Infertility and Contraception Flashcards
Define infertility
Inability to conceive within 1 year
Classifications of infertility
- Primary: have never conceived
- Secondary: have conceived in the past
- Sterility: inability to achieve pregnancy
What is the main cause of female infertility?
Ovulatory dysfunction and tubal/peritoneal factors
4 key areas of assessment for infertility
Sperm
Oocyte
Transport (fallopian tubes)
Implantation (uterus)
In semen analysis, if first result is abnormal, when should a repeat be performed?
4 weeks
Semen analysis patient instructions
- Abstain from sex 2-5 days before
- Sample needs to be in lab within an hour
Treatment options of male infertility
- Intrauterine insemination
- Intra cytoplasmic sperm injection
- Surgery
- Donor sperm
Treatment options of female infertility
- Ovulation induction (clomiphene, letrozole)
- IVF/embryo transfer
- Surgery
- Wt loss, smoking cessation
- Adoption, surrogacy, no tx at all
Define coitus interruptus
Withdrawal of penis before ejaculation
Describe the vaginal sponge
- Round plastic foam w/spermicide
- Covers cervix and kills sperm
- More effective in women who have never given birth
Which form of contraception must stay in place 6 hours after intercourse?
Cervical cap
What meds make OCPs less effective?
- Rifampin
- Griseofulvin
- St Johns wort
- Certain HIV and anti seizures
Cause of infertility?
- 75% cases are d/t female
- 15-20% cases unknown cause
How should patients be evaluated for infertility?
- BOTH partners present
- Thorough hx and physical
DES and infertility
- DES exposed daughters may have infertility
- DES exposed SONS show NO increased risk for infertility
