Lesson 3B (Part 2)

Question 1

What causes damage to the fallopian tubes? (2)

Answer 1

1. Pelvic inflammatory disease

2. Previous surgery in the abdomen or pelvis

Question 2

Pelvic inflammatory disease

Answer 2

An infection of the uterus and fallopian tubes due to chlamydia, gonorrhea or other STIs

Question 3

What can damage to the fallopian tubes be assessed with?

Answer 3

Hysterosalpingogram

Question 4

Hysterosalpingogram

Answer 4

X-ray dye introduced into the uterus to assess for obstruction

Question 5

What are causes of endometriosis? (2)

Answer 5

1. Scarring/ adhesions to the fallopian tubes

2. Inflammation of the endometrium disrupting implantation of the egg

Question 6

What are examples of causes of uterine or cervical infertility? (4)

Answer 6

1. Benign polyps or tumors (fibroids)
   - block fallopian tubes or interfere with implantation
2. Uterine abnormalities
   - abnormal shape
3. Cervical stenosis
4. Abnormal cervical mucus

Question 7

What is used to asses a females uterus and cervix? (3)

Answer 7

1. Hysteroscopy
2. Sonohysterogram
3. 3D imaging

Question 8

Hysteroscopy

Answer 8

Small camera inserted into uterus

Question 9

Sonohysterogram

Answer 9

Introduction of saline solution into the uterus and US to further assess the endometrial lining and obstructions

Question 10

ART

Answer 10

Assistive reproduction technology

Question 11

What are 3 examples of assistive reproduction technology?

Answer 11

1. Fertility drugs
2. Intrauterine insemination
3. In Vitro Fertilization
   - IVF

Question 12

What does ovulation failure usually involve?

Answer 12

An imbalance of hormones

- eg. estrogen, progesterone and low levels of FSH

Question 13

What is the primary treatment for ovulation failure?

Answer 13

Fertility drugs

- oral/injection

Question 14

What is the goal for fertility drugs?

Answer 14

Attempt to reset the normal balance and regulate or trigger ovulation

Question 15

What are 2 types of fetal drugs?

Answer 15

1. Clomid

2. Pergonal

Question 16

What is the generic name for clomid?

Answer 16

Clomiphene citrate

Question 17

What does clomid do?

Answer 17

Stimulates the pituitary gland to secrete FSH

- can be followed by hCG at the time of ovulation to help maintain the pregnancy

Question 18

Pergonal

Answer 18

Is a natural hormone derived from the urine of postmenopausal women
- triggers a positive feedback so the pituitary gland secretes more FSH (this is used when estrogen/progesterone are low)

Question 19

What is pergonal comprised of? (2)

Answer 19

1. FSH

2. LH

Question 20

When is pergonal used?

Answer 20

When clomid doesnt work

Question 21

What is a complication with fertility drugs?

Answer 21

Ovarian Hyperstimulation Syndrome

- OHSS

Question 22

Ovarian Hyperstimulation Syndrome

Answer 22

Multiple HUGE cysts on the ovaries

- Theca Lutein Cysts

Question 23

What is the sonographic appearance of OHSS? (3)

Answer 23

1. Pleural effusion
2. Ascites
3. Hypotension

Question 24

What is a complication with IVF?

Answer 24

Heterotrophic pregnancy

Question 25

Heterotrophic pregnancy

Answer 25

More than one pregnancy

Question 26

Why could a heterotrophic pregnancy be dangerous?

Answer 26

It can be easily missed

Question 27

Recruitment

Answer 27

At the beginning of menstrual cycle, 3-11 follicles start to grow

Question 28

Between the follicles, what happens around day 5-7?

Answer 28

One will begin to show dominance

- the rest will become atretic (regress)

Question 29

What does the dominate follicle do?

Answer 29

Continues to grow (about 2-3 mm a day) until ovulation

Question 30

How large does the dominate follicle get before ovulation?

Answer 30

17-27mm

Question 31

How large does the antral (resting) follicle get before ovulation?

Answer 31

5-10mm