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Reproduction, Development and Ageing > Infertility > Flashcards

Infertility Flashcards

1
Q

What is the definition of infertility?

A

A failure to conceive after 12 months of unprotected intercourse

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2
Q

What is the incidence of infertility in the developed world?

A

1/4 couples

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3
Q

Which hormones are measured to assess normal ovulation in a fertility clinic?

A
  • FSH
  • E2
  • P4
  • AMH
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4
Q

Lower reference limits for male sperm:

Count \_\_\_ M/mL
Motility \_\_\_% progressive + non progressive
Volume \_\_\_\_ mL
Total # \_\_\_\_ m
Morphology \_\_\_\_%
A 
Count = 15 M/mL
Motility=  40% progressive + non progressive
Volume = 1.5 mL
Total # = 3.9m
Morphology = 4 %
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5
Q

What is a common cause of anovulation?

A

Being under/overweight

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6
Q

Clomiphene citrate is a selective ____ receptor modulator

A

Oestrogen

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7
Q

Which drugs can be used to treat anovulation?

A
  • FSH
  • Clomiphene citrate
  • Letrozole
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8
Q

What is the first line treatment for Polycistic Ovarian Syndrome (PCOS)?

A

Weight loss

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9
Q

Which drugs can be used to treat PCOS?

A
  • Metformin
  • Clomiphene citrate
  • FSH
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10
Q

What are the treatment options for tubal disease?

A

Surgery or IVF

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11
Q

What is the treatment for cervical problems?

A

IUI (Intra-uterine insemination)

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12
Q

What are the treatment options for endometriosis?

A
  • Hormonal contraceptives

- Surgical ablation

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13
Q

What is an advantage of letrozole over clominephine citrate?

A

A greater chance of single pregnancy

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14
Q

What are the 6 steps in IVF?

A
  1. Ovarian stimulation
  2. Egg retrieval
  3. Sperm preparation and fertilisation
  4. Embryo culture
  5. Embryo transfer
  6. Embryo freezing
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15
Q

Why might a GnRH agonist be administered in the early stages of IVF?

A

To prevent ovarian hyperstimulation syndrome

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16
Q

In IVF, the egg is collected ___ hours after the trigger injection

A

36

17
Q

How is IVF cycle tracking done?

A
  • Transvaginal ultrasound scans

- Blood tests (oestrogen, progesterone)

18
Q

Why is IVF cycle tracking done?

A
  • Prevent premature rise of progesterone, affects quality of eggs and lining of uterus
19
Q

What needs to be seen on a transvaginal ultrasound before being able to trigger?

A

3 follicles, at least 17mm each

20
Q

At what stage is the lab media changed for the growing embryo in IVF?

A

8 cell stage (day 3)

21
Q

How is the lab culture made as close to physiological conditions as possible?

A
  • Incubator is 5-6% CO2
22
Q

What are the three abnormalities in OATS (oligoasthenoteratospermia)?

A
  • Low concentration
  • Poor motility
  • Irregular morphology
23
Q

Congenital absence of the vas deferens is present in almost 100% of ____ patients

A

Cystic fibrosis

24
Q

What are four causes of azoospermia?

A
  1. Kallman’s syndrome
  2. No spermatogenesis
  3. Obstructive/vasectomy
  4. Non-obstructive
25
Q

What are three methods of surgical removal of sperm?

A
  1. PESA = percutaneus epididymal sperm aspiration
  2. TESA = testicular sperm aspiration
  3. TESE = testicular sperm extraction
26
Q

What as an important factor in unexplained fertility?

A

Age

27
Q

How is unexplained fertility treated?

A

Mild stimulation with IUI or IVF

28
Q

40 year old eggs have more ____ issues and ____ defects

A

Mitochondrial

Chromosomal

29
Q

A patient with a high ovarian reserve may have _____

A

Polycystic Ovarian Syndrome

30
Q

What is aneuploidy?

A

An abnormal number or arrangement of chromosomes

31
Q

What are the benefits of time-lapse photography and single step media?

A
  • Undisturbed culture
  • Algorithms predict embryos with best potential
  • No more snapshot selection
32
Q

What is a benefit of PGD?

A
  • Only put back embryos we know have a complement of chromosomes
33
Q

How is PGD achieved?

A

Trophodecterm biopsy

Hole in zona -> cells herniate -> biopsy -> analyse

34
Q

What are three recent innovations in IVF?

A
  • Time lapse photography and single step media of IVF
  • PGS
  • Egg freezing

Reproduction, Development and Ageing (26 decks)

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