor is another option for male factor infertility
IVF
25
Q

Male semen sample instructions

A

Abstain from ejaculation for 3-7 days
Avoid hot baths, sauna and tights underwear
Attempt to catch the full sample
Deliver the sample to the lab within 1 hour of ejaculation
Keep sample warm

26
Q

Lifestyle factors affecting quality and quantity of sperm

A 
Hot baths
Tight underwear
Smoking
Alcohol 
Raised BMI
Caffeine
27
Q

Oligospermia

A

<15million

28
Q

Pre-testicular causes

A

Testosterone
HPG axis

Pituitary gland/ hypothalamus
Stress, chronic conditions, hyperprolactinaemia
Kallman syndrome

29
Q

Testicular causes

A 
Mumps 
Undescended testes
Trauma
Radiotherapy
Chemotherapy
Cancer
30
Q

Genetic or congenital disorders that result in defective or absent sperm produciton

A

Klinefelter’s syndrome
Y chromosome deletions
Sertoli cell-only syndrome
Anorchia

31
Q

Post-testicular causes

A 
Damage to testicular or vas deferens from trauma, surgery or cancer
Ejaculatory duct obstruction
Retrograde ejaculation 
Scarring from epididymitis 
Absence of vas deferens 
Young’s syndrome
32
Q

Investigations for male factor infertility

A 
Hormonal analysis
Genetic testing
Transrectal ultrasound or MRI
Vasography
Testicular biopsy
33
Q

Management of male factor infertility

A

Surgical sperm retrieval where is obstruction
Surgical correction of an obstruction in vas deferens
Intra-uterine insemination
Intracytoplasmic sperm injection
Donor insemination

34
Q

IVF attempt success

A

25-30%

35
Q

IVF complications

A

Failure
Multiple pregnancy
Ectopic pregnancy
Ovarian hyper stimulation syndrome

36
Q

Risk factors for ovarian hyper stimulation syndrome

A 
Younger age
Lower BMI
Raised anti-Mullerian hormone
Higher antral follicle count
PCOS
Raised oestrogen levels during ovarian stimulation
37
Q

Management of ovarian hyper stimulation syndrome

A 
Oral fluids
Monitor urine output
LMWH
Ascitic fluid removal 
IV colloids

Gynaecology (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions