Infertility Flashcards
Define infertility?
Failure to conceive after 12 months of unprotected sex
What is a normal (lower limit) ejaculate made of?
15 million/ml 1.5 ml 40% good motility sperm 39 million in ejaculate 4% normal sperm.
What would you look at for women fertility?
1) Ovulation: Regularity of period. Progesterone levels at day 21 and estrogen at day 12 FSH at days 2-4 anti-mullerian hormone
Timing of intercourse
STIs
Causes of anovulation and what are some treatments to stimulate ovulation?
Obestiy or annorexia.
Treatment:
Weight gain or loss.
GnRH
FSH
Clomiphene citrate - selective estrogen modulation (makes brain think there is less estrogen)
Letrazole - aromatase inhibitor (prevents the conversion of androgens to estrogen = brain produce more FSH)
What is Polysystic ovarian syndrome and who does it affect?
Has many follicles in the ovary, medium size follicles an large ovaries.
Affects 10% of women.
Infrequent or no periods
Metabolic syndrome - overweight
Increased androgens - alters apearance
Treatment: Weightloss Letrazole Metformin IVF
What tubual disease can cause infertility?
Cyst, tumour, adhesions that block the fallopian tube.
Treat: IVF, surgery to fix the tube
What is the treatment for infertility caused by cervical problems?
Treatment: Intrauterine insemination
Treatment and symptoms of edometriosis
10% affected (30% infertile)
Painful
Treatment: hormonal contraceptives, ablation surgery
How would you makes someone with premature menopause or rising FSH and decreasing AMH pregnant?
Treat with donor egg (IVF)
Time lapse photography?
Takes a photo every 10 minutes of the embryo. Can follow development to determine if it is normal.
What is oligospermia and how do you treat?
Low sperm count
Treat by taking a single sperm and inseminating an egg (intracytoplasmic sperm injection [ICSI]) or donor sperm
What is Oligoasthenoteratosperima (OATS)?
Low concentran, slow moving, abnormal form (3 defect)
Treat with intracytoplasmic sperm injection (ICSI) or donor sperm
What is azoospermiaand how do you treat?
No sperm
Causes: No GnRH - no FSH/LH. No spermatogenesis. Obstructive - vasectomy Congenital vas deferens absence.
Treatment:
Donor sperm
Testicle aspiration of sperm then intracytoplasmic sperm injection [ICSI]
Surgical removal of sperm
Fine needle taking fluid from the epididymis (1st try) or tissue from testis (2nd attempt).
Take a larger chunk if that doesn’t work.
Milk the seminephrous tubules.
What are the steps involved in intracytoplasmic sperm injection?
Select sperm with normal motility and morphology Immobilize sperm Aspirate sperm tail first Position sperm in needle. Suction pipette Insert needle into egg Rupture egg cytoplasm by aspiration Expel the sperm