PHARM 6: Infertility

Question 1

Causes of Anovulation?

Answer 1

Question 2

Diagnosis/Treatment of Polycystic Ovarian Syndrome => Infertility

Answer 2

Question 3

Causes/Treatment of Hypothalamic Hypogonadism => Infertility?

Answer 3

Question 4

Causes/Diagnosis/Treatment of Premature Ovarian Insufficiency (POI) => Infertility?

Answer 4

Question 5

Causes of Tubal/Pelvic Disease => Infertility?

Answer 5

Question 6

Growth of ectopic endometrial tissue outside the uterine cavity? Causes?

Answer 6

Endometriosis: Caused by Retrograde menstruation => blood traveling back up fallopian tube

Question 7

Causes of Obstructive Male Infertility? Testicular size/FSH Levels?

Answer 7

Obstruction of vas deferens or epididymis

• Normal testes size
• Normal FSH

Casues:

• Genetic: 5-10% obstructive azoospermia have congenital bilateral absence of vas deferens (CBAVD)
• 50% men with CBAVD carry CF gene mutation CFTR
• Infection (chlamydia/gonorrhea)

Question 8

Causes of Non-Obstructive Male Infertility? Testicular size/FSH Levels?

Answer 8

Primary testicular failure (most common)

• Reduction in testicular size
• High FSH

Causes:

• Cryptorchidism (undescended testes)
• Absence (rare)
• Injury/trauma
• Infection/Orchitis (mumps, chlamydia, SARS-CoV-2)
• Testicular cancer
• Genetic (e.g. Klinefelter syndrome)

Question 9

________ is Indicative of Ovarian Reserve!

Answer 9

AMH (granulosa cells) is Indicative of Ovarian Reserve!

Question 10

Risks of Assisted Reproductive Technologies (ART)

Answer 10

Ovarian hyperstimulation Syndrome (OHSS)

• Extracellular fluid shift
• Worsened by hCG–trigger injection or pregnancy
• If severe, can result in ICU admission

Question 11

How many sperm do we want to Isseminate in IVF?

Answer 11

Insemination want 1 x 10^ 5 sperm/oocyte
> polyspermy
< poor fertilization