Infertility Flashcards
Define infertility
inability to conceive after 12 mos of regular intercourse without use of contraception in women younger than 35 or after 6 mos older than 35
Define fecundability
probability of achieving a pregnancy in one menstrual cycle
List some risk factors for impaired fecundability
equal between men & women
- woman’s BMI less than 17 or greater than 27
- smoking
- untreated chlamydia
Describe the history and physical for infertility
Describe the lab workup for infertility
Describe the imaging/procedures done for infertility
Describe the lifestyle management of fertility
Describe the primary MOA of Clomiphene (Clomid)
selective estrogen receptor modulator
- estrogen antagonism at the hypothalamus
- induces ovulation by increased hypothalamic stimulation of FSH/LH
Describe some AEs of Clomid
- increased risk of ovarian cysts & neoplasms
- vasomotor flushing
- abdominal/pelvic pain/bloating
- breast tenderness
- urticaria
- slight hair loss
- blurry vision
Describe some procedures & ART for infertility
Describe some indications for ART in infertility
Describe some pharmacologic interventions for infertility
- clomiphene (SERM)
- letrozole (aromatase inhibitor)
- anastrozole
- bromocriptine (DA agonist)
- metformin
- tamoxifen
- ASA & Heparin
- vaginal estrogen +/- progesterone
- injectable gonadotropins (FSH/hCG)
- GnRH Agonists (Leuprolide)
Describe the etiology of multiple gestation
Describe the Hx/PE of multiple gestation
Describe the fetal presentation in multiple gestation
Describe the maternal presentation in multiple gestation
Describe the workup for multiple gestation
Describe the management of multiple gestation
Describe the etiology of twin to twin transfusion syndrome
Describe the fetal presentation of twin to twin transfusion syndrome
