Infertility

Question 1

t or f: infertility increases with age of the male partner

Answer 1

FALSE - increases with age of the FEMALE partner

Question 2

female factors account for approximately what percent of couple infertility issues? male?

Answer 2

40-50%; 25% ; in approx 40% of infertile couples there are multiple causes

Question 3

what is the definition of infertility?

Answer 3

inability to conceive after 12 months of unprotected sex

Question 4

what is the definition of primary infertility?

Answer 4

infertility without any prior pregnancies

Question 5

what is the definition of secondary infertility?

Answer 5

infertility with a prior pregnancy

Question 6

what are the main 3 male factors contributing to infertility?

Answer 6

sperm production, function, and obstruction of the ductal system

Question 7

which anti hypertensive medication is known to contribute to impairment of sperm number and function?

Answer 7

CCBs

Question 8

what is the procedure for conducting a sperm analysis?

Answer 8

pt must abstain from sex for 48 hours; semen must be analyzed within 2 hours of ejaculation/collection; 2 collections must occur 4 weeks apart

Question 9

sperm analysis is a reflection of sperm production that has occurred within what time frame?

Answer 9

3 months

Question 10

what is the normal sperm volume? semen count? normal sperm movement? normal morphology? (%)

Answer 10

2 mL; 20 million PER mL; greater than 50% with fwd movement; greater than 40% w/normal morphology

Question 11

what is the cause of most male infertility?

Answer 11

IDIOPATHIC

Question 12

t or f: elevation of basal body temperature is a good indicator that ovulation is taking place

Answer 12

TRUE

Question 13

what is the expected result of day 3 FSH if the pt is anovulatory?

Answer 13

elevated levels

Question 14

if the cause of an ovulation is pituitary inefficiency, what is the treatment?

Answer 14

intramuscular LH/FSH

Question 15

if the cause of infertility is hyperprolactinemia, what is the treatment?

Answer 15

bromocriptine (dopamine agonist) which suppresses prolactin

Question 16

what is the most common treatment for PCOS?

Answer 16

clomid (ovulation induction agent) mixed with metformin (for weight loss)

Question 17

what is the next step in infertility investigations if there is a normal semen analysis and ovulation analysis?

Answer 17

analysis of the internal architecture of the uterus and fallopian tubes is indicated

Question 18

what is asherman’s syndrome? what is the mcc? treatment?

Answer 18

intrauterine adhesions; d&c; lysis of adhesions

Question 19

what is the procedure that involves radiopaque dye injected into the cervix and uterus?

Answer 19

hysterosalpingram - dye passes through the fallopian tubes to the peritoneal cavity - demonstrates if there is patency; if there is no spillage into the cavity - it indicates that the tubes may be obstructed

Question 20

when must a hysterosalpinogram be performed?

Answer 20

during the follicular phase (avoid possibility of pregnancy)

Question 21

what is the risk associated with hysterosalpingoram?

Answer 21

salpingitis

Question 22

what is the test of choice for a pt unable to get pregnant with a hx of PID?

Answer 22

hysterosalpinogram - will determine tubal blockage due to prior PID

Question 23

what is the most effective treatment for infertility if the cause is tubal?

Answer 23

in vitro

Question 24

what is the process of intrauterine insemination?

Answer 24

washed sperm is injected into the uterus NOTE: pts must have patent/normal tubes

Question 25

t or f: IVF does NOT increase the chance of multiple gestation

Answer 25

FALSE

Question 26

what is the process of IVF?

Answer 26

egg cells are fertilized OUTSIDE the uterus and implanted into the uterus

Question 27

what is the process of artificial insemination?

Answer 27

sperm (donor most likely) is inserted into the vagina

Question 28

t or f: artificial insemination has a higher success rate when compared to IVF

Answer 28

TRUE; 70% vs. 20%