Infertility Flashcards
____ is a couple’s failure to achieve pregnancy after 1 year of regular, unprotected intercourse (woman <35 y/o, 6 mo. if >35 y/o)
infertility
infertility occurs in ~___% of couples
15%
What factors can contribute to infertility?
Factors: male ovarian cervical uterine tubal peritoneal unexplained
What are preconception core interventions?
Add folic acid Control DM and PKU levels no alcohol/drugs/smoking optimize BMI change meds that hurt fetus avoid teratogens
How is a Semen analysis performed?
What information does it give you?
Abstinence for 2-7 days
Eval specimen w/in 1 hr
Provides information on semen volume and sperm concentration/motility/morphology
___% of male factor infertility can be overcome effectively w/ Rx
<10%
____ is a term for a minimal number of sperm
Oligospermia
___ is a term for non-motile sperm
Asthenospermia
What medication is most likely to lead to pregnancy in a woman w/ PCOS?
What is the 2nd line medication?
Clomiphene citrate
Metformin (used alone or in combo with CC)
How would you work up a woman for infertility?
Basically the same way you would for secondary or primary amenhorrhea… not going to belabor this with more f***ing cards (lol lauren)
Other than Clomiphene citrate and Metformin, what other medications can you use to tx a anovulatory woman?
Aromatase Inhibitors
Exogenous Gonadotropins (FSH +/- LH)
Dopamine Agonists
Clomiphene citrate requires a functioning ____ to work and will cause ___% of women to ovulate and ___% of women will become pregnant
H-P-O axis
80%
40%
Main ADR of Clomiphene citrate …
Vasomotor: HOT FLASHES
Clomiphene citrate will not work in women with ____
primary ovarian failure
___ is indicated in anovulatory women w/ normal levels of Gn and Estrogen —> PCOS most common dx.
It is used off-label but suggested first-line for ovulation induction in PCOS with BMI>30 by some
Letrozole