Lecture 8 - Infertility

Question 1

Infertility definition?

Answer 1

failure to conceive after 12 months of unprotected intercourse

Question 2

Assessing male fertility?

Answer 2

15M/ml sperm, 40% motility, 1.5mL volume, 39mill total, 45 morphology

Question 3

Basic assessment female fertility?

Answer 3

28 day period, estrogen of day 12, progeest of day 21, FSH of days 2-4, age-related graph of AMH, timing of intercourse, STIs

Question 4

Anovulation?

Answer 4

result of underweight/overweight, treated with weight control or drugs: GnRH, clomiphene citrate, letrazole, FSH

Question 5

Polycystic Ovarian Syndrome?

Answer 5

10% women, metabolic syndrome, infrequent or no periods, increased androgens

Question 6

Fixing tubual disease?

Answer 6

surgery and IVF

Question 7

Cervical problem treatment?

Answer 7

intrauterine insemination

Question 8

Endometriosis?

Answer 8

10% women, treated with hormonal contraceptives and surgery (ablation)

Question 9

Treating premature monopause, or rising FSH/decreasing AMH with age?

Answer 9

donor egg (IVF)

Question 10

No uterus name and treatment?

Answer 10

mullerian agensis or Rokitansky syndrome, use of surrogate required

Question 11

6 Steps of IVF?

Answer 11

egg production stimulated by hormone therapy, eggs retrieved by ovary, sperm sample provided, eggs and sperm combined to allow fertilisation, fertilised eggs introduced to uterus, embryo freezing

Question 12

Drugs for ovarian control?

Answer 12

FSH (stimulation), GnRH antagonists (prevention), HGC and GnRH agonist (trigger ovulation), Progesterone (essential luteal support)

Question 13

IVF cycle tracking?

Answer 13

ultrasound to measure follicle size, blood tests (e and p)

Question 14

Time-lapse photography?

Answer 14

individual embryo tracking of cell division, uses algorithms to predict tohse with best potential without disturbing culture

Question 15

Oligospermia?

Answer 15

low sperm count, can use inta-cytoplasmic sperm injection or sperm donor

Question 16

OATS?

Answer 16

low, slow and abnormal sperm, treated with ICSI or donor

Question 17

Azoospermia?

Answer 17

no sperm, eithe Kallmans syndrome, no spermatogenesis or congenital absence of vas d (CAVD), donor or testicular sperm aspiration (surgery)

Question 18

Unexplained infertility problems?

Answer 18

unknown aetiology, fertilisation issue, age

Question 19

Unexplained infertility treatment?

Answer 19

mild ovarian stimulation with intrauterine insemination, IVF

Question 20

Aneuploidy?

Answer 20

eggs containing abnormal chromosome make-up, proportion increases with age

Question 21

Looking at DNA of embryo?

Answer 21

preimplantation genetic screening (biopsy)