Ovulation problems Flashcards
Why do polycystic ovaries lead to amenorrhoea?
Secrete increased levels of androgen; SBHG is reduced in PCOS due to increased insulin; therefore higher levels of free andogen; this suppresses FSH stimulation
In PCOS, what treatments are used to a) restore a cycle b) treat hirsutism c) decrease insulin resistance d) restore fertility.
a) combined oral contraceptive +/- antiandrogens
b) as above
c) metformin
d) clomifene citrate
Which test is carried out around day 21 in assessing ovulation?
Mid-luteal progesterone
What is the main risk of pulsatile GnRH treatment?
Ovarian hyperstimulation
What are the main causes of hypogonadotrophic hypogonadism?
Functional e.g. stress, anorexia, systemic illness
Infiltrative lesions
Tumours
Congenital (e.g. Kallman’s)
What are the Rotterdam criteria for diagnosis of PCOS?
2 of:
- polycystic ovaries (>12 follicles)
- clinical/biochemical signs of androgen excess
- oligo/amenorrhoea
What is the likely cause of amenorrhoea in a 30-year old patient with a history of cancer?
Premature ovarian failure due to chemotherapy/radiotherapy
What is the likely cause of amenorrhoea in a 30-year old patient with a history of cancer?
Premature ovarian failure due to chemotherapy/radiotherapy
What causes Kallman’s syndrome?
Congenital loss of GnRH secretion
Why might a drug such as metoclopramide cause anovulation?
Dopamine antagonists can lead to raised PRL, which can suppress ovulation
What are the most common causes of hirsutism?
PCOS
Familial (esp. Mediterranean)
Idiopathic
Late-onset congential adrenal hyperplasia
What is the likely diagnosis in a patient who presents with failure to progress through puberty, short stature and a webbed neck?
Turner syndrome
What associated conditions are seen in Turner syndrome?
Biscupid aortic valve, coarctation of the aorta
Crohns and ulcerative colitis
