Infertility: lasku Flashcards
what is estrogen fraction used to evaluate
sexual maturity, menstrual problems, fertility, fetal-placental health, estronge-producing tumors in females
when does E2 peak?
peaks during the ovulatory phase
estrodil E3
produced in placenta
major in pregnancy
estrone E1
from androstenedione peripheral tissues
drugs that elevate and decrease estrogen
increase: steroids, ampicillin, estrogen containing drugs
decrease: clomiphene (used to treat infertility)
Clinical sig of increased estrogen levels
feminization syndrome, precocious puberty
ovarian, testicular adrenal tumors
normal preg
hepatic cirrhosis
hyperthyroidism
clinical sig od decreased estrogen levels
failing pregnanxy
turners
hypopituitarism
primary and secondary hypogonadism
menopause: low estrogen/progesterone: high LH/FSH
anorexia nervosa
what is progesterone assay used for
infertility
problems maintaining the pregnancy
when should progesterone assay be done
check day 21 bc its at its highest levels
where is progesterone secreated
secreted by corpus luteum after ovulation
initiates the secretory phase of endometrium
clinical sign of increased progesterone levels
ovulation, pregnancy, luteal cysts of ovary, adrenocortical hyperplasia, choriocarcinoma (releases HCG which stimulate the corpus luteum to continue to make progesterone to support preg)
clinical sig of decreased progesterone levels
amenorrhea, ovarian hypofunction, preeclampsia, eclampsia, threatened abortion, placental failure, fetal death, ovarian neoplasm
complications during pregnancy of low progesterone:
preclampsia: high BP and protein in urine
eclampsia: develops seizures
what is serum testosterone used to evaluate
ambiguous sex characteristics
precocious puberty
virilizing syndromes in females
infertility in males
where is testosterone secreted?
leydig cells of the testicles
where are DHEA and androstenedione produced
in the adrenals
what does LH stimulate in males
FSH?
LH: stimulates the production of testosterone
FSH: stimulates spermatogenesis
clinical sig of increased testosterone levels males vs females
males: sexual precocity, congenital adrenal hyperplasia, leydig cell tumors, hyperthyroidism, adrenocortical tumor
females: pcos, congenital adrenal hyperplasia, trophoblastic tumor (during pregnancy)
what is LH/FSH assay used to evaluate
infertility, menopause, gonadal failure
interfering factors in LH/FSH assay
drugs that increase: cimetidine, digitalis, levodopa, clomiphene
drugs that decrease: estrogen, progesterone, testosterone, steroids
clinical sig of increased LH/FSH
gonadal failure
precocious puberty
pituitary adenoma
PCOS
clinical sig of decreased LH/FSH
pituitary failure
hypothalamic failure
stress
anorexia nervosa, malnutrition
what is semen evaluation used to evaluate
quality of sperm, infertile couple, to document the adequacy of operative vasectomy
performed 2-3 days of sexual abstinence
sperm count
50-200 millin/ml
anti spermatozoal antibody
in an infertility screening to detect the presence of sperm antibodies
IgA anti-sperm antibodies
decrease sperm mobility
igG anti-sperm antibodies
decrease their ability to penetrate the ovum
when are antispermatozoal antibodies present in men
positive in men with blocked efferent ducts of testes and in 30-70% of them who have had a vasectomy
postcoital test (sims-huhner test)
from cervical mucus
measures the ability of sperm to penetrate the mucus and maintain motitlity
when is the postcoital test (sims-huhner test) performed
done midcycle when estradiol levels are highest
a specimen of endocervical mucus is obtained between 2-8 hours after intercourse
normal postcoital test (sims-huhner test) findings
mucus is clear
stretchable for more than 4cm (spinnbarkeit)
exhibits a ferning pattern
contains more than 5 motile spem
abnormal postcoital test (sims-huhner test) findings
increased viscosity
absence of sperm
more than 3 WBC suggest antisperm antibodies and cervicitis or prostatitis
