infertility Flashcards
which cells in the seminiferous tubules are vital for development of spermatozoa
sertoli cells
what does the seminiferous tubule fluid do
carry spermatozoa to epididymis
what does the androgen binding globulin do
essential for sperm production (binds testosterone)
what do inhibin and activin hormones do in male fertility
essential for regulation of FSH secretion and control of spermatogenesis
what does the bulbourethral gland do
produces and releases fluid which lubricates urethra and neutralises any acidity
causes of male fertility
idiopathic- most common
obstructive
non-obstructive
obstructive causes of male fertility
cystic fibrosis
vasectomy
endocrine results: normal LH, FSH and testosterone
non-obstructive causes of male infertility
congenital: cryptorchidism (undescended testes)
chromosomal: klinefelter’s syndrome,
infection: mumps, STI
endocrine
pathological: tumour
endocrine results for non-obstructive male infertility
high LH and FSH and low testosterone
examinations of the female for infertility
general exam: height weight, sexual characteristics
pelvic exam: tenderness, ovarian and uterine abnormalities, uterine mobility
endocervical swab for chlamydia and offer smear
pelvic TVUS
investigation of tubal patency
laparoscopy- first line
hysterosalpingogram- if contraindication for laparoscopy (obesity, crohns)
criteria for IVF in scotland
couples must be co-habiting in stable relationship for 2 years
both parents non-smoking 3 months before treatment and stop drinking during
no illegal substances
methadone free for 1 year
BMI of female 18.5-30
neither partner has undergone voluntary sterilisation
Fresh cycles of treatment must be initiated by the date of the female partner’s 40th
birthday, and all subsequent frozen transfers must be complete before the woman’s
41st birthday.
complications of IVF
ovarian hyper-stimulation syndrome
multiple pregnancy
ectopic pregnancy
increased risk of miscarriage
surgical risk
