Infertility Flashcards

1
Q

Where in the world is infertility prevalence high

A

Sub Saharan Africa

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2
Q

Why is infertility prevalence high in sub Saharan Africa

A

Increasing STDs, post abortal, puerperal sepsis

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3
Q

What is infertility

A

Inability of couple to achieve pregnancy within period of unprotected intercourse over 1 year

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4
Q

What is primary infertility

A

Couple with no previous pregnancy

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5
Q

What is secondary infertility

A

At least one pregnancy irrespective of outcome

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6
Q

What is sterility

A

Either of couple has absolute defects preventing fertility

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7
Q

Main congenital causes of infertility

A

Chromosomal abnormalities
Genital tract malformation
Abnormal endocrine functin

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8
Q

Causes acquired infertility

A

STDs
Pelvic inflammatory disease
Post abortal sepsis
Puerperal sepsis

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9
Q

Is male factor the same percentage as woman factor in infertility

A

Yes - 30 to 40 %

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10
Q

Female factors in infertility

A
Disorder of ovulation 
Hirsute women 
Androgen excess (acne , oily skin )
Galactorrhea hyperprolactinemia 
Thyroid disorders 
Pelvic factors like occlusions, pelvic inflammatory diseases 
Endometriosis 
Cervix operation hx 
Cervical mucus alterations form drugs 
Dilatation and curettage 
Previous abortion 
Growths - polyps , myoma 
Diethylstilbestrol exposure 
Uterine pathologies 
Cervical incompetence 
Uterine fibroids 
Congenital abnormality of uterus 
Endometritis
Adenomyosis 
Luteal phase defect
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11
Q

Male factor involved in infertility

A
Azoospermia 
Oligospermia 
Athenozoospermia 
Teratospermia 
Aspermia 
Gonorrhea hx
STDs
Mumps orchitis
Undescended testis surgery 
Hydrocele hx
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12
Q

What is Azoospermia

A

No sperm cell

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13
Q

What’s oligospermia

A

Less than 20million per ml sperm concentration

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14
Q

What’s athenozoospermia

A

Less than 50% sperm motility

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15
Q

What’s Teratospermia

A

Less than 50% sperm with normal morphology

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16
Q

What is Aspermia

A

No ejaculate

17
Q

Female history suggesting possible infertility

A
PID
Puerperal , post abortal sepsis 
K tuberculosis 
Peritonitis 
Appendicitis 
Pelvic surgery ovarian cystectomy
Delayed puberty
18
Q

Investigation of infertility

A
History 
Menstrual history 
Pregnancies 
Abortions 
Contraception 
Exposure to environmental toxins 
Pregnancy with different partner 
Std
19
Q

Physical examination of infertility

A
General appearance to rule out turners syndrome 
BMI
Acne 
Hirsutisme 
Galactorrhea 
Clitoromegaly
20
Q

Basic investigation of infertility

A

Seminal fluid analysis
Ovulation test
Tubal potency test
Postcoital test

21
Q

Seminal fluid analysis procedure

A

No sex 3-5 days before

Semen sample by masturbation

22
Q

Test of ovulation

A

Basal body temperature
Midluteal phase - serum progesterone endometrial biopsy day 21-28
Examination of vaginal cytology and cervical mucus
Serial ultrasound folliculography

23
Q

Test of tubal patency

A

Hysterosalpingography
Laparoscopy
Ultrasound scan , hysterocontrats sonography

24
Q

Post coital test goal assess cervical factors

A
25
Q

For who is Postcoital test useful

A

Women whose spouses refused semen analysis

26
Q

Management of unexplained infertility

A

IUI
IVF
ET
ICSI

27
Q

What is assisted reproductive technology

A

Removal of eggs which are mated with sperm in lab

Transfer embryo in uterus at blastocyst

28
Q

What is surrogacy

A

Agreement in which a woman becomes pregnant and give birth to someone else child

29
Q

Is adoption a viable alternative to most infertile couple

A

Yes