Brainscape's Knowledge GenomeTM

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


See full index

Women's Health > Lecture 5: Infertility > Flashcards

Lecture 5: Infertility Flashcards

1
Q

Define infertility

A
  • Inability to conceive after 1y of unprotected intercourse of reasonable frequency in women < 35y
  • Inability after 6m for women > 35y

Primary = no prior para. Secondary = multips

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

What conditions tend to result in infertility?

A
  • Oligo/amenorrhea
  • Uterine/tubal/peritoneal disease
  • Stage 3/4 endometriosis
  • Known/suspected male infertility (varicocele)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the MCC of infertility?

A

Ovulatory issues

Male is 2nd highest, so evaluate both partners!

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

What is conization?

A

Cone biopsy of cervix, which can affect cervical anatomy and decrease mucus quality

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

What typically can cause recurrent pregnancy loss?

A
  • Monosomy X (Turner syndrome) for spontaneous miscarriage
  • APS
  • Uterine abnormalities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the MCC of premature ovarian failure < 40y?

A

Turners

Monosomy X, aka gonadal dysgenesis

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

What is mittelschmerz?

A

Midcycle pelvic pain associated with ovulation

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

What are molimina symptoms?

A
  • Breast tenderness
  • Acne
  • Food cravings
  • Mood changes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How does basal body temperature change with ovulation?

A

Basal temp increase by 0.4-0.8F is strongly predictive of ovulation

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

How do ovulation predictor kits work?

A

Measuring urinary LH, since LH surge precipitates ovulation

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

Why is FSH good to check ovarian reserve?

A
  • The less eggs you have, the less inhibin you secrete.
  • The less inhibin, the more FSH
  • FSH > 10 IU/L is associated with diminished ovarian reserve
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What does increased antimullerian hormone mean for follicle count?

A

More follicles

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

What is the initial treatment for anovulatory infertile women?

A

Clomiphene citrate (clomid)

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

What does letrozole do?

A

Aromatase inhibitor, which inhibits the production of estrogen and increases FSH

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

What is ovarian hyperstimulation syndrome?

A

Excessive exogenous gonadotropin therapy resulting in ovarian enlargement

Supportive tx

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

Describe intrauterine insemination (IUI)

A
  1. wash/concentrate sperm
  2. Insert catheter into endometrial cavity and inject sperm
17
Q

Describe in vitro fertilization (IVF)

A
  • Direct injection of mature oocytes into endometrial cavity via sonographic evidence.
18
Q

What is a hyserosalpingogram used to image? (HSG)

A

Uterine cavity and tubal imaging via radio-opaque dye

19
Q

What is chromopertubation?

A

Injection of methylene blue thru cervical canal during laparoscopy to evaluate tubal patency

20
Q

Tx for tubal occlusion

A
  • Tubal cannulation
  • Tubal reconstruction
  • Tubal resection followed by IVF
21
Q

Tx for endometriosis

A
  • Surgical treatment
  • IVF
  • GnRH
22
Q

Tx for pelvic adhesions

A
  • Surgical removal
  • IVF
23
Q

How do fibroids affect infertility?

A
  • Obstruction of tubes or distortion of uterus
24
Q

What is Asherman’s syndrome?

A
  • Intrauterine adhesions
  • Hx of D&C
25
Q

Dx and Tx of Asherman’s syndrome

A
  • Dx: HSG or hysteroscopy
  • Tx: Hysteroscopic lysis of adhesions
26
Q

Why is an endometrial biopsy performed?

A

Thought to be more informative than just a serum progesterone level.

No longer routine

27
Q

What does high estrogen do to cervical mucus?

A

Thin and slippery

It wants the sperm to go up

28
Q

How long does it take sperm to mature?

A

90d, so anything 3 months prior could be the culprit for male infertility

Sperm matures best at slightly below body temp

29
Q

How is semen analysis performed?

A
  • Dont jack off for 2-3 days
  • Sterile cup collection
30
Q

How do you treat antisperm antibodies?

A

Corticosteroids

You will see agglutination on semen analysis

31
Q

Tx of oligospermia

A

IUI

If you cant make enough, then we concentrate it and inject it

32
Q

Causes of azoospermia

A
  • Congenital absence of vas deferens (CF)
  • Severe infection
  • Vasectomy

Tx with donor or epididymal aspiration

33
Q

What is asthenospermia and causes and tx?

A
  • Decreased sperm motility
  • Prolonged abstinence
  • Antisperm antibodies
  • Infection
  • Varicocele
  • Tx with intracytoplastic sperm injection or IUI
34
Q

What is teratospermia and Tx?

A
  • Abnormal morphology
  • Tx with IVF
35
Q

What might low FSH & low testosterone suggest in a male? Tx?

A
  • Kallmann syndrome: anosmia + hypogonadotropic hypogonadism
  • Idiopathic hypogonadotropic hypogonadism
  • Tx with gonadotropins!
36
Q

What might elevated FSH with low testosterone suggest?

A

Testicular failure resulting in oligospermia.

Testicles get stimulated but they aint working

37
Q

What are the genetic causes of poor semen analysis?

A
  • Klinefelter syndrome (XXY)
  • Microdeletion of Y chromosome
  • CF

Women's Health (15 decks)

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