Infertility And Pregnancy Loss Flashcards
What proportion of couples are affected by infertility
One in 8 couples
How many months of inability to achieve pregnancy with unprotected intercourse is considered infertility
Twelve months
What percentage of infertility are caused by male, female, or combined causes
30%, 30%, 25%
What percentage of infertility is unexplained
25%
After how many months should someone under 35 or over 35 seem an evaluation
12 months, 6 months
What is included in a fertility work up for the assigned male at birth partner
Reproductive history, social history, medical & family history, semen analysis: volume, total count, concentration, motility, morphology, vitality
What is included in the fertility work up for the assigned female at birth partner
Fertility & gynecological history, medical & family history, social history, ovulation, uterine factors, patent of tubes
How does fragile x syndrome affect fertility
Premutation associated with ovarian insufficiency (20% of those with ovarian insufficiency)- cycle irregularities, FSH>40, effects women under 40
How does monosomy X affect fertility
Oocytes undergo apoptosis & disappear by age two, they are able to carry a pregnancy
How does klinefelters affect fertility
Small testes, androgen deficiency, low testosterone, azoospermia or oligospermia
How does cystic fibrosis affect fertility
Males will have congenital absence of the vas deferens (80% of people with congenital absence of vas deferens will have CFTR mutations )
What percent of couples with recurrent miscarriage will have balanced chromosome rearrangement
~2-5%
What is the most common chromosomal cause of male infertility
Y microdeletion, due to deletion of AZF region, this impairs spermatogenesis & causes azoospermia or oligospermia
What percentage of pregnancies end in loss
At least 25%
When in gestation is a loss considered a miscarriage
Before 20 weeks gestation
What is a chemical pregnancy
Early loss before confirmation on ultrasound
What is a blighted ovum or an anembryonic pregnancy
Gestational sac forms, but embryo fails to develop
What is an ectopic pregnancy
Embryo implanted outside of uterus, usually in fallopian tube
What is a missed miscarriage or missed abortion
Embryo has died or not developed, but has not been physically miscarried
When in gestation is a loss considered a stillbirth
After 20 weeks gestation
What is considered recurrent pregnancy loss
Two or more clinical recognized pregnancies that ended in loss
What proportion of couples are effected by recurrent pregnancy loss
One in one hundred
What types of evaluations are included in a work up for recurrent pregnancy loss
Anatomical, hormonal, immune, genetic
What percentage of first trimester miscarriage are chromosomal abnormal
50%
What aneuploidies are most common in first trimester miscarriages
16, 22, 21, monosomy x
What types of genetic testing are preconception options for recurrent pregnancy loss
Expanded carrier screening, karyotype, molecular testing for patient or family dx, products of conception testing
