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Women's Health > Infertility > Flashcards

Infertility Flashcards

1
Q

a disease characterized by failure to achieve successful pregnancy after 12 months of attempting or due to an impaired capacity to reproduce with one’s partner

A

infertility

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2
Q

in absence of known etiology, and presence of regular, unprotected intercourse, evaluation should be initiated at ____ months when the female is under 35 years old

A

12

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3
Q

in absence of known etiology, and presence of regular, unprotected intercourse, evaluation should be initiated at ____ months when the female is 35 years or older

A

6

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4
Q

what are the 2 most common causes of infertility in couples?

A

tubal/pelvic pathology
male

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5
Q

what is the greatest non-modifiable factor for fertility?

A

female age

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6
Q

maternal age over _____ is associated with placental abruption, pre-term delivery, low birth weight, intrauterine growth restriction, stillbirth, and perinatal mortality

A

40

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7
Q

what are the 3 tests used to evaluate ovulatory function?

A

ovulation predictor kits
basal body temp
mid-luteal serum progesterone level

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8
Q

tests for LH rise in urine to evaluate ovulatory function

A

ovulation predictor kits

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9
Q

what causes the change in body temperature during ovulation?

A

progesterone rise

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10
Q

what is the most common etiology of infertilify?

A

PCOS

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11
Q

what is the criteria for PCOS?

A

2/3:

< 9 menses/year
OR
> 35 day cycle intervals

+

Polycystic appearing ovaries on US

Hyperandrogenism

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12
Q

assesses reproductive potential as a function of the number of oocytes

A

ovarian reserve

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13
Q

what is the most predictive of live birth rates?

A

female age

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14
Q

what are the 3 tests used for ovarian reserve?

A

AMG
FSH/estradiol levels on day 3
antral follicle count

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15
Q

what are 3 tests to assess fallopian tube patency?

A

hysterosalpingogram (HSG)
hysterosallpingo-contrast sonogram
laparoscopy with chromopertubation

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16
Q

at what point in the cycle should a hysterosalpingogram be done?

A

follicular phase (days 5-12)

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17
Q

when should prophylactic antibiotics be considered for a hysterosalpingogram? (2)

A

history of STI/PID
known tubal abnormality

18
Q

what are 2 contraindications for a hysterosalpingogram?

A

pregnancy
purulent cervical discharge
allergy to iodine contrast

19
Q

large fibroids > 4-5cm and those that are close to or inside the endometrial cavity are most concerning

A

uterine leiomyoma

20
Q

patient presents with abnormal bleeding, menorrhagia, and pelvic pressure/pain. Dx?

A

uterine leiomyoma

21
Q

intrauterine adhesions that present with light/absent menses

A

asherman’s syndrome

22
Q

used to evaluate myometrial defects, intracavity defects like polyps, ovarian cysts, antral follicle count, follicular development, and pathology.

A

pelvic sonogram

23
Q

what are the 2 peritoneal factors that cause infertility?

A

endometriosis
pelvic/adnexal adhesions

24
Q

what should be considered to diagnose and treat peritoneal factors leading to infertility?

A

laparoscopy

25
Q

absence of spermatozoa in semen

A

azoospermia

26
Q

deficiency of spermatozoa in semen

A

oligospermia

27
Q

poor semen motility (weak)

A

asthenospermia

28
Q

morphologic abnormality of sperm

A

teratospermia

29
Q

what should be encouraged during pre-conception counseling? (2)

A

prenatal vitamins
folic acid 1mg

30
Q

what is the optimal timing of intercourse? (2)

A

1-5 days prior to ovulation
intercourse every day to every 3rd day

31
Q

what are 3 vaginal lubricants that are not spermicidal?

A

canola oil
mineral oil
hydroxyethyl-cellulose-based lube

32
Q

what is the 1st line treatment for infertility?

A

lifestyle modifications

33
Q

what are 2 second line treatment options for infertility? (2)

A

letrozole
clomiphene citrate

34
Q

what is the ovulation induction protocol?

A

letrozole 2.5mg on cycle day 3

35
Q

what is the ovulation induction protocol if a patient is amenorrheic? (2)

A

induce menses with Provera 10mg x 10 days
random start of letrozole 2.5 mg

36
Q

what is the ovulation induction protocol if a patient is nonresponsive?

A

increase dose to letrozole 5mg x 5 days

37
Q

used in patients with PCOS for anovulation

A

metformin

38
Q

what is the optimal treatment for unexplained infertility?

A

clomiphene citrate + intrauterine insemination for 3-6 attempts

39
Q

most aggressive treatment for infertility but has the highest success rate

A

in vitro fertilization

40
Q

what are 4 benefits of IVF?

A

decrease # of necessary sperm
fallopian tubes not needed
control # of embryos transferred
preimplantation genetic testing

Women's Health (20 decks)

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