Pharmacotherapy of Infertility

Question 1

Clear Blue Fertility Monitor detects?

Answer 1

LH and estrogen hormones

Question 2

Clear Blue Fertility Monitor general

Answer 2

99% accurate
Should be off oral contraceptives for 2 cycles
Use first urine sample of the morning!

Question 3

Fertility scope is what kind of test and what does it monitor?

Answer 3

Saliva based

Estrogen levels

Question 4

Fertility Scope General

Answer 4

Requires visual interpretation
98% accurate
OK in women with irregular periods

Question 5

Fertility Scope can be affected by

Answer 5

Eating
Drinking
Brushing teeth
Smoking within 2-3 hr
Any residue of food or alcohol

Question 6

First Response Fertility is what kind of test and what does it monitor?

Answer 6

Urine

FSH on day 3 of menses

Question 7

First Response cannot be used if

Answer 7

Taken oral contraceptive or hormonal medication within 60 days

Question 8

First Response Daily Ovulation Test is what kind of test and what does it monitor?

Answer 8

Urine

LH surge

Question 9

First Response Daily Ovulation Test General

Answer 9

Do not open the foil pouch until containing strips until DAY 5 of period
Must be used within 30 days after opening
Test around the same time every day

Question 10

OvWatch is what kind of test and what does it monitor?

Answer 10

Wrist-mounted

Transdermal Chloride

Question 11

OvWatch general

Answer 11

Cl surge = fertile window
Notifies 4 days before ovulation (high probability of pregnancy)
EXPENSIVE
No OCs
Begin wearing within 3 days start of menses

Question 12

Treatment of Infertility

Answer 12

Ovulation induction or controlled ovarian hyperstimulation

Question 13

Goals of treatment

Answer 13

Achieve pregnancy
Birth of a healthy infant
Minimize the stress, physical discomfort, financial cost and risk

Question 14

Non-Steroidial Estrogen Receptor Blocker Example

Answer 14

Clomiphene

Question 15

Clomiphene MOA

Answer 15

Inhibit estrogen binding and prevents normal feedback inhibition, increasing LH and FSH

Question 16

Clomiphene Side Effects

Answer 16

Hot flashes, ab discomfort, multiple prego, n/v/d

Question 17

Clominphene place in therapy

Answer 17

First line for ovulation induction with timed intercourse, PCOS and women with normal GnRH production

Question 18

Counseling Points for Clominphene

Answer 18

Patient should have a blood check of progesterone around day 21 to detect if an increase has occured

Question 19

Aromatase Inhibitor

Answer 19

Letrozole

Question 20

Letrozole MOA

Answer 20

Inhibits conversion of testosterone to estrogen increase release of FSH and LH

Question 21

Letrozole place in therapy

Answer 21

Ovulation stimulation

Clomiphene failure

Question 22

Monitoring with Clomiphene and Letrozole

Answer 22

Via Ovulation prediction kits of ultrasounds

Question 23

hMG

Answer 23

Repronex
Menopur
75 IU FSH and LH

Question 24

HP-FSH

Answer 24

Bravelle

75 IU FSH

Question 25

Follitropin-alpha and beta | Lutropin alpha

Answer 25

Gonal F and Follistim AQ both are 75 IU FSH | Luveris is 75 IU LH

Question 26

hCG Brand Names

Answer 26

Pregnyl Novarel Ovidrel - Usually an additive therapy

Question 27

hCG MOA

Answer 27

Supplement LH to mimic LH surge

Question 28

hCG Side Effects

Answer 28

Headache, irritability, restlessness, fatigue, edema

Question 29

hCG Place in Therapy

Answer 29

Female: ovulation induction and correct lack of LH surge Male: Spermatogenesis if with hypogonadotropic hypogonadism

Question 30

Lupron

Answer 30

leuprolide GnRH Agonists Injection

Question 31

Zoladex

Answer 31

Goserelin GnRH Agonists Implant

Question 32

Synarel

Answer 32

Nafarelin GnRH Agonists Nasal Spray

Question 33

Lutrepulse

Answer 33

Gonadorelin acetate GnRH Agonists Pump

Question 34

GnRH Agonists MOA

Answer 34

Stimulate gonadotropin release form pituitary | Few weeks later, shuts it down

Question 35

GnRH Agonists Side Effects

Answer 35

Vaginal bleeding Breast tenderness Hot flashes, headaches, vaginal dryness

Question 36

GnRH Agonists Place in Therapy

Answer 36

Anovulation due to GnRH deficiency PCOS Increase Sperm Count

Question 37

Antagon | Cetrotide

Answer 37

Ganirelix Cetrorelix GnRH Antagonists

Question 38

GnRH Antagonists MOA

Answer 38

Decrease FSH and LH via competition for receptors

Question 39

Antagon should be used with

Answer 39

hCG

Question 40

GnRH Antagonists Place in Therapy

Answer 40

Suppress premature LH surge and premature ovulation

Question 41

OCs as hormonal supplements

Answer 41

Before fertility treatment to induce withdrawal bleeding | Reduces androgenicity and ovarian cysts

Question 42

Estrogen use

Answer 42

Increase volume and thin cervical mucus and facilitate growth of endometrium

Question 43

Progesterone use

Answer 43

Maintain endometrium | Dosing not user friendly

Question 44

When would you use a dopamine agonists?

Answer 44

Hyperprolactinemia

Question 45

Drugs for ovulation induction/

Answer 45

Clomiphene | +/- gonadotropins

Question 46

Drugs for controlled ovarian hyperstimulation

Answer 46

Gonadotropins +/- GnRH agonists OR antagonists hCG