Infertility

Question 1

define infertility

Answer 1

failure to achieve clinical pregnancy after 12 months or more of regular unprotected sexual intercourse

Question 2

classification of infertility

Answer 2

1. primary= never conceived

2. secondary= previously conceived but was unsuccessful

Question 3

physiological causes of infertility

Answer 3

before puberty
pregnancy
lactation
menopause

Question 4

gynaecological causes of infertility

Answer 4

hypothalamic= anorexia/bulimia, excess exercise
pituitary= hyperprolactinaemia, tumours, Sheehan syndrome
ovarian= PCOS, premature ovarian failure

Question 5

other causes of infertility

Answer 5

chronic renal failure
testosterone secreting tumours
CAH
hypothyroid
drugs e.g. depoprovera, explanon, OCP

Question 6

two types of tubal disease

Answer 6

infective

non-infective

Question 7

infective causes of tubal disease

Answer 7

PID
transperitoneal spread
after a procedure

Question 8

non-infective causes of tubal disease

Answer 8

endometriosis
surgical
fibroids
polyps
congenital

Question 9

management of proximal obstruction in tubal disease

Answer 9

salpinography plus catheterisation or cannulation

Question 10

what is a hydrosalpinx?

Answer 10

fallopian tube becomes blocked and filled with fluid near the ovary

Question 11

presentation of hydrosalpinx

Answer 11

abdominal/pelvic pain
vaginal discharge
infertility

Question 12

management of hydrosalpinx

Answer 12

salpingectomy

Question 13

what is endometriosis?

Answer 13

presence of endometrial glands outside the uterine cavity

Question 14

presentation of endometriosis

Answer 14

dysmenorrhoea
dyspareunia
pelvicpain

Question 15

diagnosis of endometriosis

Answer 15

chocolate cysts on ovary

Question 16

management of endometriosis

Answer 16

remove cysts via ablation, resection or cystectomy

Question 17

investigations for infertility

Answer 17

endocervical swab for chlaymida, smear
tubal patency either laparoscopic or HSG
bloods for endocrine cause

Question 18

classification of male infertility

Answer 18

1. non-obstructive

2. obstructive

Question 19

causes of non-obstructive infertility in males

Answer 19

47XXY
chemo/radiotherapy
undescended testes

Question 20

presentation of non-obstructive infertility in males

Answer 20

low testicular volume
reduced secondary sexual characteristics
vas deferens present

Question 21

diagnosis of non-obstructive infertility in males

Answer 21

high LH/FSH

low testosterone

Question 22

causes of obstructive infertility in males

Answer 22

CF
infection
vasectomy

Question 23

presentation of obstructive infertility in males

Answer 23

normal testicular volume
normal sexual features
vas deferens absent

Question 24

diagnosis of obstructive infertility in males

Answer 24

normal LH, FSH and testosterone