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Reproduction > Infertility > Flashcards

Infertility Flashcards

1
Q

Give some of the main reasons couples seek ART

A 
Endometriosis 
Male factor
Tubal disease
Ovulatory disorder
Idiopathic
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2
Q

What advice should be given to couples before starting ART?

A 
4 units alcohol per week (woman)
BMI 19-29
Stop smoking
Folate supplement
Rubella immunisation
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3
Q

What are the main ART treatments?

A

Donor insemination
Intra-uterine insemination (IUI)
In-vitro fertilisation (IVF)
Intra-cytoplasmic sperm injection (ICSI)

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4
Q

What occurs in intra-uterine insemination?

A

Prepared semen inserted into uterine cavity at time of ovulation

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5
Q

Give some indications for IVF

A

Unexplained infertility
Pelvic disease
Anovulatory infertility

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6
Q

What is the first step of IVF?

A

Down regulation - synthetic GnRH given to time ovulation

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7
Q

What occurs after down regulation?

A

The ovary is stimulated with high dose gonadotrophin

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8
Q

After ovary stimulation what occurs?

A

Oocyte collected in theatre

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9
Q

What occurs once the oocyte has been collected?

A

Fertilisation using sperm

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10
Q

How many days after fertilisation is the embryo transferred?

A

5

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11
Q

Give some indications for intra cytoplasmic sperm injection

A

Severe male infertility

Previous failed fertilisation

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12
Q

In ICSI, what procedure is carried out if the man has azoospermia?

A

Surgical sperm aspiration

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13
Q

What is the main complication of ART?

A

Ovarian hyperstimulation syndrome

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14
Q

What occurs in ovarian hyperstimulation syndrome?

A

Too many eggs are produced

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15
Q

Give some clinical features of OHSS

A

Ascites
Oliguria
Thromboembolism
Renal failure

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16
Q

How can OHSS be treated?

A

Reduce thrombosis risk (fragmin)

Single embryo transfer

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17
Q

Why are rates of multiple pregnancy in ART decreasing?

A

As there is a move to blastocyst transfer

18
Q

There is an increased incidence of ectopic pregnancy in ART. True/false?

A

True

19
Q

What are the approximate success rates for IVF?

A

35%

20
Q

What are the two primitive genital tracts?

A

Wolffian

Mullerian

21
Q

Which primitive genital tract leads to the development of the male internal genital tract?

A

Wolffian

22
Q

Which hormone is responsible for the differentiation of external genitalia?

A

Dihydrotestosterone

23
Q

What occurs in androgen insensitivity syndrome?

A

Patients have a male karyotype but are phenotypically female

24
Q

Why it is important for the testes to descend?

A

As the lower temperature outside the body facilitates spermatogenesis

25
Q

What is cryptorchidism?

A

Failure of testes descent

26
Q

Which cells are responsible for the production of testosterone?

A

Leydig cells

27
Q

Give some functions of the Sertoli cells

A

Form blood-testes barrier
Nutrition
Phagocytosis
Seminiferous tubule fluid secretion

28
Q

Which pituitary hormone regulates testosterone secretion?

A

LH

29
Q

Which pituitary hormone enhances spermatogenesis?

A

FSH

30
Q

Give some of the effects of testosterone

A

Pubertal characteristics
Spermatogenesis
Secondary sexual characteristics

31
Q

What is male infertility?

A

Failure of the sperm to normally fertilise the egg

32
Q

Give some obstructive causes of male infertiltiy

A

Cystic fibrosis
Vasectomy
Infection (chlamydia)

33
Q

Give some non-obstructive causes of male infertility

A

Cryptorchidism
Mumps
Testicular tumour
Chemotherapy

34
Q

Give some endocrine causes of male infertility

A 
Pituitary tumours (prolactinoma)
Kallman's syndrome (no GnRH)
Thyroid disorders
Diabetes
Congenital adrenal hyperplasia
35
Q

What is the normal testicular volume in men?

A

12-25 ml

36
Q

Give some factors which may affect semen analysis

A

Period of abstinence
Condition during transport
Health of donor

37
Q

Give some clinical features of obstructive male infertility

A

Normal testicular volume
Normal secondary sexual characteristics
Absent vas deferens
Normal LH/FSH/testosterone

38
Q

Give some clinical features of non-obstructive male infertility

A

Low testicular volume
Reduced secondary sexual characteristics
Present vas deferens
High LH/FSH

39
Q

What is the main treatment for main infertility?

A

Intracytoplasmic sperm injection

40
Q

What is involved in ICSI?

A

Sperm prepared from semen

Sperm injected into egg

41
Q

What is involved in surgical sperm aspiration?

A

Needle inserted into epididymis and sperm aspirated

Reproduction (33 decks)

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