Infertility Flashcards

1
Q

what is infertility

A

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

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2
Q

name some factors that increase the chance of conception

A

women under 30
previous pregnancy
normal BMI
non-smokers
no recreational drug use
low caffeine intake

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3
Q

name some physiological causes of anovulatory infertility

A

before puberty, pregnancy, lactation, menopause

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4
Q

name some hypothalamic causes of anovulatory infertility

A

anorexia/bulimia, excessive exercise, stress, kallman’s syndrome

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5
Q

name some pituitary causes of anovulatory infertility

A

hyperprolactinaemia, tumours, sheehan syndrome

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6
Q

name 2 ovarian causes of anovulatory infertility

A

PCOS, premature ovarian failure

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7
Q

name some common causes of secondary infertility

A

tubal disease
fibroids
endometriosis
weight or age related

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8
Q

what is the primary cause of infertility

A

male infertility

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9
Q

name some pre-testicular causes of infertility

A

ED, ejaculatory failure
hypogonadism
hypothyroidism

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10
Q

name some testicular causes of infertility

A

klinefelter syndrome, Y chromosome deletion
infective
heat, irradiation, drugs, chemo
testicular torsion or varicocele

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11
Q

name some post-testicular causes of infertility

A

CF
vasectomy
ejaculatory duct obstruction

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12
Q

clinical features of non-obstructive male infertility

A

low testicular volume
reduced secondary sexual characteristics
vas deferens present

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13
Q

endocrine features of non-obstructive male infertility

A

high LH and FSH, low testosterone

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14
Q

endocrine features of obstructive male infertility

A

normal LH, FSH and testosterone

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15
Q

investigations for female infertility

A

swab for chlamydia
cervical smear
bloods for rubella immunity
test of tubal patency
midluteal progesterone level

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16
Q

abnormal midluteal progesterone level

A

< 30 nmol/L

17
Q

how might we assess tubal patency in women

A

laparoscopy or hysterosalpingogram

18
Q

investigation of male infertility

A

semen analysis twice over 6 weeks apart

19
Q

lifestyle advice for helping infertility

A

stop smoking, reduce BMI
reduce alcohol, caffeine intake
stop recreational drugs

20
Q

vitamin supplements for women wanting to get pregnant

A

folic acid and vitamin D

21
Q

name some risks of ovulation induction and assisted conception

A

ovarian hyperstimulation
multiple pregnancy
slight risk of ovarian cancer