Infertility Flashcards
What is it that men can lack if they have cystic firbrosis which would make them infertile
Vas deferens
If a patient has a milky dischagre from their nipple and is infertile, what is the likley cause of their infertility
Hyperprolactinemia
What is the definition of infertile
Not being able to concieve after 12 months of regualr intercourse
WITHOUT usinf contraception
What must a patient complaining of infertiily not be using, and it may be worth asking them if they’re a bit of an idiot
If they are using contraception
How many couples under 40yo will get pregnant in 12 months by having regular sexy time
80%
How long does a women have to try to get pregnant if she is:
a) <35yo
b) 35-45
c) >45
a) 12 months
b) 6 months
c) not gonna happen bro
What are some of clinical fetures to look out for in infertiliy
Hirsuitism
Ace
Acanthosis nigricans
Galactorrhoea
Hirusitism, acne and acthanosis nigricans are all potential signs of infertility
What is the medical term to describe all these symtpoms and what condition do they occur in (which is a potential cause of infertility)
Term -> hyperandgrogenism
Condition -> PCOS
For women who are inferitle, what is the 1st line investigation
Female Hormone Proflie
What 4 things do you test for in a female hormone profile
Sex Hormone Binding Globulin
FSH
LH
Prolcatin
Testosterone
Decreased levesl of which hormone on a female hormone profile is almost diagnositc of infertiliy
Sex hormone binding hormone
What do you need to consider in a couple who can’t get pregnant
Availability of eggs
Availability of sperm
Can the sperm and egg meet
Can the embryo implant in the womb
What investigations should be undergone for infertile women
Hormone profile
Rubella immunity check
Chlaymdia test
Tubual patency tests (HSG & HyCoSy)
Pelvic USS
What investigations should be undergone for infertile men
Semem analysis
Genital exam
What do you check for in semen analysis
Spem concentration & volume
Spem motility
Total sperm number
Morphological changes
Why is a rubella immunity test done in women who are infertile
As they can’t be treated unless their immune to rubella
Tubual patency test are needed to see if the fallopian tubes are open enough for sperm to pass through, give 2 examples are of these tests
Hystero Contrast Sonography (HyCoSy)
Hystero-salpingo-graphy (HSG)
What are some risk factors for infertile
Chemotherapy & radiotherapy
STIs
HIV
Obesity
Why is obesity a risk factor for infertilily in women
As it decreases ovulation
What are some of the causes of infetiliy in men
Usually unexplained bro
Cystic firbosis -> absecence/mutated vas deferens
Azospermia (semen has no sperm)
Vasectomy
What are the layman terms for a man and a woman being infertile
Man -> sterile
Woman -> baron
What is the term used to desrcibe semen with no sperm
Azospermia
Are there usually knwon causes for infertiliy
Nope
What are some of the causes of inferitliy in women
Usually unexplained
PCOS
Rubella
Chalymdia
Firbroids
Endemteriosis
Menopause
Hypertecomty & saplingectomy
What are the treatments for infetility in women
Clomiphene
GnRH analgoues
Emberyo freezing
In-vitro fertilisatoin (IVF)
Intra-cytoplasmic sperm injection (ICSI)
What are the treatments for male infertilty
Sperm aspiration
Surgical sperm removal
Sperm donor
Vasectomy removal
What are the 3 classifications of ovulatory disorders which can cause infertility
Hypothalamic pituitary failure
Hypothalamic pituitary ovarain failure
Ovarian failure
What are the 2 main treatments for ovulatory disorders, which can obvs cause infertiliy
Clomiphene
GnRH analgoues
(both increase GnRH levels which triggers the menstrual cycle)
Tubual patency probelms can cause infertiliy in women, give 3 examples
Fibroids
Endometriosis
Hydrosaplinx
Seen on a USS or CT, what is the term for a swelling in a fallopian tube due to a blockage
Hydrosalpinx
What is surgery is undergone if the fallopian tubes are found not to be patent and what is then offered after the surgery
Surgery -> salpingectomy
Offered after -> IVF
