Infertility Flashcards
Definition of infertility
Inability to conceive for 12 or more months of unprotected intercourse
Fertile interval
6 days prior to ovulation to day of ovulation
highest probability within 2 days
Ovulatory disorders
Hypothalamus disorder PCOS Premature ovarian failure Hyperprolactinemia Oocyte aging
Meds, toxins, drugs that may cause male infertility
anti-HTN chemo alcohol marijuana etc etc etc
Most common causes of female infertility
ovulatory dysfunction, fallopian tube abnormalities, endometriosis, uterine abnormalities and cervical factors
Fallopian tube damage that causes infertility
OBSTRUCTIONS
endometriosis
pelvic adhesions
PID
Uterine factors that can cause infertility? How?
EFFECT IMPLANTATION
submucosal uterine fibroids
congenital abnormalities
scarring of uterine wall from infection and surgical procedures
Cervical factors that cause infertility? How?
SPERM TRANSPORT
cervical stenosis
congenital abnormalities
antibodies against sperm in cervical mucus
How to test if male reasons for infertility?
semen analysis (volumes, concentration, motility, morphology, WBC)
Pelvic exam findings that may suggest infertility?
Cervical abnormalities
Signs of infection
Fundal size and masses
Ovarian masses (nodules, endometriosis)
How to test ovulatory function as reason for infertility?
urine ovulation kits
mid-luteal phase serum progesterone
Clomphene citrate challenge test
How to test uterine and tubal factors that may cause infertility?
Baseline pelvic U/S
Hysterosalpinography (injected contrast; r/o structure or obstruction)
Laparoscopy (r/o endometriosis)
Lab analysis to rule out female as cause of infertility?
TSH and prolactin
Pre-pregnancy screen: CBC, blood type, Rh, Rubella titer
Infectious screen: Chlamydia, Gonorrhea, syphilis, hepatitis
Day 21 progesterone
Which lab is a definitive confirmation of ovulation?
day 21 progesterone level
Why check thyroid on PE for infertility concern?
check for hypothyroidism
