Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Reproduction Year 3 > Infertility + Assisted Conception > Flashcards

Infertility + Assisted Conception Flashcards

1
Q

How is ovarian reserve tested

A

antral follicle count or AMH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is AMH

A

anti-mullerian hormone is a substance produced by granulosa cells in the ovarian follicles

production decreases and then stops as the follicles grow. There is almost no AMH made in follicles >8mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

when can AMH be tested

A

any day of a woman cycle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

how can AMH be a fertility test

A

AMH is only produced in small follicles so blood levels can be used to measure the size of the pool of growing follicles
Women with may small follicles, e.g. PCOS will have high AMH
Women that have few remaining follicles and those that are close to menopause have low AMH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what must BMI of both partners be to be considered for fertility treatment

A

between 19-29

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Indications for intra-uterine insemination (IUI)

A

unexplained infertility
mild/moderate endometriosis
mild male infertility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

how does IUI work

A

prepared semen inserted into uterine cavity around the time of ovulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Indications for IVF (in-vitro fertilisation)

A

unexplained infertility >2 years
pelvic disease (endometriosis, tubal disease, fibroids)
anovulatory infertility
mild male factor infertility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what needs to happen to women about to under go IVF treatment

A

down regulation- puts women artificially into menopause so there is no spontaneous ovulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is used to induce down regulation

A

synthetic GnRH analogue

administered as injection/spray

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

how is follicular development encouraged in IVF

A

ovarian stimulation- gonadotrophin hormone containing either synergic or urinary gonadotrophin (FSH +/- LH)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Side effects of ovarian stimulation

A

mild allergic reaction

Ovarian hyperstimulation syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

sign of thickened endometrium on USS

A

Triple line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is the method for sperm collection in IVF

A

abstinence for 72 hours

ejaculated sample

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what factors are assessed in a sperm sample

A

volume
density- number of sperm
motility- what proportion are moving
progression- how well they are moving

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

how are oocytes collected

A

in theatre

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

risks of oocyte collection

A

bleeding, infection, failure to obtain oocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

how can you tell if an egg has been fertilised

A

two pronuclei

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

at what day after fertilisation does it become a blastocyst

A

day 5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what day is the embryo usually transferred to the mum

A

day 5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is given as luteal support during embryo transfer

A

progesterone suppositories for 2 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what are the indications for intra-cytoplasmic sperm injection (ICSI)

A

severe male factor infertility
previous failed IVF
preimplantation genetic diagnosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is ICSI

A

when you inject sperm into the egg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

how are sperm retrieved for ICSI

A

Extraction from epididymis (if obstructive infertility) testicle (if non-obstructive)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what will be required in azoospermia

A

surgical sperm aspiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what is OHSS and its symptoms

A

Ovarian Hyper Stimulation Syndrome
Enlarged ovaries- excess follicles

Symptoms- abdo pain, bloating, nausea, diarrhoea, SOB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

How is OHSS prevented

A

only transfer one embryo in IVF
anti-thrombotic drugs
monitor closely

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

current IVF success rate

A

35%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

complications of assisted conception

A

multiple pregnancies
ectopic pregnancy
OHSS

30
Q

which chromosome has the sex determining region

A

Y chromosome

31
Q

what are the 2 primitive genital tracts

A

Wolffian ducts

Mullerian ducts

32
Q

which primitive duct becomes male genitals

A

wolffian duct

33
Q

which primitive duct becomes female genitals

A

mullerian duct

34
Q

what causes the development of the male genital tract

A

testosterone + mullerian inhibiting factors cause mullerian duct to degenerate + wolffian ducts to become male tract

35
Q

what causes the development of the female genital tract

A

without stimulus of male testicular hormones, wolffian duct degenerates + mullerian duct becomes female genital tract

36
Q

why are males with CF infertile

A

absent vas deferens

37
Q

where are sperm aspirated from

A

epididymis

38
Q

what is dropping of the testes into the scrotum dependent on

A

androgens

39
Q

what is cryptorchidism

A

undescended testes

40
Q

what does cryptorchidism cause

A

decreased sperm count

usually still fertile if unilateral

41
Q

what is orchidopexy? why is it done?

A

surgically descending the testes

reduces risk of germ cell cancer

42
Q

what cells in the testes produce testosterone

A

leydig cells

43
Q

where does spermatogenesis occur

A

Sertoli cells in seminiferous tubules

44
Q

function of Sertoli cells

A

form a blood-testes barrier
provide nutrients
phagocytosis
secretion of seminiferous tubule fluid, androgen binding globulin, inhibin + activin hormones

45
Q

what stimulates spermatogenesis

A

FSH + testosterone

46
Q

what inhibits FSH secretion

A

inhibin

47
Q

what stimulates release of testosterone

A

LH

48
Q

what does the release of testosterone do to GnRH + LH

A

works by negative feedback to decrease GnRH + LH

49
Q

Where is FSH released from? What is its action? how is it inhibited?

A

released from granulosa cells in anterior pituitary
acts on Sertoli cells to stimulate spermatogenesis
inhibin released from sertoli cells decreases FSH

50
Q

where is LH released from? What is its action? how is it inhibited?

A

released from theca cells in the anterior pituitary
acts on leydig cells to release tesosterone
inhibited by negative feedback from testosterone

51
Q

what type of hormone is testosterone? what is it derived from?

A

steroid hormone derived from cholesterol

52
Q

what is testosterone protective against

A

osteoporosis

53
Q

route of sperm

A

testes - epididymis - vas deferens - ejaculatory duct - urethra

54
Q

what structure produces seem into ejaculatory duct

A

seminal vesicles

55
Q

function of bulbourethral glands

A

secretion of mucus lubricant

56
Q

function of the prostate gland

A

produces alkaline fluid + clotting enzymes

57
Q

ejaculation is under what control

A

SYMPATHETIC

there is smooth muscle contraction

58
Q

how does an erection occur

A

blood fills the corpora cavernosa

59
Q

erection is under what control

A

PARASYMPATHETIC

60
Q

Most common cause of male infertility

A

idiopathic

61
Q

obstructive causes of male infertility

A

CF, vasectomy, infection

62
Q

non-obstructive causes of male infertility

A

undescended testes, chemotherapy, tumour, chromosomal abnormality, endocrine problem, semen abnormality

63
Q

genetic conditions that cause male infertility

A

Kleinfelters ( 47 XXY)

Robertsonian translocation

64
Q

endocrine causes of male infertility

A

pituitary tumours- acromegaly, cushings, prolactinoma

Hypothalmic causes- Kallmans syndrome, tumours

Thyroid- hyper/hypothyroidism

Diabetes

Steroid abuse

65
Q

why does Kallman’s syndrome cause infertility

A

do not produce GnRh- therefore no LH, FSH or testosterone

66
Q

normal testes volume in adults

A

12-25 mls

67
Q

what is globozoospermia

A

round sperm

68
Q

investigations for male infertility

A 
semen analysis 
endocrine profile (LH, FSH, Testosterone, Prolactin, TSH)
Chromosome analysis 
Testicular biopsy
Scrotal Scan
69
Q

clinical + endocrine features of an obstructive cause

A

Clinical: normal testicular volume, normal secondary sexual characteristics, vas deferens may be absent (CF)

Endocrine: normal LH, FSH, Testosterone

70
Q

clinical + endocrine features of a non-obstructive cause

A

Clinical: low testicular volume, reduced secondary sexual characteristics

Endocrine: high LH + FSH and low testosterone
(note all would be low in Kallman’s)

71
Q

what methods of assisted conception can be used when male infertility is the problem

A

IUI
ICSI
Surgical sperm aspiration
donor sperm

Reproduction Year 3 (36 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions