Infertility

Question 1

what % of people will conceive within 6 months of trying (under 40)

Answer 1

80%

90% in 2 years

Question 2

who should be referred for infertility?

Answer 2

woman over 35
menstrual disorder
PID/STI

male had genital surgery/pathology/STI/systemic illness

one year of trying

Question 3

uterine abnormalities which can cause infertility

Answer 3

adhesions
polyps (myomectomy)
septate uterus

Question 4

tubal disease causing infertility

Answer 4

hydrosalpinx (proximal/distal)
adhesions (ovarian/tubal)

causes of these - chlamydia, gonorrhoea, endometriosis surgery

-> IVF, adhesionolysis, salpingostomy, endometriosis, ablation

Question 5

assessment of tubal patency

Answer 5

hysterosalpingogram (HSG)

HyCoSy

Question 6

test to check ovulation

Answer 6

mid-luteal progesterone (day 21 if 28 day cycle (cycle length-7)

if it is below 16 then they arent ovulating

Question 7

test to check ovarian reserve

Answer 7

FSH - if its high then the body is working harder to ovulate
antral follicle count - scan
anti-mullerian hormone (AMH) - produced by growing follicles

Question 8

other tests for fertility

Answer 8

semen analyisis (repeat after 3mo if low)
testicular size/2y sexual characteristics 
CF screen
karyotype

HSG
mid luteal progesterone
FSH

Question 9

general fertility advice

Answer 9

lose weight
stop smoking
folic acid
sex 2-3/week
no alcohol
BMI - 19-30

Question 10

fertility treatments

Answer 10

clomifene to induce ovulation
treat underlying causes
lose weight etc
IVF
ovarian drilling