Brainscape's Knowledge GenomeTM

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


See full index

RED > L07: Fertility And Infertility Diagnosis And Causes > Flashcards

L07: Fertility And Infertility Diagnosis And Causes Flashcards

1
Q

What do you need to do to be fertile (to in males and females)

A 
Produce sperm 
Produce egg 
Sperm should transverse female tract
Sperm has to penetrate and fertilise the egg
Implantation of embryo into uterus 
Normal pregnancy i.e no miscarriage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the definition of fertility

A

Measure of actual outcome of the reproductive process- number of children born

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

What is the definition of fecundability

A

Probability of pregnancy each month of an individual or population.

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

What is the definition of fecundity

A

Measure to conceive AND produce a live birth

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

What is the definition of infertility

A

Inability to conceive after a period of unprotected intercourse or inability to carry a pregnancy to term

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

What does NICE say the definition of infertility is

A

Failing to get pregnant after 2 years of regular unprotected sex

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

What is the definition of sub fertility

A

A state of reduced fertility

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

What causes increase the risk of infertility

A

Age
Smoking
Obesity
STI’s

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

Name and STI

A

Chlamydia

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

What are the groups of diseases that can cause fertility problem in females

A

Ovulatory disorder
Tubal damage
Endometriosis
Uterine abnormalities

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

What investigations can be carried out for a female patient presenting with fertility problems

A

LH/FSH ratio
Day 21 progesterone
Laparoscopy
Hysterosalpingogram (HSG)

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

What does looking at FSH/LH ratio help us to look at

A

Ovarian reserve

PCOS

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

What does day 21 progesterone help us to look at

A

If ovulation is occurring

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

What is laparoscopy

A

Key hole surgery that allows to view the uterus

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

What is hysterosalpingogram

A

Dye is inserted into the uterus and viewed with X-RAY

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

What does hysterosalpingoram allow to detect

A

Blockage of tubes

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

If there is no tubal blockage what happen to the dye

A

Spills into the pelvic cavity

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

What can ovulation disorders present as

A

Ammenorhhea
Secondary ammenorhhea
Oligomenorrhea

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

What are possible disorders that cause ovulation disorders

A

Idiopathic ovarian failure
PCOS
Luteinesed unruptured follicle syndrome
Abbreviated luteal phase

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

What does the idiopathic ovarian failure result in

A

Oestrogen levels do not rise and follicles to not mature this results in small follicles

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

What are the hormones like in PCOS

A

High FSH
High androgen
No oestrogen deficiency

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

What is the abbreviated luteal phase hormone Satus like

A

Decreased progesterone

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

What does decreased progesterone result in

A

Poor luteinisation

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

What are the disorders that can occur in the female tract

A

Tubal obstruction

Endometriosis

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

What can tubal obstruction occur as a result of

A

Infection

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

If the tube is blocked what becomes affected

A

The release of the egg
The transport of sperm to the egg
Due to loss of cilia and intraluminal cells and scarring that cause adhesion

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

What is endometriosis

A

When the endometrium of the uterus increases in ectopic sizes such as oviduct, ovary, peritoneal cavity

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

What are the maternal problems that can occur that affects fertility

A

Cervical incompetence
Implantation defects
Autoimmune
Immunological incompatible in terms of ABO or rhesus blood group loci

29
Q

What increases the risk of tubal infection

A

STD, eg gonorrhoea, chlamydia, tuberculosis

30
Q

What is the biochemical test for testing for pregnancy

A

HCG in blood or urine

31
Q

At what day do we test for HCG after the last period

A

18-30 days

32
Q

How do we test for clinical pregnancy

A

Ultrasound at week 5 as a foetal sac

33
Q

If we do an ultrasound at week 7 what would be visible

A

Foetal heart

34
Q

What is the main cause of spontaneous pregnancy loos

A

Chromosomal abnormalities

35
Q

What are the 3 categories that result in chromosomal abnormality

A

Translocation
Errors of ploidy
Errors of chromosome number or somy

36
Q

What is errors of ploidy

A

Deletion or duplication of a complete set of haploid chromosome i.e from diploid to tetraploid

37
Q

What are the errors of chromosome or somy about

A

Loss or gain of a single chromosome

38
Q

What does aneuploidy mean

A

Having one or more chromosome above or below the normal chromosome number

39
Q

What happens to the risk of aneuploidy as maternal age increases

A

Risk increases

40
Q

Why is there an increased risk of aneuploidy with increased age

A

Egg quality decreases as egg can become damaged

41
Q

What can be the causes of male disorders for fertility

A 
Production of sperm
Transport of sperm 
Motility of sperm 
Sperm function in female tract 
Fertilisation and events after
42
Q

What tests should be done for a male with fertility issues

A

Semen analysis

Blood test

43
Q

If a male has a sperm production of less than 5 million per ml what is required

A

Endocrine evaluation

44
Q

What does normozoospermic mean

A

Normal sperm with:

  • more than 15 million spermatozoa
  • more than 32% motility
  • more than 4% normal morphology
45
Q

What does oligozoospermic mean

A

Less than 15 million spermatozoa per ml

46
Q

What does asthenozoospermic

A

Less than 32% of rapid and medium forward progressive motility

47
Q

What does tetrazoospermic mean

A

Less than 4% of sperm with normal morphology

48
Q

What does azoospermic mean

A

No sperm

49
Q

Why can a patient be azoospermic

A

Congenital testicular deficiency e.g klinefelters syndrome XXY
Maldescent testis i.e cyrptorchidism
Acquired via trauma or mumps
Endocrine disorder

50
Q

What are the congenital acquired testicular deficiency that lead to azoospermic

A 
Klinefelters syndrome (XXY)
Y chromosome deletion
51
Q

What can be the acquired causes of azoospermic

A

Trauma

Orchitis (MUMPs)

52
Q

Apart from the basic analysis of sperm what other tests can we do on semen

A 
Leukocytes 
Sperm viability test 
Sperm vitality 
Antisperm antibodies 
CASA
53
Q

At what leukocyte level indicates infection

A

More than 1 million per ml

54
Q

What does sperm viability test look at

A

Even though the sperm is not moving, is it still alive

55
Q

What are the causes for failure of transmission of sperm to the female tract

A

Erectile dysfunction

Ejacgulatory dysfunction

56
Q

What are the 2 forms of ejaculatory dysfunction

A

Retrograde

Defects of accessory sex glands

57
Q

Describe the normal process that occurs in normal ejaculation

A

1) prostate, seminal vesical and vas deferens contracts under the influence of SNS
2) seminal fluid and sperm enter the urethra
3) urethral and pelvic floor muscles contract and ejaculation occurs
4) vesicular urethral spinchter closes bladder neck

58
Q

What is retrograde ejaculation

A

1) the urethral spinchter at the bladder neck does not close
2) ejculaton is into the bladder
3) so the sperm is low or nil

59
Q

What are the associated conditions with retrograde ejaculation

A

Diabetes
Post traumatic paraplegia
Post bladder neck surgery

60
Q

How is retrograde ejaculation confirmed

A

Semen in urine

61
Q

What are the causes of total failure in transport of sperm

A

Infections

Congenital bilateral absences of vas deferens (CBAVD)

62
Q

What is CBVAD linked to

A

Cystic fibrosis

63
Q

What occurs in CVAD

A

Improper development of the vas deferens

64
Q

It there is no obstruction in the male tract but patient is azoospermic or oligozoospermia what need to be tested

A

Genetic testing for chromosomal abnormality

65
Q

What is the definition of unexplained infertility

A
  • normal frequency of unprotected intercourse
  • no obstruction or malformation of female/male tract
  • normal follicle growth and ovulation and no signs of inflammatory reactions in female
  • normal motile sperm and no signs of inflammatory reactions in males
66
Q

What does high levels of FSH/LH indicate

A

Low ovary reserve as there is no negative feedback

67
Q

What does low levels of LH/FSH indicate

A

Pituitary and hypothalamus pathology

68
Q

In PCOS why is there higher levels of LH

A

LH stimulates theca cells to produce testosterone

69
Q

Why are there normal levels of oestrogen in PCOS

A

1) there is normal levels of FSH

2) FSH acts on granulosa cells to produce aromatase which converts the testosterone into oestrogen

RED (19 decks)

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