Infertility

Question 1

Workup Semen analysis

Answer 1

Looks at sperm concentration, motility, morphology, and viability
Volume – 2-5 ml
pH level – 7.2-7.8
Sperm concentration – 20 million or greater
Motility – 50% forward progression
Morphology – Normal sperm (>4%)
White blood cells – Fewer than 1 million cells/μL

Question 2

Most frequently used tool to evaluate endometrial cavity

Answer 2

Hysterosalpingogram

Should be performed during early follicular phase

Question 3

Tests for men

Answer 3

Sperm analysis FIRST
Blood tests: Testosterone
Ultrasound: Anatomical variants i.e. varicocele

Question 4

Initial tests for women

Answer 4

Ovulation kits: Urine LH test
FSH, Prolactin, TSH
Hysterosalpingogram
Hysteroscopy and laparoscopy only used if abnormalities or no identifiable cause is found

Question 5

Ovulatory dysfunction Medical Tx:

Answer 5

Treat underlying causes
Clomiphene citrate (Clomid)
50mg/day starting on day 3-5 of the menstrual cycle. Can be used with PCOS
If Clomid is unsuccessful:
IVF and injectable ovulation-inducing agents (human menopausal gonadotropin, exogenous FSH, & gonadotropin-releasing hormone

Question 6

Infertility Definition

Answer 6

Defined as, failure to conceive (regardless of cause) after 1 year of unprotected intercourse