Menstrual Cycle, Infertility & Conception Flashcards
Menopause is considered premature if it occurs prior to ___ years old.
40
Many birth control pills work by blocking the ___, thus inhabiting the release of an egg.
LH surge
This hormone stimulates growth and development of ovarian follicles.
FSH
Ovarian follicles produce ___ which stimulates endometial groth.
estrogen
When implantation does NOT occur, decreasing ___ levels permit sloughing of the uterine lining.
progesterone
What three phases does an ovary go through during a normal cycle?
- follicular
- ovulatory
- luteal
What cycle days are follicular?
1-14
Whay cycle days are ovulatory?
14/15
What cycle days are luteal?
15-28
Any follicle measuring greater than ___ will must likely ovulate.
11 mm
Sonographic findings that ovulation has occurred may include…
- sudden decrease in follicular size
2. free fluid in the posterior cul-de-sac
Involution of the ruptured Graafian follicle results in the formation of a…
corpus luteum.
The corpus luteum produces ___ which will maintain the secretory endometrium should implantation occur.
progesterone
Sonographically, the luteal phase looks like…
- echogenic structure representing thrombus
- small, irregular cystic mass with borders
- doppler findings of a hypervascular corpus luteum with low resistance flow
What are the three menstrual phase of a normal cycle?
- menstrual
- proliferative
- secretory
What cycle days are menstrual?
1-5
Sonographically, the menstrual phase looks like…
- thickened, echogenic endometrium prior to the start of menses
- complex appearance at the beginning of menses
- thin, slightly irregular endometium after the shedding of tissue
- maximum AP diameter is 2 mm (post menses)
What cycle days are proliferative?
6-14
Sonographically, the proliferative phase looks like..
- hypoechoic area around the prominent midline echo
- thickened, isoechoic endometrium
- max AP diameter is 6-8 mm
The bright middle line of the proliferative phase is the reflection of both…
the mucosal and basal layers touching each other.
T/F? The three uterine lines of proliferative phase are brighter in the early part of the phase.
FALSE, the later part
What cycle days are the secretory phase?
15-28
Sonographically, the secretory phase looks like…
- hyperechoic endometrium with obscured midline, may have posterior acoustic enhancement
- max AP diameter up to 18 mm
This is excessive volume during cyclic menstrual bleeding.
hypermenorrhea
This is an abnormally small amount of menstrual bleeding.
hypomenorrhea
This is frequent menstrual bleeding occurring at less than 21 days apart.
polymenorrhea
This is menstrual bleeding occuring more than 35 days apart.
oligomenorrhea
This is irregular frequent bleeding.
metrorrhagia
This is bleeding that is irregular in both frequency and volume.
menomerorrhagia
This is painful bleeding.
dysmenorrhea
This is the absence of menstral flow.
amenorrhea [Primary: never had a period, Secondary: stopped having periods]
This is vaginal bleeding not related to endometrial pathology
dysfunctional uterine bleeding (DUB)
How many American couples suffer from infertility?
1:7
What female factors contribute to infertility?
- anovulation & abnormal ovulation
- tubal & transport factors (adhesions, hydrosalpinx)
- endometriosis
- uterine factors (myomas, congenital anomalies)
- polycystic ovarian disease
What male factors contribute to infertility?
sperm failure
In vitro fertilizations programs help to…
- establish normality or abnormality
- monitor development
- confirm response to drugs
- guide decisions
This drug increases FSH secretion to induce ovulation.
Clomid
This is the most common ovulation induction drug.
Clomid
This drug is equal parts FSH & LH, but has more side effects.
Pergonal (hMG)
This drug is an insulin-lowering medication used for PCOS patients.
Metformin
This drug is used to lower prolactin levels and reduce pituitary tumor size.
Parlodel
What is the method of choice for monitoring follicular development?
vaginal u/s
Follicles are typically aspirated for IVF when they measure…
18-24 mm.
This assisted reproduction technology consists of catheter delivery of embryos into the uterus.
IVF
This ART involves an embyro placed into the fallopian tube.
ZIFT
ZIFT stands for…
Zygote Intrafallopian Transfer
This ART involves sperm and ova placed into a fallopian tube via tranvaginal guided cannulization.
GIFT
GIFT stands for…
Gamete Intrafallopian Transfer
This ART involvesa sperm preparation guided into the uterine fundus via catheter.
Intrauterine Insemination
This condition results from the excessive stimulation of the ovaries.
ovarian hyperstimulation syndrome (OHS)
Who’s at increased risk for OHS?
young, lean, PCOS
T/F? Severe cases of OHS are associated with high mortality rate and require hospitalization.
true
OHS can cause ___ of the ovaries.
torsion or rupture
Sonographically, OHS presents with ___ cysts with an ovarian diameter of ___ and is ___lateral.
large simple, > 5 cm, bi
This drug prevents contraception by inhibiting ovulation.
oral contraceptive pill (OCP)
Most OCPs use what two hormones?
estrogen and progesterone
T/F? Women on OCP do not develop ovarian follicles.
FALSE, they do but they’re smaller, 5-19mm
T/F? You will not see normal uterus or ovarian cycles responses if the patient is taking OCPs.
true
T/F? Oral contraceptives may alter the normal sonographic appearance of both uterus and ovaries.
true
What would you see on a patient who is on OCPs?
- corpus luteum cysts
- triple thick endometrium
- small multiple follicles
This device has been used as contraception for 40 yrs.
IUDsT/
T/F? IUDs prevent ovulation but do not implantation.
FALSE, the opposite
An u/s is useful to ___ IUD position and document ___.
confirm, myometrial penetration
Where in the uterus should the IUD be?
in the corpus or fundus
T/F? IUDs cast a posterior acoustic shadow and are highly echogenic.
true
