Infertility

Question 1

We can talk about sterility when conception does not occur in the course of regular sex life without using any contraceptive method:
A) within 1 year
B) within 6 months
C) within 2 years
D) within 10 regular cycles

Answer 1

A) within 1 year

Question 2

Which of the complications listed below is the most common after in vitro fertilization (IVF)?
A) Pelvic inflammatory disease
B) Chronic anovulation
C) Ovarian hyperstimulation syndrome
D) Asherman syndrome

Answer 2

C) Ovarian hyperstimulation syndrome

Question 3

Postpartum galactorrhea-amenorrhea syndrome:
A) Morgagni syndrome
B) Sheehan syndrome
C) Chiari-Frommel syndrome
D) Schmidt syndrome

Answer 3

C) Chiari-Frommel syndrome

Question 4

Which of the groups of medicine listed below contains clomifen citrat, which is used to treat infertility?
A) Progesteron
B) Antiprogesteron
C) Oestrogen
D) Antioestrogen
E) GnRh-agonist

Answer 4

D) Antioestrogen

Question 5

Which of the following options is not true of the Stein-Leventhal syndrome?
A) Obesity
B) Hirsutism
C) Primer amenorrhoea
D) X-linked inheritance

Answer 5

D) X-linked inheritance

Question 6

When detecting hyperprolactinaemia, the first examination to be carried out is:
A) Skull X-ray
B) Measuring the serum FSH level
C) Sella-CT or –MRI
D) Pelvic ultrasound
E) Measuring the serum estradiol level

Answer 6

C) Sella-CT or –MRI

Question 7

Medications used to induce ovulation, except for:
A) Clomiphene citrate
B) hMG
C) hCG
D) cyproproteron-acetat

Answer 7

D) cyproproteron-acetat

Question 8

Which of the following cannot cause hyperprolactinaemia?
A) Prolactine-producing hypophysis tumour
B) Neuroleptics
C) Pregnancy
D) Hyperthyreosis

Answer 8

D) Hyperthyreosis

Question 9

The following methods have an important role in the modern sterility examination, except for:
1) Hysterosalpingography
2) Ultrasound folliculometry
3) Laparoscopy with chromopertubation
4) CTG

A) only options 1, 2, and 3 are correct
B) only options 1 and 2 are correct
C) only options 2 and 4 are correct
D) only option 4 is correct
E) all the 4 options are correct

Answer 9

D) only option 4 is correct

Question 10

Which one or ones of the conditions listed below can cause infertility?
1) Endometriosis
2) Corpus luteum insufficiency
3) PCO syndrome
4) Hyperprolactinaemia

A) only answers 1, 2 and 3 are correct
B) only answers 1 and 3 are correct
C) only answers 2 and 4 are correct
D) only answer 4 is correct
E) all the 4 answers are correct

Answer 10

E) all the 4 answers are correct

Question 11

Which of the following medicines are suitable for inducing ovulation?
1) HMG
2) pure FSH
3) Clomiphene citrate
4) pure LH

A) only options 1, 2, and 3 are correct
B) only options 1 and 2 are correct
C) only options 2 and 4 are correct
D) only option 4 is correct
E) all the 4 options are correct

Answer 11

A) only options 1, 2, and 3 are correct

Question 12

Which one(s) is/are typical of normal ejaculation:
1) Volume: 2-5 ml
2) Motility: at least two-third of the sperms are moving
3) Morphology: at least 60 % is normal-shaped sperms
4) Concentration: 8-10 million sperms/ml

A) only answers 1, 2 and 3 are correct
B) only answers 1 and 2 are correct
C) only answers 2 and 4 are correct
D) only answer 4 is correct
E) all the 4 answers are correct

Answer 12

A) only answers 1, 2 and 3 are correct

Question 13

The following diagnostic methods are used to verify the cervical factor in infertility evaluation / testing:
1) post-coital cervical mucus test
2) „Spinnbarkeit” test
3) Sims-Huhner test
4) Ultrasound examination

A) only options 1, 2, and 3 are correct
B) only options 1 and 2 are correct
C) only options 2 and 4 are correct
D) only option 4 is correct
E) all the options are correct

Answer 13

A) only options 1, 2, and 3 are correct

Question 14

Determining the serum progesterone level to verify ovulation is suggested in the following cycle:
1) 1st-3rd days
2) 4th-6th days
3) 1st-13th days
4) 19th-23rd days

A) only options 1, 2, and 3 are correct
B) only options 1 and 2 are correct
C) only options 2 and 4 are correct
D) only option 4 is correct
E) all the options are correct

Answer 14

D) only option 4 is correct

Question 15

The following procedures can be used to examine the possible blockage of the fallopian tubes:
1) Hysterosalpingography
2) Laparoscopy + chromo pertubation
3) Chromo pertubation + Douglas puncture
4) Hystero-salpingo-sonography

A) only answers 1, 2, and 3 are correct
B) only answers 1 and 2 are correct
C) only answers 2 and 4 are correct
D) only answer 4 is correct
E) all the 4 answers are correct

Answer 15

E) all the 4 answers are correct

Question 16

The following one(s) can cause infertility:
1) Ashermann syndrome
2) Anovulation cycle
3) Blocked fallopian tubes
4) Oligozoospermia

A) only options 1, 2, and 3 are correct
B) only options 1 and 2 are correct
C) only options 2 and 4 are correct
D) only option 4 is correct
E) all the 4 options are correct

Answer 16

E) all the 4 options are correct

Question 17

The cause of infertility due to blocked fallopian tubes can be:
1) Uterine intervention
2) Uterus hypoplasia
3) Applying intrauterine contraceptive device
4) Frequent pelvic inflammation
5) Vaginism
A) options 1, 2, 4 and 5 are correct
B) all of the options are correct
C) options 2 and 4 are correct
D) options 1, 3 and 4 are correct
E) options 2, 4 and 5 are correct

Answer 17

D) options 1, 3 and 4 are correct

Question 18

Which are the typical hormonal changes of the classical Stein-Leventhal syndrome?
1) The LH/FSH ratio elevates
2) The prolactine level decreases
3) The testosterone level increases
4) SHBG decreases
5) The androstendiol decreases

A) only answers 1, 2, 4 and 5 are correct
B) all the answers are correct
C) only answers 2 and 4 are correct
D) only answers 1, 3 and 4 are correct
E) only answers 2, 4 and 5 are correct

Answer 18

D) only answers 1, 3 and 4 are correct

Question 19

The progesterone values of the samples taken every other day in the middle of the second half of the cycle are: 6,3-9,5-7,9 ng/ml. What is the probable diagnosis?
1) PCO syndrome
2) Luteal insufficiency
3) Anovulation
4) Habitual abortus due to corpus luteum insufficiency
5) Idiopathic Oestrogen Deficiency syndrome

A) Options 1.2.4. and 5. are correct
B) All the options are correct
C) Options 2 and 4 are correct
D) Options 1., 3. and 4. are correct
E) Options 2., 4. and 5. are correct

Answer 19

C) Options 2 and 4 are correct

Question 20

Which one(s) is/are typical of normal andrological findings?
1) The amount of the ejaculatum is 2-5 ml
2) The motility is less than 50%
3) The proportion of sperms showing normal morphology is greater than 60%
4) The number of white blood cells per viewfield is fewer than 10
5) The total liquefaction occurs in more than 80 minutes

A) Options 1.2.4. and 5. are correct
B) All the options are correct
C) Options 2 and 4 are correct
D) Options 1., 3. and 4. are correct
E) Options 2., 4. and 5. are correct

Answer 20

D) Options 1., 3. and 4. are correct

Question 20

Which one(s) is/are typical of normal andrological findings?
1) The amount of the ejaculatum is 2-5 ml
2) The motility is less than 50%
3) The proportion of sperms showing normal morphology is greater than 60%
4) The number of white blood cells per viewfield is fewer than 10
5) The total liquefaction occurs in more than 80 minutes

A) Options 1.2.4. and 5. are correct
B) All the options are correct
C) Options 2 and 4 are correct
D) Options 1., 3. and 4. are correct
E) Options 2., 4. and 5. are correct

Answer 20

D) Options 1., 3. and 4. are correct

Question 21

Match them.
A) clomiphene citrate
B) corticosteroid
C) bromocriptine
D) hMG (humane menopausal gonadotropin)

OBG - 6.21 - It affects through androgen production
OBG - 6.22 - The increased prolactine level can be decreased by giving this
OBG - 6.23 - Having an antiestrogen effect
OBG - 6.24 - It directly increases the serum level of gondotropins

Answer 21

21- B
22- C
23- A
24- D

Question 22

Match the therapeutic options with the conditions.
A) GnRH
B) clomiphene citrate
C) oradexon
D) parlodel

OBG - 6.26 - Hyperprolactinaemia
OBG - 6.27 - Infertility with increased testosterone and/or DHEAS (dehydroepiandrosteron-sulfat)
OBG - 6.28 - Hypothalamic insufficiency

Answer 22

26- D
27- C
28- A

Question 23

Administration of GnRH pulsatorically is suggested because continuous infusion causes „down regulation” of the receptors, which results in a reverse effect of what we expect.

A) both are correct, there is causality between them.
B) both are correct, but there is not causality between them
C) the first one is correct in itself, but the second one is incorrect
D) the first one is incorrect, the second one is correct in itself
E) both of them are incorrect

Answer 23

A) both are correct, there is causality between them.

Question 24

A woman with blocked fallopian tubes cannot be considered to be of non-childbearing potential absolutely, because in her case a fallopian tube reconstruction surgery or in vitro fertilization can help.

A) both are correct, there is causality between them.
B) both are correct, but there is not causality between them
C) the first one is correct in itself, but the second one is incorrect
D) the first one is incorrect, the second one is correct in itself
E) both of them are incorrect

Answer 24

A) both are correct, there is causality between them.

Question 25

One of the most common causes of fallopian tube blockage is endometriosis, therefore clarifying obstruction is a base of examining infertility.

A) both are correct, there is causality between them.
B) both are correct, but there is not causality between them
C) the first one is correct in itself, but the second one is incorrect
D) the first one is incorrect, the second one is correct in itself
E) both of them are incorrect

Answer 25

D) the first one is incorrect, the second one is correct in itself

Question 26

During ovulation induction ultrasound examinations of the pelvis are recommended, since the hyperstimulation of the ovaries can occur during treatment.

A) both are correct, there is causality between them.
B) both are correct, but there is not causality between them
C) the first one is correct in itself, but the second one is incorrect
D) the first one is incorrect, the second one is correct in itself
E) both of them are incorrect

Answer 26

A) both are correct, there is causality between them.

Question 27

By performing hysterosalpingography we can get information about the blockage of the fallopian tubes, because the contrast medium in a healthy woman gets into the abdominal cavity through the fallopian tubes.

A) both are correct, there is causality between them.
B) both are correct, but there is not causality between them
C) the first one is correct in itself, but the second one is incorrect
D) the first one is incorrect, the second one is correct in itself
E) both of them are incorrect

Answer 27

A) both are correct, there is causality between them.

Question 28

Homolog intrauterine insemination (IUI) is a commonly used assisted reproduction procedure in treating some forms of sterility, because it is unanimously confirmed that its real effectiveness is more resultful than the opportunities provided by other insemination procedures (praecervicalis, intracervicalis).

A) both are correct, there is causality between them.
B) both are correct, but there is not causality between them
C) the first one is correct in itself, but the second one is incorrect
D) the first one is incorrect, the second one is correct in itself
E) both of them are incorrect

Answer 28

A) both are correct, there is causality between them.

Question 29

Asherman syndrome can cause secondary amenorrhea, because adhesions are formed in the fallopian tubes.

A) both are correct, there is causality between them.
B) both are correct, but there is not causality between them
C) the first one is correct in itself, but the second one is incorrect
D) the first one is incorrect, the second one is correct in itself
E) both of them are incorrect

Answer 29

C) the first one is correct in itself, but the second one is incorrect

Question 30

What examinations do you recommend?
The medical history of a 30-year-old woman contains 5 spontaneous abortions. The miscarriages happened between the 8th and the 14th weeks of pregnancy. The serum progesterone levels were within normal range. The androgen hormone level showed no deviation. The FSH/LH ratio is normal, there is no bleeding disorder. She got her first period at the age of 13. No deviation was shown in the liver and renal functions.
1) examining the husband
2) ovarium biopsy
3) HSG (hysterosalpingographia)
4) determing the lupus-anticoagulant and the anticardiolipid antibodies
5) hysteroscopy

A) options 1., 2., and 4. are correct
B) options 1., 3., and 5. are correct
C) options 2., 3., and 5. are correct
D) options 2., 3., and 4. are correct
E) all the options are correct

Answer 30

B) options 1., 3., and 5. are correct

Question 31

Which of the listed conditions is the most probable?
The medical history of a 30-year-old woman contains 5 spontaneous abortions. The miscarriages happened between the 8th and the 14th weeks of pregnancy. The serum progesterone levels were within normal range. The androgen hormone level showed no deviation. The FSH/LH ratio is normal, there is no bleeding disorder. She got her first period at the age of 13. No deviation was shown in the liver and renal functions.

A) corpus luteum insufficiency
B) PCO syndrome
C) Abnormal uterus development
D) Turner syndrome

Answer 31

C) Abnormal uterus development

Question 32

What is your therapy recommendation?
The medical history of a 30-year-old woman contains 5 spontaneous abortions. The miscarriages happened between the 8th and the 14th weeks of pregnancy. The serum progesterone levels were within normal range. The androgen hormone level showed no deviation. The FSH/LH ratio is normal, there is no bleeding disorder. She got her first period at the age of 13. No deviation was shown in the liver and renal functions.

A) endoscopic septal resection, reconstruction or metroplasty in case of coarse alteration
B) Clostilbegyt therapy starting during the period for 5 days. Ultrasound control is needed because of a possible hyperstimulation.
C) there is no therapeutic opportunity.
D) ovarian wedge resection or laparoscopic ovarian coagulation.

Answer 32

A) endoscopic septal resection, reconstruction or metroplasty in case of coarse alteration

Question 33

Can uterine fibromyoma lie behind the condition in the former case?
The medical history of a 30-year-old woman contains 5 spontaneous abortions. The miscarriages happened between the 8th and the 14th weeks of pregnancy. The serum progesterone levels were within normal range. The androgen hormone level showed no deviation. The FSH/LH ratio is normal, there is no bleeding disorder. She got her first period at the age of 13. No deviation was shown in the liver and renal functions.

A) No. This type of tumor does not occur at this age.
B) Yes. The therapy would be the removal of the uterus becuse of the frequent malignization of the juvenile myomas.
C) Yes. Depending on location, myoma enucleation or endoscopic resection is to be performed.
D) No. Myoma causes nothing but bleeding disorder and abdominal pain.

Answer 33

C) Yes. Depending on location, myoma enucleation or endoscopic resection is to be performed.