Infertility And Pregnancy Loss

Question 1

What proportion of couples are affected by infertility

Answer 1

One in 8 couples

Question 2

How many months of inability to achieve pregnancy with unprotected intercourse is considered infertility

Answer 2

Twelve months

Question 3

What percentage of infertility are caused by male, female, or combined causes

Answer 3

30%, 30%, 25%

Question 4

What percentage of infertility is unexplained

Answer 4

25%

Question 5

After how many months should someone under 35 or over 35 seem an evaluation

Answer 5

12 months, 6 months

Question 6

What is included in a fertility work up for the assigned male at birth partner

Answer 6

Reproductive history, social history, medical & family history, semen analysis: volume, total count, concentration, motility, morphology, vitality

Question 7

What is included in the fertility work up for the assigned female at birth partner

Answer 7

Fertility & gynecological history, medical & family history, social history, ovulation, uterine factors, patent of tubes

Question 8

How does fragile x syndrome affect fertility

Answer 8

Premutation associated with ovarian insufficiency (20% of those with ovarian insufficiency)- cycle irregularities, FSH>40, effects women under 40

Question 9

How does monosomy X affect fertility

Answer 9

Oocytes undergo apoptosis & disappear by age two, they are able to carry a pregnancy

Question 10

How does klinefelters affect fertility

Answer 10

Small testes, androgen deficiency, low testosterone, azoospermia or oligospermia

Question 11

How does cystic fibrosis affect fertility

Answer 11

Males will have congenital absence of the vas deferens (80% of people with congenital absence of vas deferens will have CFTR mutations )

Question 12

What percent of couples with recurrent miscarriage will have balanced chromosome rearrangement

Answer 12

~2-5%

Question 13

What is the most common chromosomal cause of male infertility

Answer 13

Y microdeletion, due to deletion of AZF region, this impairs spermatogenesis & causes azoospermia or oligospermia

Question 14

What percentage of pregnancies end in loss

Answer 14

At least 25%

Question 15

When in gestation is a loss considered a miscarriage

Answer 15

Before 20 weeks gestation

Question 16

What is a chemical pregnancy

Answer 16

Early loss before confirmation on ultrasound

Question 17

What is a blighted ovum or an anembryonic pregnancy

Answer 17

Gestational sac forms, but embryo fails to develop

Question 18

What is an ectopic pregnancy

Answer 18

Embryo implanted outside of uterus, usually in fallopian tube

Question 19

What is a missed miscarriage or missed abortion

Answer 19

Embryo has died or not developed, but has not been physically miscarried

Question 20

When in gestation is a loss considered a stillbirth

Answer 20

After 20 weeks gestation

Question 21

What is considered recurrent pregnancy loss

Answer 21

Two or more clinical recognized pregnancies that ended in loss

Question 22

What proportion of couples are effected by recurrent pregnancy loss

Answer 22

One in one hundred

Question 23

What types of evaluations are included in a work up for recurrent pregnancy loss

Answer 23

Anatomical, hormonal, immune, genetic

Question 24

What percentage of first trimester miscarriage are chromosomal abnormal

Answer 24

50%

Question 25

What aneuploidies are most common in first trimester miscarriages

Answer 25

16, 22, 21, monosomy x

Question 26

What types of genetic testing are preconception options for recurrent pregnancy loss

Answer 26

Expanded carrier screening, karyotype, molecular testing for patient or family dx, products of conception testing