Infertility & assisted conception Flashcards
What infections are checked for prior to assisted conception treatment?
Rubella
BBVs (Hep B/C, HIV)
How do you assess ovulation?
Progesterone Day 21
How is intrauterine insemination performed?
Prepared semen inserted into uterine cavity around time of ovulation
In IVF what is used to down regulate prior to the baseline scan?
Synthetic gonadotrophin
How are the ovaries stimulated in IVF?
H containing gonadotrophins (FSH +/- LH)
What is the purpose of the action scan in IVF?
To assess response to FSH
Assess for risk of OHSS
Plan date/timing of HCG injection (mimics LH)
What is the main concerning complication of IVF?
Ovarian HyperStimulation Syndrome (OHSS)
How does OHSS present?
Abdo pain/bloating
Nausea
Diarrhoea
Breathlessness
How is OHSS treated?
if before transfer ‘coasting.elective freeze
If after mnitor,anti-thrombotic
What are the current success rates for IVF?
35%
Which embryological ducts go onto form the repro tract in males?
Wolfian ducts
Which embryological ducts go onto form the repro tract in females?
Mullerian ducts
What causes androgen insensitivity syndrome?
Androgen induction of Wolfian duct does not occur
How is cryptorchidism treated?
Orchidoplexy if <14 y/o (to reduce cancer risk)
If an adult consider orchidectomy
What cells produce testosterone?
Leydig cells
What do sertoli cells secrete?
Inhibin & activin
Secrete androgen binding globulin
What does inhibin do?
Regulates FSH secretion & controls spermatogenesis
What does testosterone inhibit?
GnRH & LH
What are the functions of dihydrotestosterone?
Enlargement of male sex organs
Secondary sexual characteristics
Anabolism
What is thefunction of the epididymis & vas deferens?
Exit route from testes to urethra
Concentrate & store sperm
Sperm maturation
What is the function of theseminal vesicles?
Produce sperm into ejaculatory duct
Supply fructose
Secrete prostaglandins (stimulates motility)
Secrete fibrinogen
What is the function of the prostate gland?
Produce alkaline (neutralise vagina) Produces clotting enzymes to clot semen within females
What is the function of the bulbourethral glands?
Lubricant
What are obstructive causes of male infertility?
CF
Vasectomy
Infection
What hormones are checked in a male infertility screen?
LH FSH Testosterone PRL TSH
