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Special Pops Exam 1 > Infertility -> > Flashcards

Infertility -> Flashcards

1
Q

Definition of infertility?

A

Inability to achieve clinical pregnancy w/in 1 year of having regular intercourse w/o contraception
(interchangeable with subfertility)

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2
Q

Term that refers to the capacity to have a live birth?

A

Fecundity

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3
Q

Term that refers to the probability of achieving pregnancy in a single menstrual cycle, regular sperm exposure, w/o contraception, resulting in a live birth?

A

Fecundability

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4
Q

What is fertility?

A

The ability to achieve a clinical pregnancy

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5
Q

What is sterility?

A

Permanent infertility

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6
Q

What is ‘time to pregnancy’?

A

Length of time it takes a couple to conceive

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7
Q

Normal fertility typically occurs within how many menstrual cycles of trying to conceive?

A

6

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8
Q

Prevalence of females w/ infertility?

A

13%

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9
Q

Rate of infertility varies depending on what?

A

Age

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10
Q

Are ethnicity/race factors w/ infertility?

A

No

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11
Q

85-90% of couples having unprotected sex will conceive within what length of time?

A

1 year

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12
Q

Is sterility common?

A

No, 1-2% of couples

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13
Q

Are males or females more commonly a factor of infertility cases?

A

Females

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14
Q

Main cause of female infertility?

A

Ovulatory dysfunction and tubal factors

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15
Q

Other factors that influence infertility?

A

Thyroid disorders, infection, structural abnormalities, obesity, testicular pathology (varicocele)

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16
Q

When is a patient evaluation done for infertility if the patient us <35 y/o?

A

After 12 months

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17
Q

When is a patient evaluation done for infertility if the patient us >35 y/o?

A

At 6 months

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18
Q

Who can initiate an infertility evaluation?

A

PCP and OB/GYN

19
Q

Treatment for infertility is best provided by who?

A

An infertility specialist
*important that both partners present

20
Q

When evaluating for infertility, what will guide decision for diagnostic testing?

A

Thorough hx and physical

21
Q

What aspects of hx should be considered for female infertility?

A

Pubertal development, menstrual cycle characteristics, contraceptives, intercourse frequency, prior pregnancies/outcomes, GYN, surgical, infection, family hx, abnormal PAP/TX, medications, general health/lifestyle, social

22
Q

What aspects of hx should be considered for male infertility?

A

Congenital abnormalities, undescended testes, prior paternity, intercourse frequency, toxin exposure, surgical, infection (mumps), medications, general health/lifestyle, social, decreased frequency of shaving (lack of hair/testosterone levels low)

23
Q

Physical exam aspects for infertility?

A

Height, weight, BMI, BP, vitals, head & neck, abdominal, male/female GU/GYN, skin (dry -hypothyroid, acanthosis -PCOS), mental health

24
Q

What are the 4 key areas of assessment for infertility?

A

Sperm, oocyte, transport-fallopian tubes, implantation-uterus

25
Q

How long should a patient abstain from sex before collection of sperm sample for evaluation?

A

2-5 days

26
Q

Where should a sperm sample be taken?

A

In a lab or transported there within the hour

27
Q

How many semen samples should be taken for infertility evaluation?

A

2 samples a week apart

28
Q

If the first semen sample is abnormal, when should the test be repeated to confirm?

A

In 4-6 weeks

29
Q

Normal semen liquefaction?

A

30 minutes

30
Q

Normal semen count?

A

15 million/mL or more

31
Q

Normal semen motility?

A

> 40%

32
Q

Normal semen volume?

A

1.5 mL

33
Q

Normal semen morphology?

A

4% normal forms

34
Q

How to confirm female ovulation in fertility evaluation?

A

Test: FSH, estradiol, serum progesterone, TSH, prolactin, LH
(OTC ovulation kit available)

35
Q

How to evaluate pelvic factors in female fertility evaluation?

A

Pelvic exam, transvag US, hysterosalpingogram, laparoscopy* (sometimes)

36
Q

When is laparoscopy indicated in female pelvic factor eval?

A

If endometriosis or adhesions suspected

37
Q

How to evaluate cervical factors in female fertility eval?

A

Speculum exam, PAP smear

38
Q

Treatment of infertility depends on what factors?

A

Identifiable cause, age, duration of infertility, cost/insurance

39
Q

Male factor infertility treatment considerations?

A

Endocrine/systemic disorders, lifestyle changes, smoking cessation, surgery, intra cytoplasmic sperm injection (ART), donor sperm

40
Q

There is an increased risk of what with intra cytoplasmic sperm injection (ART)?

A

Genetic disorders

41
Q

What is ICSI?

A

Sperm is injected into a retrieved egg’s cytoplasm using a fine needle

42
Q

Female factor infertility treatment considerations?

A

Ovulation induction: Clomiphene (Letrozole for PCOS - off label), IVF/embryo transfer (ART), donor egg, surgery, weight loss, smoking cessation, adoption/surrogacy/no tx

43
Q

What is the process of IVF?

A

Ova are aspirated by transvag US probe w/ needle attached, sperm introduced to egg, embryo transferred into uterus

Special Pops Exam 1 (8 decks)

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