Infertility and Assisted Conception

Question 1

1 in how many couples require assistance of infertility in the UK?

Answer 1

1 in 6

Question 2

what is the name given to any treatment that involves gametes outside the body?

Answer 2

Assisted conception treatment (ACT)

Question 3

what must women do before ACT?

Answer 3

limieted to 4 untis alcohol/wk

BMI 19-29

folic acid supplement

cervical smears up to date

screened for blood borne viruses

Question 4

what must be done prior to donor insemination?

Answer 4

abstinence for 72hrs

Question 5

which ACT involves prepared semen being inserted into uterine cavity around time of ovulation?

Answer 5

Intra-Uterine Insemination (IUI)

Question 6

define azoospermia

Answer 6

semen contains no sperm

Question 7

explain Intra Cytoplasmic Sperm Injection (ISCI)

Answer 7

egg is stripped, sperm immobilised and single sperm injected

incubated overnight at 37^oC

Question 8

what needs to be done to obtain sperm if azoospermia?

Answer 8

surgical aspiration

Question 9

what are the treaement steps in IVF?

Answer 9

down regulation to allow precise timing of oocyte recovery using HCG trigger

ovarian stimulation

oocyte collection

fertilisation

transfer of blastocyst day 5

embryo transfer

Question 10

what are some complications of IVF?

Answer 10

multiple pregnancies

ectopic pregancy

Ovarian hyper-stimulation syndrome

Question 11

how woul dovarian hyperstimulation syndrome present?

Answer 11

abdo bloating and pain

larger ovarian size

N&V

Question 12

embryo research is permitted up to how many days?

Answer 12

14 days

Question 13

which chromosome has the sex determinign region?

Answer 13

Y chromosome

Question 14

what are the male and female primitive genital tracts?

Answer 14

male → wolfian ducts

female → mullerian ducts

Question 15

the Wolffian ducts will develop into female genital tract without stimulus of which hormones?

Answer 15

testicular hormones- testosterone and mullerian inhibiting factor

Question 16

external genitalia is determined by which hormone?

Answer 16

dihydrotestosterone

Question 17

the internal genital tract starts to differentiate from what week?

Answer 17

week 9

able to recognise on scan week 16

Question 18

what is the term used fro undescended testes?

Answer 18

cryptorchidism

Question 19

what stimulates release of LH and FSH froma nterior pituitary?

Answer 19

GnRH

Question 20

function of LH and FSH in males?

Answer 20

LH- stimulates testosterone release

FSH- stimulates spermatogensis

Question 21

which cells release testosterone?

Answer 21

Leydig Cells

(LH Leydig)

Question 22

functions of testosterone?

Answer 22

-ve feedback with LH

spermatogensis

-ve feedback of GnRH

Question 23

what are the hormones responsible for the stimulation and inhibition of FSH?

Answer 23

activin- stimulates FSH

inhibin- inhibits FSH

Question 24

testosterone is a steroid hormone derived from which molecule?

Answer 24

cholesterol

Question 25

funciton of seminal vesicles?

Answer 25

produce semen into ejaculatroy duct

supply fructose/prostaglandins

Question 26

the prostate gland produces alkaline/acidic fluid?

Answer 26

alkaline (vaginal acidity)

Question 27

testicular volume <5mls is still likely to be fertile T/F?

Answer 27

false

Question 28

what factors can affect semen anaylsis?

Answer 28

abstinence <3 days

condition transport i.e. cold,

.1hr to rpoduce sample

health of man 3 months before production

Question 29

if unhappy w result of semen analysis how soon can you repeat?

Answer 29

6 weeks later

Question 30

obstructive or non-obstructive azoospermia will present with low testicular volume?

Answer 30

non-obstructive

obstructive will have normal testicualr volume

Question 31

what is the treatment for azoospermia?

Answer 31

treat any specific cause i.e reversal of vasectomy

<4units alcohol, BMI <30, stop smoking

ICSI (higher success in obstructive)

Donor insemination