MCQ Flashcards
What is role of cervix in fertility?
🌹facilitates sperm capacitation and serves as a reservoir for normal sperm.
🌹Cervical mucus enhances the transport of sperm from the Vagina to the Uterus during the ovulation window (mid cycle mucus) by forming parallel channels of micelles due to sterogen that makes the mucus thin, stretchy and to contain higher NaCl. Sterogen also filters out non spermal contents by forming parallel.
🌹
Mention the causes of Cervical mucus abnormality?
▪︎Iatrogenic
🌹cervical conization
🌹cryosurgery
🌹loop electrosurgical excison procedure (LEEP)
▪︎infection
🌹 C. Trochamatis,
N. Gonorrhoea,
Uroplasma urealyticum and
Mycoplasma hominins.
They may also cause scaring, cervical stenosis that decreases sperm motility and transport.
An anti sterogen agent causing infertility
Clomophine citrate
What is the name of the test of testing anti-sperm antibodies?
Explain!
It is called as post coital test ( sims-huhner test)
It asses the quality of cervical mucus and ability of sperm to survive it.
Atleast 10-15 normal motile sperm should be seen per HPF. ( some books say atleast 5 )
It should be done at ovulation window( duriging sterogen surge) .
It may be done as alternative dx to sperm analysis.
The couples are asked to have sex and cervical mucus status( i.e elasticity-spinnbarkiet) and sperm motility is examined.
If anti sperma antibodies are present it shows shaking motility or completely imotile sperm.
It has limited use.
The treatment of cervical infertility?
It is controversial
Bypass-intra uterine insemination (IUI)- particularly cervical mucus abnormality
Antibiotics to infections
Ethnyl-steradiol to anti sterogen agents like clomiphene citrate.
Mention 3 methods of treating infertility due to anti sperm antibodies?
🌹 use of barrier methods for atleast 3months.
🌹 corticosteroids to female couple.
🌹IUI (intra uterine insemination)
What is the best treatment of cervical factor and unexplained factors of female infertility?
IUI ( intrauterine insemination)
Uterine and cervical together acount for 10 percent of female infertility.
True
Uterine infertility can be
Acquired- ashermen syndrome( adhesions due to surgery, PPH , infections-TB,c. Tra, N. Gonorrhoea) , luteal phase defect, lieomyoma, polyps, adenomysis.
Congenital- unicornuate, septate, didelphys mullarian agenesis.
What is the gold stand of evaluating the uterus
Hysterescopy
HSG contraindications include…
Pregnancy
Bleeding
Active genital infection
Genital TB
Dye allergy
Although pregnacy rate after oil-based HSG is more than that ofwater-based HSG
We still prefer water based due to
Decreased allergy
HSG, SIS, TVUS, 3D TVUS, Hysterescopy, MRI ,Laproscopy can be used to dx
HSG- tubal potency, uterine cavity and (some intra uterine adhesions endometrosis)
SIS, 3D US uterine cavity , developmental defects, ovaries but TVUS can do the same but may miss certain developmental defects and uterine cavity abnormalities.
Hysterescopy is the gold stand. Of evaluating uterine cavity can also detect developmental defects along with laporoscopy
MRI can detect everything except tubal patency.
Laporoscopy can detect every thing except uterine cavity and needs Hysterescopy in developmental defects.
After HSG detects abnormality, Laproscopy or Hysterescopy with chromotubtion is considered before treatment!
True Williams gyne page 438 last line of the lft side.
What is the sensitivity and specificity for detection of tubal obst
Respectively.
65% sensitivity and 83% specificity
