Reproduction 16 Flashcards

1
Q

Of 100 couples trying to conceive naturally how many will get pregnancy?

A

20 will conceive within one month 85 will conceive in year 95 will conceive within two years

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2
Q

Describe disorders of the female tract leading to infertility

A

Ovulatory disorders

Disorders of the female tract

Tubal disorders- secondary to pelvic inflammatory disease due to STDs

Scaring and adhesions in the uterine tubes- impaired oocyte and sperm transport

Diagnosed by HysteroSalpingoGram

Endometriosis- endometrial tissue growth in ectopic sites causing scarring hand adhesion

Uterine disorders- Separate or bicornate uterus leading to miscarriage, premature birth and mallee sensation can be removed surgically

Uterine leiomyomas (fibroids)- benign tumours (oestrogen and obesity) common in menopause, develop in the uterine wall leads to menorrhagia, sub fertility, miscarriage Treated with hormone therapy (Mirena), surgery

_Problems with implantation, growth amd developmen_t

25% pregnancies fail before week 6, 9% pregnancies fail between weeks 6-13, 1-2% pregnancies fail before weeks 13-24, 0.5% pregnancies and in stillbirth

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3
Q

Describe male infertility disorders

A

Production of spermatozoa transport of spermatozoa through male tract, transmission of sperm to the female tract, sperm funciton in the female tract

Semen analysis:

Normozospermia= >15 million sperm/ml

>32% rapid forward motility

>4 normal morphology

Can also get oligozoospermic (low sperm count), Asthenozoospermic (poor motility), Teratozoospermic (dont look good enough), Azoospermic (no sperm in ejaculate)

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4
Q

Describe Production of spermatozoa, transport of spermatozoa through male tract, transmission of sperm to the female tract, sperm funciton in the female tract problems

A

Production of spermatozoa = can be genetic, aquired from trauma, lifestyle etc

Transport of spermatozoa through male tract = Obstructive tracs, post infection, congenital bilateral absence of vas deferens (improper development of vas deferens)

Failure in transmision = Erectile dysfunction (incompetance of urethral sphincter, ejaculation volume nil or low, confomation in urine

Unexplained infertility = no obstructions or anything, inferliety just happens which we dont know why

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5
Q

What is the effect of age on fertility?

A

Bigger factor on women, decline after 20s, sharp decline after 35

Makes mainly due to other age related causes

Quality of eggs decrease over time

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6
Q

Describe assisted conception

A

To circumvent infertility, assist conception

Clomiophene for anovulation (ovulation induction with times intercourse) - antioestrogen to increase FSH. Also need to monitor number of follicles

IUI- intrauterine insemination (injection of sperm into uterus) by passes cervical mucous, paired with ovulation induction- low success rate 5-10% with 10% multiple pregnancy

IVF- egg + 100000 sperm in petri dish- failed previous fertility treatment, tubal obstruction or unexplained infertility

ICSI (intra cytoplasmic sperm injection)- sperm injected directly into egg after failed IVF and male factor infertility

USse donated sperm/egg/embryos if severe male inferlity , permature ovariun failure, both partners carry heritable disease

Preimplantation Genetic Diagnosis (PGD) - Removal of 1/2 cells from early embryo for genetic analysis

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7
Q

Describe the process of ovarian stimulation

A
  1. Pituitary stimulation (GnRH agonist/antagonist)
  2. Ovarian stimulation (recombinant FSH)- multi follicular development)
  3. Monitoring of follicular growth
  4. hCG triggering (longer half life than LH)- final egg maturation
  5. Egg collection
  6. Insemination/injection
  7. Embryo culture (day 2/3 or 5/6)
  8. Embryo transport
  9. Luteal support (progesterone)
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8
Q

Describe blastocyst

A

Culture in vitro for 5-6 days-

switching on of embryonic genome, p

ast stages of totipotency to first differentiation

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9
Q

What are the risks of IVF/ICSI?

A

Multiple pregnancies

Invasive for women

Ovarian hyper stimulation syndrome- excessive response to fertility drugs- multiple follicles produce VEGF- vascular permeability leading too fluid accumulation in peritoneal cavity

Risk of congenital abnormalities, imprinting disorder Oocyte damage

Inheritence of male infertility

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