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reproduction > infertility > Flashcards

infertility Flashcards

1
Q

what is infertility ?

A

inability to conceive after 12 months of regular intercourse without use of contraception

1/7 couples

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2
Q

what are aspects of the female history in infertility ?

A 
duration
previous contraception
fertility in previous relationships
previous pregnancies and complications
menstrual history
medical and surgical history
sexual history 
previous investigations
psychological assessment
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3
Q

what are aspects of the female exam in infertility ?

A 
weight 
height 
BMI
fat and hair distribution
galactorrhea
abdominal exam
pelvic exam
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4
Q

how do you measure androgen excess ?

A

clinical score - Ferriman Gallwey score

biochemical - Testosteron, DHEAS, progesterone

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5
Q

what are baseline fertility investigations ?

A 
female;
rubella immunity
chlamydia
TSH
regular period - mid luteal progesterone
irregular period - day 1-5 FSH, LH, PRL, TSH, testosterone
hysterosalpingography

male - semen analysis

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6
Q

what are aspects of the male history in infertility ?

A

development - testicular descent, change in shaving, loss of body hair
infections - mumps, STI
surgical - varicocele repair, vasectomy
drugs/environment
sexual history - libido, intercourse frequency
chronic illness

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7
Q

what are aspects of the male exam in infertility ?

A 
weight
height
BMI
fat and hair distribution
abdominal and inguinal exam
genital exam
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8
Q

what are group 1 ovulation disorders ?

A

hypothalamic pituitary failures

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9
Q

how do you treat group 1 ovulation disorders ?

A

gain weight
moderation of exercise

gonadotropin releasing hormone
clomifene

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10
Q

what are signs of polycystic ovary syndrome ?

A

androgen excess - clinical/biochemical
infrequent periods
polycystic ovary on USS

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11
Q

what is the mechanism of clomifene ?

A

binds to oestrogen receptors

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12
Q

what are side effects of clomifene ?

A

vasomotor

visual

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13
Q

what is the biggest disadvantage to gonadotrophin therapy ?

A

multiple pregnancy

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14
Q

what is necessary before IVF if a woman have hydrosalpinges ?

A

offer salpingectomy

will increase chance of live birth

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15
Q

what are investigations for azoospermia ?

A

history
exam
FSH, LH, testosterone, karyotype, PRL
CF screen

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16
Q

what is management of a woman with unexplained infertility ?

A

try to conceive for 2 years
IVF beyond

DO NOT give clomifene

reproduction (26 decks)

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