Infertility and Assisted Conception

Question 1

What is Buserelin?

Answer 1

A synthetic GnRH analogue that is administered as a spray or injection and causes reversible down regulation

Question 2

Name the syndrome that can occur as result of ovarian stimulation

Answer 2

Ovarian Hyperstimulation Syndrome (OHSS)

Question 3

What temperature do the collected eggs need to be kept at?

Answer 3

Above 35 degrees - incubated at 37 degrees celcius

Question 4

How many embryos can be transferred to patients under the age of 40?

Answer 4

Tend to put only one in but no more than 2

Question 5

How many embryos can be transferred to patients aged 40 and over?

Answer 5

2 but 3 may be transferred in exceptional circumstances

Question 6

What is given following the embryo transfer?

Answer 6

Cyclogest (progesterone) pessaries

Question 7

What is azoospermia?

Answer 7

The absence of motile sperm in the semen

Question 8

What are the symptoms of OHSS?

Answer 8

Ovarian Hyperstimulation Syndrome
Abdominal pain/bloating
Nausea/diarrhoea
Breathless

Question 9

Risks involved in having a child at an older age

Answer 9

Miscarriage
Ectopic Pregnancy
Chromosomal Abnormalities
Low birth weight/premature
Still birth

Question 10

What procedure should be carried out if undescended testicles are found in a boy under the age of 14 years

Answer 10

Orchidopexy - move undescended testicle into the scrotum

Question 11

What should be carried out if undescended testicles are found in an adult male?

Answer 11

Orchidectomy - removal of the testes

Question 12

Where does spermatogenesis occur in the male?

Answer 12

In the seminiferous tubules of the testis

Question 13

Where does production of testosterone occur within the male?

Answer 13

In the Leydig cells of the testis

Question 14

What is the definition of male infertility?

Answer 14

The failure of sperm to normally fertilise the egg

Question 15

Name some endocrine causes of male infertility

Answer 15

Acromegaly
Thyroid disease
Hyperprolactaemia
Anorexia
Cushing's

Question 16

Name some obstructive causes of male infertility

Answer 16

Congenital abnormality - CF
Vasectomy
Infection

Question 17

Name some of the causes of male infertility that are related to testicular failure

Answer 17

Undescended testes
Genetic abnormality - Kleinfelter's 
Chemo
Radiotherapy
Idiopathic

Question 18

Name erectile difficulty related causes of male infertility

Answer 18

Psychosexual
Diabetes
Spinal cord injury

Question 19

On assessing someone with non-obstructive infertility what hormonal picture would you expect to see?

Answer 19

Increased LH
Increased FSH
Decreased testosterone

Question 20

Which fertility treatment is indicated in those with a low sperm count?

Answer 20

Intrauterine insemination

Sperm sample is taken and a concentrated sperm sample is produced to inseminate into the uterine cavity.

Question 21

What fertility treatment is indicated in those with azoospermia?

Answer 21

Surgical Sperm Aspiration

Then injected into the oocyte

Question 22

When would donor sperm insemination be considered?

Answer 22

Azoospermia or very low sperm count, genetic or infective conditions

Question 23

What portion of couples suffer form infertility?

Answer 23

1 in 6 - approximately 15%

Question 24

Embryo transfer is most successful at what stage of development?

Answer 24

Blastocyst

Question 25

What would be the best treatment for a couple with a five year history of unexplained infertility?

Answer 25

IVF

Question 26

What would be the best treatment for a couple where the male had a vasectomy 3 years ago?

Answer 26

Surgical sperm retrieval and ICSI

Question 27

What effect does clomifene citrate have?

Answer 27

Stimulates ovulation - often used in women with PCOS

Question 28

Oliogoasthenospermia

Answer 28

Low sperm count and low motility

Question 29

Teratoasthenospermia

Answer 29

Low motility and abnormal forms