L50 Assisted Reproduction Flashcards
What fertility treatment is best for:
- tubal pathology
- endometriosis
- reduced sperm motility
- diminished ovarian reserve
- PCOS
- pituitary disease
- unexplained fertility
IVF
What are the IVF exclusion criteria?
Age: <24 or 40<
Smokers or partner smokes
BMI: <19 or 30<
FSH 10< on 3 occasions (ovarian reserve)
What is anti-mullerian hormone measured for?
Checking ovarian reserve.
Regulates late follicular development.
What is the difference between azoospermia and oligospermia?
Azoospermia = no sperm in ejaculate
Oligospermia = decreased sperm in ejaculate
What treatment is best for oligospermia?
IVF
What treatment is best for azoospermia?
Previous donor insemination, or ICSI (intracytoplasmic sperm injection) - either by centrifuging ejaculate to find a viable sperm or by testicular biopsy (obstructive azoospermia)
True or false: Use of clomiphene increases the risk of multiple pregnancy?
True
Can you use clomiphene to treat infertility caused by polycystic ovary syndrome?
Yes, but you increase the risk of twins
Why is it important to carefully monitor infertility patients being treated with gonadotropins?
High risk of multiple pregnancy
What causes hyperprolactinaemia?
Common cause is prolactinoma - surgery can be used, more commonly dopamine agonists (bromocriptine, cabergoline)
What agent is used in controlled ovarian hyperstimulation therapy?
Abolish endogenous gonadotropins with LHRH agonist, use exogenous FSH to stimulate multiple follicle growth. Use LH (hCG) to stimulate ovulation.
When treating infertility with controlled ovarian hyperstimulation, how many follicles do you aim to grow?
Between 5 and 20 (mean is 12)
Less than 5 is inadequate, more than 20 is risk of hyperstimulation - abandon therapy.
