Infertility Flashcards
what is infertility
failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse in a couple who have never had a child
name some factors that increase the chance of conception
women under 30
previous pregnancy
normal BMI
non-smokers
no recreational drug use
low caffeine intake
name some physiological causes of anovulatory infertility
before puberty, pregnancy, lactation, menopause
name some hypothalamic causes of anovulatory infertility
anorexia/bulimia, excessive exercise, stress, kallman’s syndrome
name some pituitary causes of anovulatory infertility
hyperprolactinaemia, tumours, sheehan syndrome
name 2 ovarian causes of anovulatory infertility
PCOS, premature ovarian failure
name some common causes of secondary infertility
tubal disease
fibroids
endometriosis
weight or age related
what is the primary cause of infertility
male infertility
name some pre-testicular causes of infertility
ED, ejaculatory failure
hypogonadism
hypothyroidism
name some testicular causes of infertility
klinefelter syndrome, Y chromosome deletion
infective
heat, irradiation, drugs, chemo
testicular torsion or varicocele
name some post-testicular causes of infertility
CF
vasectomy
ejaculatory duct obstruction
clinical features of non-obstructive male infertility
low testicular volume
reduced secondary sexual characteristics
vas deferens present
endocrine features of non-obstructive male infertility
high LH and FSH, low testosterone
endocrine features of obstructive male infertility
normal LH, FSH and testosterone
investigations for female infertility
swab for chlamydia
cervical smear
bloods for rubella immunity
test of tubal patency
midluteal progesterone level
abnormal midluteal progesterone level
< 30 nmol/L
how might we assess tubal patency in women
laparoscopy or hysterosalpingogram
investigation of male infertility
semen analysis twice over 6 weeks apart
lifestyle advice for helping infertility
stop smoking, reduce BMI
reduce alcohol, caffeine intake
stop recreational drugs
vitamin supplements for women wanting to get pregnant
folic acid and vitamin D
name some risks of ovulation induction and assisted conception
ovarian hyperstimulation
multiple pregnancy
slight risk of ovarian cancer
