Pregnancy Planning: Ovulation/ Pregnancy Testing + FSD Flashcards
the ovum is viable for
12-24hrs
sperm can live up to
5 days
what are the 4 optimal times for fertilization
2 days before ovulation
day of ovulation
day after ovulation
(ideally 24hrs after LH surge)
how do saliva tests work for ovulation testing
as E increases, NaCl in mucus secretions increase = causes ferning of mucus when dried = large ferns = ovulating
saliva tests should provide _______ of advanced notification of ovulation
24-72hrs
how long must you sleep before getting a basal body temp
4hrs
what is the basal body temp
temp that occurs prior to rising in the morning
how do basal thermometers work for ovulation testing
Body temp rises as ovulation occurs- coincides with progesterone release
0.5F or 0.28C over 3 days (3 days of elevated temp = ovulation occurred)
what kind of mucus is usually seen in ovulation
thin/ clear
what are some issues with basal temp monitoring for ovulation
Ovulation may have occurred before actual detection
Interference: emotions, infections, movements, eating, drinking, talking, smoking
basal body temp measuring is best used in conjunction with
ovulation prediction tests
how often should you have sex once you have a + ovulation result
1. daily
2. BID
3. q2d
4. q3d
3
how do urine ovulation tests work
Use monoclonal antibodies specific to LH
LH gets sandwiched between 2 antibodies = color change
Color intensity dep amount of LH present
do 2 lines on an ovulation prediction tests always mean that you’re ovulating
no- may have low amount of LH it picks up
which is why it’s important to test 2-4 days before expected ovulation, then continue for 5-7 consecutive days to track the colour intensity
how should urine based ovulation tests be used
Begin testing 2-4 days before expected ovulation, then test for 5-7 consecutive days to determine color change
fertility monitors detects ______ and the rise of ________
LH and estrone-3-glucuronide (E3G)
fertility monitors can identify up to ____ fertile days and store ___ cycles of information
6 days
6 cycles
which of the following does not require regular cycles to easily use
1. saliva tests
2. ovulation urine tests
3. basal thermometers
4. fertility monitors
4
what are home sperm tests
self diagnostic tool, help decide if further clinical eval needed
what is a + result for home sperm tests
> 15-20million sperm/ mL
how do home sperm tests work?
Uses monoclonal antibodies that recognizes sperm specific acrosomal protein SP-10
when is the best time to use a home sperm test
at least 48hrs but no more than 7 days since last ejaculation
home sperm tests use antibodies that recognizes sperm acrosomal protein _____
SP-10
HCG in urine can be detected up to ____ after conception
6-8 d
after birth, HCG levels drop to undetectable after ____
8wks
HCG doubles ____ until peak at _____after conception, then ↓ to lower level throughout pregnancy
q2d
60-70d
at what time of day is HCG conc the highest
9am-12pm
what is the most common reason for inaccurate pregnancy test results
human error
urine HCG tests are sensitive to ____mIU/mL, blood ____mIU/mL
urine = 20
blood = 1
what is a limitation of urine HCG tests
wide variations in HCG concentrations (12-2438mIU/mL) during 4th week of pregnancy
if a pregnancy test is negative, when should you retest?
in 7 days if menses has not occured
false + pregnancy tests may be due to
miscarriage or abortion in preceding 8wks, tumors which secrete HCG, fertility meds (ex- HCG injection)
false - preg tests may be due to
test performed too early or too late, expired testing kit, chilled or dilute urine, cloudy/ pink/ red urine
what is FDS
term used to collectively describe various conditions including low libido, sexual arousal, orgsmic dysfunction, and painful intercourse
FDS is
1. underreported
2. includes painful intercourse and lack of orgasms
3. incudes sexual aversion disorder
4. all of the above
4
what are the 4 types of FSD
desire
arousal
orgasmic
pain
describe desire FSD
hypoactive sexual desire (low libido), sexual aversion disorder (disgust towards sex)
what is arousal FSD
subjective arousal disorders ,genital arousal disorders, combined subjective and genital
pain FSD includes
: dyspareunia (painful intercourse), vaginismus (vaginal spasms with penetration)
list the 3 NT that have a + effect on desire and the one that has negative effect
+: testosterone, dopamine, estrogen
-: prolactin
list the 4 NTs that have + and 1 that is - effect on arousal
+: NE, dopamine, ACh, NO
-: 5HT
which NT has a + effect on orgasm? what about -?
1. serotonin
2. NE
3. dopamine
4. NO
NE +
serotonin -
what is the PLISSIT model
permission
limited information
specific suggestions
intensive tx
what RF modification may be done for FSD
smoking cessation, limit alcohol intake, treat alcohol/ illicit drug abuse, manage comorbidities (HPTN, DM, etc), switch to drugs with less sexual SEs
what psychological tx may be done for FSD
CBT, sex tx, couples/ relationship tx, psychiatric counselling (ex- hx of sexual abuse), distraction techniques (fantasize, relaxation, etc)
which of the following is not a treatment for FSD
1. vaginal dilators
2. vaginal estrogen therapy
3. transdermal testosterone therapy
4. mirtazapine
4
testosterone therapy in women
1. is not approved by health canada for use in FSD
2. prefers PO testosterone
3. requires calculated dose out to 15mg/d
4. sees acne as the most common reason for d/c
1
oral T for FSD in women can lead to
AEs on lipids (reduced HDL) and liver toxicity
T dose for FSD is
5mg/d
T or F: monitoring for T in FSD is recommended for efficacy at baseline ,then at 4-6wks
F- not for efficacy, for toxicity
monitoring levels may be insensitive and inaccurate
free androgen index (FAI) =
total T/SHBG x 100
what is the most common reason for T d/c in FSD
1. deepening of voice
2. acne
3. hair growth in application area
4. anger/ irritability
anger/ irritability
testosterone FSD SEs
acne, hair growth (in application area), anger/ irritability (most common reason to d/c), deepening of voice (not common with small doses used for females)
T or F: deepening of voice is uncommon in FSD with T use
T
most PDE-5i studies in women have been with _____ for females with _____ induced dysfunction
it may also be useful for females with ________ to increase blood flow ot the area
with sildenafil
for females with SSRI induced dysfunction
spinal cord injury
what are the 5 pharm tx for FSD
testosterone
PDE-5i
buproprion
DHEA
filbanserin
buproprion is mainly used in __________ sexual dysfunction
SSRI induced
DHEA in FSD has soem efficacy data in __________
adrenal insufficiency
flibanserin is for
hypoactive sexual desire disorder in pre/ post menopausal women
flibanserin MOA
5HT1A agonist + serotonin 2A antagonist
flibanserin AEs
drowsiness, dizzy, fatigue, N, hyperthermia, limit EtOH (↑risk of syncope, hypotension, depression)
how long should filbaserin be trialed
8wks
filbaserin intx
mod/strong CYp3A4 inhibitors
what are the 3 CAM products for FSD
L arginine
gingko bilbo
yohimbine
L arginine is often topical for FSD and mixed with
menthol
