infertility Flashcards
infertility definition
couple having sex for one year without the ability to conceive.
first line therapy for infertility
counseling for proper methods
who to blame first?
the man. even though its usually the female.
what tests for male
erections, sperm count, flagellated motile sperm
For ED
nighttime tumescence test –if he has erections then its NOT organic AND IT IS PSYCHOGENIC.
organic, no tumescence. phosphodiesterase inhibitors
if count or motility what do we use
artificial insemination. concentrated sperm in turkey baster. hyperconcentrated sperm past the cervix. this is least effective.
IVF
mom on hormones, harvest eggs and incubate them with sperm. implant the zygote. natural fertilization, implantation
ICSI intracytoplasmic spermal injection
mom on hormones, harvest eggs, take sperm and inject it into the egg forming a zygote, then implant.
first test for mom
mucous work up. mucous is hard at beginning of cycle –keeps out infections. during ovulation it becomes soft -giving spermal entry easier.
how is mucous tested
smush test: after sex the mucous is harvested and smeared on a slide. hard mucous breaks. if greater than 6 cm and positive sperm then the mucous is fine.
estrogen does what to the mucous
ripens and loosens it. good for inhospitable mucous.
anovulation treatment
clomiphine and perganol
if ovulation is okay, what test is next
hystosalpinogram. assesses the anatomy. anatomical defects make implantation difficult.
some are: strictures from PID, fibroids, mullerian issues.
if there are anatomy issues then surgery is an option. artificial insemination.
if anatomy tests are normal then what?
endometriosis
usually something in the history that is suggestive.
treatment for endometriosis
(chocolate cyst) laser ablation, estrogen, OCPs.
