Brainscape's Knowledge GenomeTM

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


See full index

1 Obs & Gyn > Infertility > Flashcards

Infertility Flashcards

1
Q

Define infertility

A

inability of heterosexual couple to conceive within 12 months

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

Difference between primary and secondary infertility?

A

primary= no previous pregnancies

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

List three factors that affect fertility

A

Female age
Previous pregnancy
Timing of intercourse
Weight (low or high BMI)

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

What is the viability of sperm within female?

A

72 hours

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

How often should people have sex to conceive?

A

2-3 times/week

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

List two issues associated with increased weight

A

miscarriage
gestational diabetes
PE
DVT
PIH= pregnancy induced hypertension

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

How to assess semen?

A

Volume
Concentration
Total motility
Progressive motility
Normal forms
Vitality
(WHO standard)

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

How does semen collection work?

A

Sample provided after 3-5 days of abstinence and must be analysed in lab within 1 hour of being produced

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What might cause low concentration? =oligospermia

A

genetic abnormality- kleinefelter’s
Cystic fibrosis
Y microdeletion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

List three investigations for oligospermia/azoospermia

A

karyotypr
Y microdeletion
CF status
FSH
SSR

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

Define azoospermia

A

no sperm production

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

List two causes of azoospermia

A
  1. Obstructive- blockage or epididymis or vas deferns, congenital absence of vas deferens
  2. Non obstructive
    - testicular failure (high FSH, e.g. kleinefleter’s), or low FSH (hypogonadotrophic hypogonadism)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Couple struggling to conceive. Man has azoospermia and low FSH. What condition does he have?

A

hypogonadotrophic hypogonadism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

When is baseline level test done?

A

Day 1-3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Which days to test ovulation?

A

based on 28 day cycle, if 30 day cycle then you do day 21 +2= day 23.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the WHO classificaiton of irregular or no cycle?

A

group 1- primary or secondary amennorrhoea

group 2

group 3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the causes of group 1 amenorrhoea/irregular menses?

A

weight
stress
exercise
craniopharygioma
kallman’s syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the physiological cause of group 1 irregular cycle?

A

hypothalmic pituitary failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the levels of FSH, LH, E2 in group 1 patients?

A

Low FSH, low LH, low E2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the management of group 1?

A

GnRH agonist
FSH/LH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What happens to the feedback cycle in group 2?

A

hypothalamic pituitary dysfunction

22
Q

Which is the main condition associated with hypothalamic pituitary dysfunction?

A

PCOS/PCO

23
Q

Name two other conditions associated with group 2

A

hyperprolactinaemia
hypothyroid
hyperthyroid
adrenal insufficiency

24
Q

How to test group 2?

A

induce withdrawal bleed with progesterone
hormone tests day 1 and day 3

25
Q

What are the hormone levels in group 2?

A

E2 normal
prolactin norma
increased free androgen index
reversed FSH/LH ratio

26
Q

How to diagnose PCOS

A

2/3 features Rotterdam criteria
1. Clinical or biochemical evidence
2. Oligomenorrhoea/amenorrhoea
3. USS findings

27
Q

String of pearls in ovary is a sign of?

A

PCOS

28
Q

What is the most common cause of anovulatory infertility?

A

PCOS

29
Q

What is the effect of PCOS on fertility

A

oocyte quality= poor
ovulatory function
endometrial receptivity

+secondary to obesity, metabolic and inflammatory disturbance

Cause= hormone imbalance and insulin resistance (increase in testosterone)

30
Q

What is the management of PCOS?

A

weight loss!!
ovarian drilling?
Letrozole= 1st line

31
Q

What is the MOA of letrozole?

A

aromatase inhibitor
blocks oestrogen biosynthesis, blocks negative feedback, increase FSH, ovulation stimulation

32
Q

WHat is the original use of letrazole?

A

breast cancer (anti-oestrogenic effect)

33
Q

Other than latrazole, name one other agent to treat infertility in PCOS

A

clomiphene

34
Q

What is the MOA of clomiphene

A

Selective oestrogen receptor modulator

35
Q

What is the risk of clomiphene

A

ovarian cancer risk

36
Q

How to improve fertility in PCOS?

A

weight loss
latrozole or clomiphene
IVF

37
Q

What is the cause of group 3?

A

ovarian failure/insufficiency (pituitary/hypothalamus fine)

38
Q

What happens to the levels of FSH and E2 in group 3?

A

increased FSH
Reduced E2

39
Q

List three causes of group 3?

A

idiopathic
chemo
surgical removal of ovaries
autoimmune
chromosomal
turner’s syndrome
androgen insensitivity (46 XY but Y is unresponsive)
fragile X

40
Q

What is the management of group 3 in regard to having children?

A

oocyte donation with IVF
adoption
fostering
embryo donation
accept childlessness

41
Q

What are the components of the holy triad?

A

Fallopian tubes
oocyte
sperm

(+endometrium, uterus anomalies)

42
Q

What is the elgibility for IVF treatment?

A

<43 years by the time treatment is completed
BMI 18.5-30
No smoking for at least 3 months no smoking
no biological child from either partner
no sterilisation
cohabiting stable relationship for >2 years

43
Q

What is ICSI?

A

single sperm injucted into a mature egg (increased risk of congenital abnormality)

44
Q

What is the technique for IVF?

A

sperm fertilised egg on its own (sperm has to do the work itself)

45
Q

What is IUI?

A

directly inserting sperm into uterus (female same sex)

46
Q

Can someone with hep B/C/HIV have IVF?

A

yes! specialised centres

47
Q

What is ovarian hyperstimulation?

A

ovaries over respond to gonadotrophin injections

48
Q

What are the complications of ovarian hyperstimulation?

A

thrombosis
renal dysfunction
liver dysfunction
adult respiratory distress syndrome

49
Q

Why do complications arise with ovarian hyperstimulation?

A

release of vasoactive producted from hyperstimulated ovaries

50
Q

Which condition increases the risk of ovarian hyperstimulation?

A

PCOS

1 Obs & Gyn (31 decks)

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