Infertility Flashcards
What is primary infertility
never been able to get pregnant
what is secondary infertility
has been able to get pregnant in the past but has been infertile x12 mo
What is the period of time considered as infertile for women > 35
6 mo of attempting to conceive (instead of 12)
Define fecundability
likelihood that you will get pregnant in any given menstrual cycle = 20-25%
Female related reasons for infertility
- ovulatory disorders (MC)
- endometriosis
- pelvic adhesions
- tubal blockage
- hyperprolactinemia
MC cause for male related infertility
testicular defects in spematogenesis
What labs do you do when assessing infertility in a female?
- hCG
- TSH
- PRL
- total testosterone
- DHEA-S
- FSH
- LH
- estrodiol
What is a semen analysis looking at?
count
motility
morphology
What labs do you do when assessing infertility in a male?
- testosterone
- FSH
- LH
- PRL
Low T, high FSH, high LH?
Low T, low FSH, low LH?
Low LH, low spern count, nl testosterone?
Low T, high FSH, high LH= primary hypogonadism
Low T, low FSH, low LH= secondary hypogonadism
Low LH, low spern count, nl testosterone= possible exogenous steroid use
What are some lifestyle modifications that can be done for tx of infertility in younger couples?
- BMI
- tobacco cessation
- diet
What is the tx of choice for female infertility in women <36 w/ oligomenorrhea or amenorrhea w/ nl FSH, including PCOS
Clomiphene citrate (Clomid)
What is Intrauterine insemination & who is it used for?
Sperm ‘washed’ to remove prostaglandins
-injected transcervically into uterus
for mild-moderate MALE factor infertility
What is Intracytoplasmic sperm injection and who is it used for?
- Sperm injected into each oocyte
- used in conjunction w/ IVF
for severe MALE factor infertility
In pts w/ infertility w/ unidentified etiology, what is the prognosis?
60% get pregnant w/in 3 yrs w/o treatment!
