infertility Flashcards
Infertility
disease of reproductive system defined by failure to achieve clinical pregnancy after 12 months or more of regular unprotected sexual intercourse.
European society of Human reproduction and embryology(ESHRE
disease characterised by failure to establish a clinical pregnancy after 12 months of regular, unprotected sexual intercourse or due to impairment of persons capacity to reproduce, with their individual or partner.
Same- sex couple
unsure if same sex couple will be able to be accepted for fertility
are same sex couple entities for assisted reproduction?
In the UK: lesbian couples are not entitled to NHS treatment unless they have self-funded 6 cycles of donor insemination without success. However heterosexual vouples are entileted to IVF even if man doesn’t have a sperm.
Primary infertility
someone has never conceived a child in the past has difficulty conceiving
Secondary infertility
someone had 1 or more pregnancies in the past but has difficulty conceiving again
Basics of reproduction male
Basics of reproduction male:
Middle of brain-hypothalamus and below its pituitary gland, anterior pituitary gland
Anterior produce 2 hormones-FSH and LH
Androgen feeds back to brain-controls how much GnRH is produced.
Leydig cell-produce testosterone
Spermatogonium move closer and diploid cells into haploid cells , losing the cytoplasm and gaining a tail at the end making it a sperm.
4 Male fertility problems:
-hormonal (lack of gonadotrophins LH or FSH from pituitary)
-poor quality semen sample
-sperm DNA damage- DNA is vulnerable to attack-has no cytoplasm
-sperm do not bind or fertilise egg- only diagnosed by IVF
cause of infertility in woman
-hormonal anovulation-when ovulation doesn’t happen not enough ovaries in the egg which can lead to primary or secondary ovarian failure
3 ways on how to investigate for polycystic ovarian disease(produces excessive amount of androgens when it usually provides small amounts)
1.ultrasound scan of ovaries and uterus
2.-endocrine tests-anti 3.Mullerian hormone(AMH), basal FSH, mid- luteal
Tubal disease or blockage
infection/ surgery/ anatomy
Uterine anomaly
Endometriosis
endometria’s tissue outside the uterus
2 barriers to infertility diagnosis and treatment
-ration expensive treatment or prioritise access according to certain criteria which vary
-lack of national policy
3 ways there are barriers to diagnosis and treatment
1.cultural challenges
2.stigma
3.stress for patients
4.reproductive tourism
Lifestyle advice for females 4 ways to avoid this infection
1.folic acid
2. balanced die
3, exercise
4.sleep
