Infertility Flashcards
What is required from a history and examination in a sub-fertile female?
History:
- Duration of infertility
- Previous contraception
- Fertility in previous relationships
- Previous pregnancies and complications
- Menstrual history
Examination:
- Weight
- Height
- BMI
- Fat and hair distribution (Hirsuitism - androgen excess)
- Galactorrhoea
- Abdominal & pelvic examination (masses, tenderness, vaginal septum, cervical abnormalities, fibroids)
What is required from a history and examination in a sub-fertile male?
History:
- Loss of body hair or change in shaving frequency
- STI’s or Mumps
- Varicocele repair or vasectomy
- Previous fertility
- Exposure to radiation
- Alcohol, smoking
Examination:
- Weight
- Height
- BMI
- Fat and hair distribution
- Genital examination (epididymis, testes, vas deferens, varicocele)
What are the investigation pathways in male and female infertility?
Female:
- Rubella immunity
- Chlamydia
- TSH
- Check hormone levels (if regular periods - progesterone, if irregular periods- FSH, LH, TSH & Testosterone)
Male:
- Semen analysis
What investigations could be carried out at the fertility clinic?
- Pelvic USS
- Physical examination
- Testing for ovulation
- Semen analysis
- Check for occlusion of fallopian tubes (hysterosalpingography)
What are the treatment options available in male and female infirtility?
Female:
Ovulation Induction
Gonadotrophins
Male:
Reversal of vasectomy
Surgical sperm removal
Donor insemination
How does IVF treatment work?
1 - Eggs taken from ovary
2 - Eggs fertilised in the lab with sperm
3 - Emryos undergo a number of cell divisions
4 - Embryos transferred to womb
When is the option of IVF treatment offered?
Once all other fertility treatments have been tried
What drug can be given to induce ovulation and what does it do?
Clomifene - blocks estrogen receptors
