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Human reproduction and fertility > Infertility and assisted reproductive technologies > Flashcards

Infertility and assisted reproductive technologies Flashcards

1
Q

Reasons for the global decline in fertility rate

A

increased access to education
lower child mortality
increased cost of raising children
exposure to chemicals/hormones interfering with spermatogenesis
could be differences in counting assays

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2
Q

Oligozoospermia

A

low sperm count
occurs in 1/20 of males
accounts for 1/3 of difficulties

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3
Q

Asthenozoospermia

A

low sperm mobility
sperm movement impeded so they can’t reach egg

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4
Q

Teratozoospermia

A

abnormal sperm
may have an unusual shape
harder to move + fertilise

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5
Q

Azoospermia

A

no sperm

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6
Q

Possible problems with sperm production

A

varicoceles
undescended testes
chromosomal abnormalities
hormonal problems
lifestyle

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7
Q

Possible problems with sperm transport

A

infection
tube blockages
tumours
congenital absence of vas deferens

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8
Q

Possible problems with sexual dysfunction

A

retrograde ejaculation
spinal cord injury
prostate surgery
medicines

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9
Q

Fecundity

A

likelihood of conception
drops between 30-40 and 40-45

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10
Q

Varicoceles

A

most common on left side
when blood flows backwards down internal spermatic vein
causes dilation in vein of testes

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11
Q

How does varicoceles cuase infertility?

A

complex and multifactorial reasons
increases ROS is a key factor

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12
Q

Problems with oogenesis + ovulation

A

age decreased ovarian reserve + decline in quality
hormone imbalances
over/under active thyroid
premature ovarian failure
genetic causes

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13
Q

Problems with oocyte/zygote transport and implantation

A

tubal damage- infection or ectopic pregnancy
endometriosis
fibroids
surgical damage
pelvic inflammatory disease

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14
Q

Problems with pregnancy

A

chromosomal abnormalities
structural issues with uterus
autoimmune condition
lifestyle factors

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15
Q

Polycystic ovarian syndrome

A

most common endocrine disorder in females of reproductive age
associated with absent/irregular menstrual cycles

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16
Q

What is PCOS caused by?

A

imbalance in HPG axis
too much GnRH produced

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17
Q

How does increased GnRH cause polycystic ovarian morphology?

A

increased levels of LH
thecal cells expand + produce androgens but granulosa cells don’t due to lack of FSH in comparison
ovaries become full of half developed oocytes

18
Q

What other effects does PCOS have?

A

higher testosterone- impacts insulin
hyperinsulinemia
impact on liver enzyme production

19
Q

Diagnosis of infertility in males

A

semen analysis
then hormone analysis

20
Q

Diagnosis of female infertility

A

blood hormone analysis

21
Q

Assisted reproductive technologies

A

used to treat infertility and usually involves treatments where gametes are handled outside the body

22
Q

IVF

A

in vitro fertilisation
mature eggs removed and fertilised in vitro before reinsertion into uterus

23
Q

IVM

A

in vivo maturation
oocytes collected at antral phase and cultured in vivo in presence of FSH + other factors

24
Q

ICSI

A

intra-cytoplasmic sperm injection
sperm/spermatids injected directly into egg cytoplasm

25
Q

CT

A

cytoplasmic transfer
giving infertile women’s oocytes a boost with donor oocytes
mixed or heteroplasmic population of mitochondrial DNA
banned due to developmental worries

26
Q

GIFT

A

gamete intra-fallopian transfer
eggs+ sperm combined in vitro and immediately inserted into fallopian tube through abdomen incision

27
Q

ZIFT

A

zygote intra-fallopian transfer
same as GIFT but wait until fertilisation occurs

28
Q

NT

A

nuclear transfer

29
Q

What is the benefit of IVM?

A

women can avoid use of drugs
important if vulnerable to ovarian hyperstimulation syndrome

30
Q

Why does IVF require fertility drugs?

A

suppression of HPG axis + natural cycle
stimulation of oocyte production by ovaries
suppression of ovulation
also addition of sperm capacitation factors

31
Q

Stages of IVF treatment

A

ovarian hyperstimulation → egg retrieval → sperm preparation → co-incubation → embryo transfer → pregnancy

32
Q

Benefits of ICSI

A

bypasses normal fertilisation + allows use of non-motile sperm
successful procedure
possibility for azoospermic patients if late stage spermatids used instead

33
Q

What are the benefits of GIFT?

A

fertilisation happens inside the body + embryo transplants naturally
can be important for religious reasons

34
Q

Methods of cyropreservation

A

slow freezing- traditional
vitrification- use of high initial cryoprotectants and ultra rapid cooling

35
Q

Ethical and legal considerations for cryopreservation

A

unclaimed embryos
couples breaking up
death of partner

36
Q

Mitochondrial transfer

A

similar to CT
aimed at people who have a high risk of passing on debilitating/fatal genetic diseases to their children

37
Q

MT techniques

A

spindle transfer
pronuclear transfer
polar body transfer

38
Q

Spindle transfer

A

metaphase II spindle removed from both of the eggs
patient chromosomes are inserted into the egg
fertilisation occurs and embryo forms

39
Q

Pronuclear transfer

A

patients oocytes are fertilised
pronulcei are removed + transferred to enculceated egg with normal mitochondria

40
Q

Problems with mitochondrial transfer

A

mutated mitochondria may gradually increase and reintroduce disease

41
Q

Somatic cell nuclear transfer

A

similar to mitochondrial transfer
no recombination of chromosomes
associated with much higher levels of abnormalities/illness

42
Q

Therapeutic cloning

A

embryo created using SCNT → pluripotent ESCs are harvested from inner cell mass of blastocyst → can differentiate in vitro into specific lineage

Human reproduction and fertility (5 decks)

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