Infertility

Question 1

What is the definition of infertility?

Answer 1

Failure to achieve pregnancy after 12 months in the absence of known cause

Question 2

What are the main anovulatory causes of infertility?

Answer 2

Functional e.g. anorexia nervosa
PCOS
Premature ovarian failure

Question 3

How can tubal patency be affected by infection?

Answer 3

STDs causing pelvic inflammatory disease

Transperitoneal spread e.g. from abscesses, appendicitis

Question 4

What is endometriosis? What is the characteristic finding on ultrasound?

Answer 4

Presence of endometrial glands outside the uterine cavity

Chocolate cysts

Question 5

How can tubal patency be tested?

Answer 5

Hysterosalpingiogram

Explorative laparoscopy

Question 6

What is the best test for assessing ovulation?

Answer 6

Mid-luteal progesterone

Question 7

What is the best test for assessing ovulation?

Answer 7

Mid-luteal progesterone

Question 8

What is the first-line treatment in anovulatory disorders?

Answer 8

Anti-oestrogens such as clomifene citrate, tamoxifen. Or aromatase inhibitors

Question 9

What is second line treatment of anovulation?

Answer 9

Daily gonadotrophin injections

Ovarian drilling/diathermy

Question 10

What is second line treatment of anovulation?

Answer 10

Daily gonadotrophin injections

Ovarian drilling/diathermy

Question 11

Which endocrine profiles should be assessed in infertility?

Answer 11

PRL
FSH LH and GnRH
Androgens and SHBG
TSH
Oestrogen

Question 12

What is the first-line investigation in male factor infertility?

Answer 12

Semen analysis