Infertility Flashcards
1
Q
description of infertility
A
trying to concieve without success for 12months
2
Q
Aetiology?
A
- Sperm problems
- failure of production
- previous orchiditis
- abnormal karyotype ie klinefelter
- failure of transport
- impotence
- CF
- failure of production
- Ovulation problems
- PCOS
- ovarian failure
- hypothalamic/pituitary failure
- Tubal probems
- PID
- endometriosis
- Uterine problems
- Unexplained
3
Q
Ix?
A
- BMI of woman
- sperm analysis
- Bloods
- serum LH & FSH
- serum progesterone
- anti-mullarian hormone
- US pelvis
- hysterosalpingogram
- laparoscopy and dye test
4
Q
what is the function of anti-mullarian hormone?
A
most accurate marker of ovarian reserve (no of follicles left)
high level= good ovarian reserve
5
Q
what is a hysterosalpingogram and what is its’ purpose?
A
- look at patency of fallopian tubes
- also has a therapeutic benefit
- can do tubal cannulation
- X-Ray images taken of uterus and tubes once contrast medium inserted
- screening for chlamydia &gonorrhoea should be done prior
6
Q
Mx options?
A
- Anovulation
- laparoscopic ovarian drilling (PCOS)
- GnRH
- clomifene
- letrozole
- metformin
- Tubal factors
- tubal cannulation
- laparoscopy to remove adhesions/endometriosis
- IVF
- Sperm problems
- surgical sperm retrieval
- intrauterine insemination
- intracytoplasmic sperm injection
7
Q
when is metformin given?
A
where there is insulin insensitivity and obesity
8
Q
what is clomifene?
A
- selective oestrogen receptor modulator
- stops -ve feedback of oestrogen on hypothalamus, resulting in a greater release of FSH and LH
9
Q
how does letrozole work?
A
- can be used instead of clomifene
- also an anti-oestrogen
