infertility, abortion, mult gestation Flashcards
Fecundity
- fertility
- capacity to concieve and produce offspring
sterility vs infertility
- sterility: inability to conceive offspring
- infertility: diminished capacity to conceive
primary vs secondary infertility
- primary: individual has never conceived
- secondary: infertility after prior fertility
define infertility
- inability to concieve after 12 months of intercourse without use of condom for women < or = 35; or 6 months in a woman > 35
fecundability
- probability that conception will occur during a specific time period
basic workup for infertility involves evaluation of
- ova
- spermatozoa
- patent oviduct
Mittelschmerz
- Usually one-sided, lower belly pain associated with normal ovulation.
what cervical mucus is associated with ovulation
-
egg white cervical mucus
- believed to assist in sperm transport
polycystic ovarian syndrome ia a condition that includes a spectrum of associated features including
- hyperandrogenism - hirsuitism, acne
- oligomenorrhea, amenorrhea
- obesity and insulin resistance
- polycystic ovaries on US
oligomenorrhea
- light or infrequent menstrual periods caused by irregular sloughing of endometrium
hyperplastic growth of endometrium is caused by
- lack of progesteron which causes unopposed estrogen exposure
what is the LH surge predictor kit
- OTC kit that detects pre-ovulation surge in LH
US “string of pearl” sign is consistent with
polycystic ovarian syndrome
can hypo or hyper thyroid disrupt normal ovulation
both
if prolactin levels are persistently elevated, what imaging is recommended to rule out prolactinoma
MRI
treatment of choice for PCOS in patient who desires conception is
- ovulation induction, usually with Clomid (clomiphene)
MOA of Clomid (clomiphene)
- selective estrogen receptor modulator
side effects of Clomid (clomiphene)
- ovarian hyper-stimulation
Clomid (clomiphene) is often used in conjunction with
- intrauterine insemination
anatomic disruption or blockage of both oviducts leading to infertility is often caused by
- untreated STDs/PID
- surgical procedure
tubal blockage can be ruled out with
- hysterosalpingogram
- evaluates patency of tubes, not necessarily function
what are the four main categories of male factor infertility
- hypothalamic pituitary dysfunction
- primary hypogonadism
- post-testicular defects
- seminiferous tubule dysfunction
what is the most common congenital abnormality causes primary hypogonadims
- Klinefelters syndrome
- 47 XXY
what medications are used to induce abortion
- Misoprostol + Mifepristone
- effective 95-98%
