Infertility Flashcards
What ares some examples of conditions which may be indicators for ACT?
Endometriosis
Tubal disease
Ovulatory disorders
Male factor infertility
Give some examples of important criteria which must e met before ACT can be started?
Alcohol: females <4 units, men <14 units
Weight BMI 18.5-30
Abstinence from drugs
Smoking cessation
What are the treatment options available of assisted conception?
Donor insemination
In vitro fertilisation (IVF)
Intra-uterine insemination (IUI)
Intra cytoplasmic sperm injection (ICSI)
Fertility preservation
Surrogacy
What are some of the possible complications of assisted conception?
Ovarian hyper-stimulation syndrome
Multiple pregnancy
Ectopic pregnancy
How does ovarian hyper-stimulation syndrome present?
Abdominal bloating
Abdominal pain
N&V
US evidence of ascites
What is a heterotrophic pregnancy?
Both intrauterine (normal) and extrauterine (ectopic) pregnancy occur simultaneously
How is intra uterine insemination (IUI) performed?
Prepared semen is inserted into the uterine cavity around the time of ovulation
How is in vitro fertilisation (IVF) performed?
Egg and sperm are combined outwith the body
egg is collected form the female and sperm form the male
For how long must a male abstain before producing sperm for IVF?
72 hours
How is intra cytoplasmic sperm injection (ICSI) performed?
Sperm may need to be surgically aspirated
Egg is stripped, sperm is immobilised then injected
What are the two primitive genital ducts?
Wolffian and Mullerian ducts
Describe the development of the reproductive tracts from the primitive genital ducts in males and females
MALE
Wolffian duct forms the reproductive tract
Mullerian duct degenerates
FEMALE
Wolffian duct degenerates
Mullerian duct forms the reproductive tract
How does androgen insensitivity syndrome present?
Phenotypically female
- Female external genitalia but absence of the uterus and ovaries and have a short vagina
present at puberty with amenorrhoea
What is androgen insensitivity syndrome?
Congenital insensitivity to androgens
X-linked recessive
Male karyotype (46 XY) but phenotypically female
What is the normal testicular volume pre-pubertal and in adults?
1-3mls pre-pubertal
12-25mls in adults
What is used to measure testicular volume?
An orchidometer
What is the medical term for undescended testes?
Cryptorchidism
What cells does LH act on and what effect does this have?
LH acts on Leydig cells to stimulate testosterone secretion
What cells does FSH act on and what effect does this have?
FSH acts on sertoli cells to enhance spermatogenesis
Inhibin and activin are important for feedback to the pituitary gland. They are produced from which cells?
Sertoli cells
What effects does testosterone have throughout life?
Descent of the testes
Puberty and secondary sexual characteristics
Spermatogenesis
What are some of the causes of obstructive male infertility?
Cystic fibrosis
Vasectomy
Infection
What are some of the non-obstructive causes of male infertility?
Cryptochordism
Klinefelter’s
Endocrine disorders
Systemic disorders e.t.c
What are the hallmarks of Kallman’s syndrome?
Don’t produce LH and FSH
Poor sense of smell
