Brainscape's Knowledge GenomeTM

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


See full index

Repro > Lecture 12 - Contraception > Flashcards

Lecture 12 - Contraception Flashcards

1
Q

Contraception

A

Block transport of sperm to avoid fertilisation of oocyte
Disrupt HPG axis to disrupt ovulation
Inhibit implantation of the conceptus into the endometrium

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

Methods of contraception

A
  1. Natural
  2. Barrier control
  3. Hormonal control
  4. Prevention of implantation
  5. Sterilisation
  6. Emergency contraception
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Natural contraception

A

Abstinence
Withdrawal method
Fertility awareness
Lactation amenorrhoea

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

Abstinence

A

Not participating in intercourse

Advantages - 100% effective

Disadvantages - no sex

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

Withdrawal

A

Withdraw before ejaculate

Advantages - no devices or hormones used

Disadvantages

  • not reliable
  • May not withdraw in time
  • pre-ejaculate contains sperm
  • no STI protection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Fertility awareness

A

Using fertility indicators such as cervical mucous viscosity, temperature and length of menstrual cycle

Advantages- no hormones or devices used

Disadvantages - unreliable and no protection against STIs

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

Lactation amenorrhoea

A

Breastfeeding delays the return of ovulation after childbirth

  • suckling stimulates inhibition of dopamine
  • less inhibition of prolactin release
  • prolactin inhibits GnRH release so less gonadal hormones released preventing ovulation

Disadvantages

  • relies on exclusive breast feeding
  • only effective for 6 months after giving birth
  • unreliable
  • No STI protection

Advantages
- no hormones or devices

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

Barrier protection

A

Male and female condoms

  • prevents entrance of sperm into cervix
  • can contain spermicide to kill sperm

Advantages

  • reliable
  • Protections from STIs
  • condoms are widely available

Disadvantages

  • Danger of expiring
  • May rip
  • Reduce sexual pressure
  • Allergy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Hormone protection

A

Combined oestrogen and progesterone:

  • COCP
  • vaginal patches
  • patches

High dose progesterone

  • progesterone implant
  • progesterone injection

Low does progesterone
- progesterone only pill (POP)

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

Combined oral contraceptive pill

A

Oestrogen and progesterone

Action:
Prevents ovulation due to negative feedback
Reduced endometrial receptivity to inhibit implantation
Thickens cervical mucus to inhibit perpetration of sperm

Reliability - 98%

Advantages

  • Reliable
  • no periods
  • receive menstrual disorders
  • reduced risk of ovarian cysts
  • reduced risk of ovarian and endometrial cancer

Disadvantages

  • no protection against STI
  • compliance
  • contraindications - BMI, migraines and breast cancer (risk of DVTs)
  • side effects - breast tenderness, mood disturbance and bleeding
  • increased risk of - DVTs, MI, Stroke, cervical and breast cancer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

COCP missed pill rule

A

Taken for 21 days followed by 7 day break or with 7 day placebo

If miss 1 day - take the pill even if 2 pills in a day
Can’t miss more than 2 pills

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

High dose progesterone injection

A

Intramuscular injection every 12 weeks

Action:

  • prevents ovulation by negative feedback reducing LH
  • thickens cervical mucus to inhibit penetration of sperm
  • prevents endometrial proliferation

Reliability - 99%

Advantages

  • reliable
  • does not disrupt sexual intercourse
  • if can’t have COCP

Disadvantages

  • appointment every 12 weeks
  • side effects
  • delay in fertility returning - 18 months to 2 years
  • no STI protection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

High dose progesterone implant

A

Last 3 years

Action:

  • inhibits ovulation
  • thickens cervical mucus to inhibit penetration of sperm
  • prevents endometrial proliferation

Advantages:

  • lasts for 3 years
  • reliable
  • reversible
  • alternative for people who can’t have COCP
  • natural fertility returns quickly when removed

Disadvantages

  • minor procedure
  • side effects - 1/3rd no bleeding, normal bleeding, bleeding continuously
  • no STI protection
  • nearer to the end of the 3 years, may get bleeding
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Low dose progesterone - progesterone only pill

A

Taken everyday without break

Action:

  • thickens cervical mucous
  • ovulation usually not present

Reliability - 99%

Advantages

  • quickly reversible
  • reliable
  • doesn’t disrupt sexual intercourse
  • can be used when can’t use COCP

Disadvantages

  • user dependent
  • common menstrual problems
  • no protection against STIs
  • interacts with other meds
  • risk of ectopic pregnancy - reduced motility of myometrium
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Implants

A

Intrauterine system

Intrauterine device

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

Intrauterine system

A

Plastic device that releases progesterone
Works for 3 - 5 years

Action:
Prevents implantation
Reduces endometrial proliferation - controls menorrhagia
Thickens cervical mucus

Advantages:
Longw duration of action
Can limit menorrhagia

Disadvantages:

  • Unpleasant insertion
  • risk of uterine perforation
  • menstrual irregularity
  • doesn’t protect against STIs
  • displacement or expulsion may occur
17
Q

Intrauterine device

A

Plastic device with added copper
Works for 5 - 10 years

Action:
copper is toxic to sperm and ova
Inflammation of endometrium - prevents implantation
Changes consistency of cervical mucus

Advantages:
Long duration of action
Reliable

Disadvantages:

  • Unpleasant insertion
  • risk of uterine perforation
  • menstrual irregularity
  • doesn’t protect against STIs
  • displacement or expulsion may occur
  • menorrhagia
18
Q

Sterilisation

A

Vasectomy
Tubal ligation or clipping

  • permanent
  • no side effects
19
Q

Vasectomy

A

Vas deferens cut or tied to prevent sperm from entering the ejaculate

Under local anaesthetic

12 - 16 weeks after, a semen analysis is done to check success as does not work straight away

Failure rate: 1 in 2000 males

20
Q

Tubal ligation/clipping

A

Fallopian tubes cut or blocked to stop the ovum travelling from the ovary to the uterus

Under local or general anaesthetic

Failure rate: 1 in 200-500 women

21
Q

Emergency contraception

A

IUD - up to 5 days after sex

Emergency pill with ulipristal acetate- up to 5 days after sex

Emergency pill with levonorgestrel- up to 3 days after sex
(High dose progesterone)

22
Q

Subfertility

A

Failure of conception in a couple having regular unprotected coitus for 1 year

Regular = 2 to 3 times a week

23
Q

Primary subfertility

A

Someone who has never conceived a child in the past is having trouble conceiving

24
Q

Secondary subfertility

A

When someone who has been pregnant in the past is having trouble conceiving again

25
Q

Male causes of subfertility (30%)

A

Endocrine

  • hypothyroidism
  • diabetes

Testicular

  • XXY
  • Turners syndrome

Infective:
STI

Vascular

  • testicular torsion
  • varicocele

Antispermatogenic

  • heat
  • drugs
  • chemotherapy

Coital

  • ED
  • ejaculatory failure

Others
- Stress

26
Q

Ovulatory disorders (25%)

A

Hypothalamic pituitary failure - group 1 - 10%

  • amenorrhoea
  • hypogonadotropic hypogonadism

Hypothalamic pituitary ovarian dysfunction - group 2 - 85%

  • polycystic ovary syndrome
  • hyperprolactinaemia amenorrhoea

Ovarian failure - group 3 - 5%

  • turners XO
  • premature ovarian failure (early menopause)
27
Q

Uterine disorders 10%

A 
Uterine fibroids 
Endometriosis 
Pelvic inflammatory disorder 
Asherman syndrome - scarring of uterus 
Cervical stenosis 
Previous surgery
28
Q

Mullerian development anomaly

A

Agenesis
Didelphys - duplication of uterus, cervix and vagina
Bicornuate -2 uteri sharig a vagina and cervix
Septate - single uterus with a fibrous band going down the centre

29
Q

Tubal damage (20%)

A

Ectopic pregnancy
Pelvic surgery
Past pelvic infection - chlamydia

30
Q

Male examinations for subfertility

A

Testicular examination

31
Q

Female examination for subfertility

A

BMI
Breast examination - producing milk galactorrhoea
Pelvic examination
Signs of secondary sexual characteristics

32
Q

Male investigations for subfertility

A

Semen analysis

  • count
  • motility
  • pH
  • volume
  • morphology

Blood test

  • anti - spermantibodies
  • FSH/ LH/ testosterone

Penile swab

USS testes

Cystic fibrosis screening

Karyotype

33
Q

Female investigation for subfertility

A

Blood test

  • follicular phase - FSH/LH
  • luteal phase - progesterone - day 21
  • prolactin and androgens

Cervical smear
Cervical and vaginal swab
Pelvis USS
Hysterosalpingogram - tubal patency

Repro (20 decks)

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