Infertility and contraception Flashcards
what is infertility
inability to conceive within 1 year
primary- those who have never conceived
secondary- those who have conceived in the past
Incidence of primary infertility is a result of
social changes, delayed child bearing
85-90% will conceive within 1 year
causes of infertility
d/t either partner 15-20% no cause found male is a factor in 25% Ovulatory dysfunction and tubal/peritoneal factor are main cause of female infertility Thyroid D/p
what are the 4 key areas of evaluation in infertility
sperm
ooctye
transport-fallopian tubes
implantation-uterus
Semen analysis
normal results excludes need for any other system eval
Pt should abstain from se 2-5 days before collecting sample and need to be done within an hour
what is done in female eval
confirm ovulation
FSH, estradiol, serum progesterone, TSH, prolactin
Pelvic US
edometrial Bx
what things can be done to increase female factors for pregnancy
clomiphene, letrozole
IVF, surgery
weight loss, smoking cessation
what is contraception
The deliberate use of artificial methods or other techniques to prevent pregnancy as a consequence of sexual intercourse.
what are S/E with Birth control pills/ patch / vaginal ring
N/V
breast tenderness
decreased libido
weight gain
Who should not use the combo pill
risk for heart attack, stroke, blood clots
smoker 35+ should not use
what meds can make the birth control less effective
rifampin
griseofulvin
st john’s wort
HIV and seizure meds
what are side effects of the birth control shot/ Depo
Weigh Gain menstrual irregularity HA reduced bone density after stopping may take a while to get pregnant
what is a benefit of birth control implant method
can be used in breast feeding at 4 wks postpartum
what are side effects with birth control implant under the skin
mood swings weight gain HA acne risk of blood clots, problems at insertion site
what is benefit of IUD
can be used while breast feeding
what is a copper IUD CI with
wilsons disease
what are risks with IUD
can slip out
infection
uterine perforation
what are S/E of IUD
pain with insertion
Acne, HA
breast tenderness with hormonal IUD
what are inconviences with IUD
has to be placed by HC provider
r/o pregnancy and STI before procedure
exam after 1st period to ensure placement
tubal sterilization
permanent sterilization
closing or blocking off fallopian tubes
tubal ligation is done how
under sedation and laprascopt
Essure is done how
with hyperscope and not sedation
what are the risk with tubal ligation or essure
risk with surgery and anesthesia
wrong placement with Essure tubes may not be blocked after 3 month
Vasectomy
not immediately effective about 3 months
what are the risk with a vasectomy
risk with any surgery
tubes may grow back together
regret
what types of emergency contraception are there
birth control pill
copper IUD
Morning after pill
