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

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
What are three methods of surgical removal of sperm?
1. PESA = percutaneus epididymal sperm aspiration 2. TESA = testicular sperm aspiration 3. TESE = testicular sperm extraction
26
What as an important factor in unexplained fertility?
Age
27
How is unexplained fertility treated?
Mild stimulation with IUI or IVF
28
40 year old eggs have more ____ issues and ____ defects
Mitochondrial | Chromosomal
29
A patient with a high ovarian reserve may have _____
Polycystic Ovarian Syndrome
30
What is aneuploidy?
An abnormal number or arrangement of chromosomes
31
What are the benefits of time-lapse photography and single step media?
- Undisturbed culture - Algorithms predict embryos with best potential - No more snapshot selection
32
What is a benefit of PGD?
- Only put back embryos we know have a complement of chromosomes
33
How is PGD achieved?
Trophodecterm biopsy | Hole in zona -> cells herniate -> biopsy -> analyse
34
What are three recent innovations in IVF?
- Time lapse photography and single step media of IVF - PGS - Egg freezing