Infertility Flashcards
define infertility
failure to achieve clinical pregnancy after 12 months or more of regular unprotected sexual intercourse
classification of infertility
- primary= never conceived
2. secondary= previously conceived but was unsuccessful
physiological causes of infertility
before puberty
pregnancy
lactation
menopause
gynaecological causes of infertility
hypothalamic= anorexia/bulimia, excess exercise pituitary= hyperprolactinaemia, tumours, Sheehan syndrome ovarian= PCOS, premature ovarian failure
other causes of infertility
chronic renal failure testosterone secreting tumours CAH hypothyroid drugs e.g. depoprovera, explanon, OCP
two types of tubal disease
infective
non-infective
infective causes of tubal disease
PID
transperitoneal spread
after a procedure
non-infective causes of tubal disease
endometriosis surgical fibroids polyps congenital
management of proximal obstruction in tubal disease
salpinography plus catheterisation or cannulation
what is a hydrosalpinx?
fallopian tube becomes blocked and filled with fluid near the ovary
presentation of hydrosalpinx
abdominal/pelvic pain
vaginal discharge
infertility
management of hydrosalpinx
salpingectomy
what is endometriosis?
presence of endometrial glands outside the uterine cavity
presentation of endometriosis
dysmenorrhoea
dyspareunia
pelvicpain
diagnosis of endometriosis
chocolate cysts on ovary
management of endometriosis
remove cysts via ablation, resection or cystectomy
investigations for infertility
endocervical swab for chlaymida, smear
tubal patency either laparoscopic or HSG
bloods for endocrine cause
classification of male infertility
- non-obstructive
2. obstructive
causes of non-obstructive infertility in males
47XXY
chemo/radiotherapy
undescended testes
presentation of non-obstructive infertility in males
low testicular volume
reduced secondary sexual characteristics
vas deferens present
diagnosis of non-obstructive infertility in males
high LH/FSH
low testosterone
causes of obstructive infertility in males
CF
infection
vasectomy
presentation of obstructive infertility in males
normal testicular volume
normal sexual features
vas deferens absent
diagnosis of obstructive infertility in males
normal LH, FSH and testosterone
