Infertility Flashcards
1
Q
what would you want to ask a female who presents with infertility
A
- how long since trying to concieve
- sexual history
- menstrual history
- previous pregnancy / fertility in past relationships
- previous contraception
- previous investigations
2
Q
female examinations
A
- height / weight / BMI
- examine for any androgenic symptoms ie fat & hair distribution
- could indicate PCOS
- galactorrhoea
- pituitary tumour
- abdo and pelvic examination
- fibroids/ masses
- pelvic distortion- fixed retroverted uterus
3
Q
male history
A
- previous fertility
- previous investigations & treatment
- PMH, SH etc
4
Q
male examination
A
- height / weight / BMI
- hair & fat distribution
- abdo and inguinal exam
- genital exam
- penis
- varicocele
- epididymis
- epididymitis= STI
- testes
- size / maldescent
- vas deferens
- CF/ congenital lack of VD
- sperm count
5
Q
when do you refer a couple?
A
after 1 year of trying, unless problem before that
6
Q
investigations of female and male ?
A
female:
- rubella immunity
- chlamydia
- TSH
in clinic:
- pelvic US
- tubal patency test
male:
semen analysis
7
Q
female causes of fertility problems?
A
- PCOS
- endometriosis
- ovulatory disorders
8
Q
management of ovulatory disorders?
A
- BMI >18 <35
- ovulation induction
- Clomifene + Gonadotrophins
9
Q
what is clomifene and how is it monitored?
A
- SERM
- scan of follicle at 1st cycle
10
Q
side effect of clomifene?
A
vasomotor
11
Q
what gonadotrophin would u give and how
A
FSH
- injection given
- up to 3-6 cycles needed
12
Q
main causes of male fertility problems?
A
Azoospermia
- semen with no sperm
13
Q
treatment options for male fertility problems?
A
- intra-uterine insemination
- donor insemination
- IVF
- reversal of vasectomy
14
Q
outline the process of IVF
A
- injection of sperm into cytoplasm of a mature egg
- allowed to incubate overnight
- embryo is the transplanted into uterus via catheter
