Infertility Flashcards
1
Q
What is infertility?
A
- inability of a couple to conceive after 12 months of regular intercourse without the use of contraception
- 1/7 couples report infertility problems
2
Q
What is examined in females?
A
- weight
- height
- BMI (kg/m2)
- fat and hair distribution
- androgen excess
- galactorrhoea
- abdominal exam
- pelvic exam
- masses, pelvic distortion, tenderness, vaginal septum, cervical abnormalities, fibroids
3
Q
What are the baseline investigations?
A
- female
- rubella immunity
- chlamydia
- TSH
- mid luteal progesterone (regular periods)
- day 1-5 FSH, LH, PRL, TSH, testosterone (irregular periods)
- male
- semen analysis
4
Q
What investigations are carried out at a fertility clinic?
A
- pelvic US
- physical examination
- testing for ovulation
- semen analysis repeat
- tubal patency test
5
Q
What is examined in males?
A
- weight
- height
- BMI (kg/m2)
- fat and hair distribution
- hypoandrogenism
- abdominal and inguinal exam
- genital exam
- varicocele
- Klinefelter syndrome (small testes + azoospermia)
6
Q
What is a varicocele?
A
- dilitation of the pampiniform plexus of the spermatic veins in the scrotum
- usually infertile
- surgery (if symptomatic, not fer fertility treatment)
7
Q
What is Klinefelter syndrome?
A
- primary hypogonadism
- impaired spermatogenesis
- testosterone deficiency
- small testes
- azoospermia
- dec. body hair
- enlarged breast
- type 2 diabetes
- osteoporosis
- anxiety
- XXY chromosome arrangement
- hormonal testing FSH testosterone
- karyotype testing
- testosterone replacement therapy
- surgical sperm retrieval
8
Q
What are the 3 classifications of ovulatory disorders?
A
- group I- hypothalamic pituitary disorder (hypothalamic amenorrhoea or hypogonadotrophic hypogonadism)
- group II- hypothalamic-pituitary-ovarian dysfunction (predominately (PCOS)
- group III- ovarian failure (POI)
9
Q
What is Polycystic Ovary Syndrome (PCOS)?
A
- androgen excess
- hirtuism
- testosterone
- infrequent periods
- anovulation
- polycystic ovaries
- US
10
Q
What is the general management for ovulatory disorders?
A
- treat underlying cause
- weight gain/loss (BMI > 18 and < 35)
- ovulation induction
- clomifene (selective oestrogen receptor modulator)
- gonadotrophins- FSH injection
11
Q
What is the management for tubal factor + endometriosis?
A
- hydrosalpinges- laparoscopic salpingectomy before IVF
12
Q
What is general management for males?
A
- urologist
- IVF/ICSI
- intra-uterine insemination
- surgery
- vasectomy reversal
- surgical sperm retrieval
- donor insemination
13
Q
What is the process of IVF?
A
- eggs harvester from ovary
- eggs fertilised in the lab with sperm
- embyos undergo a number of cell divisions
- embryos transferred to the womb
14
Q
What is the process of Intracytoplasmic Sperm Injection (ICSI)?
A
- mature egg injected with single sperm
- incubation overnight
- develops to embryo
- embyo transferred to the womb
