Reproductive Disorders Flashcards
What is the definition of infertility?
No pregnancy after 12 months of unprotected sex in a couple with no children
What is primary and secondary infertility?
Primary = no pregnancy Secondary = pregnant but ectopic/miscarriage
Name 5 risk factors for infertility?
Older age Chlamydia Obesity Caffeine Drugs
What is anovulatory disease?
No ovulations
Name 5 causes of an anovulation disorder .
Anorexia Tumours Hyperprolactinemia Ovulation disorder Endometriosis
What are group 1 ovulation disorders caused by + name 3 causes?
H-P axis failure No GnRH/LH or FSH Hypogonadotrophic hypogonadism Kallman's syndrome Anorexia
Treatment for group 1 ovulation disorders?
Pulsatile GnRH
What are group 2 ovulation disorders caused by + an example?
H-P-O axis failure
PCOS
What is the definition of PCOS?
12 or more 2-9 mm follicles and increased ovarian volume
What is the diagnostic criteria for PCOS?
2 out of:
Chronic anolvulation
Polycystic ovaires
Hyperandrogenism
Treatment for group 2 ovulation disorders?
Clomifene citrate
FSH/LH injections
What is the profile of PCOS in terms of LH/FSH and BG?
High LH/FSH
High BG
What is the cause of group 3 ovulation disorders + 2 examples?
High gonadotrophin causing low oestrogen
Ovarian failure
Hypergonoadotrophic hypogonadism
What 3 conditions are associated with ovarian failure?
Turner’s syndrome
XX gonadal agenesis
Fragile X syndrome
What is the diagnostic criteria for ovarian failure?
3x FSH > 30
Low oestrogen
Treatment for ovarian failure?
HRT
OCT
What is the definition of oligomenorrhea?
Less than 9 periods/year
What is the definition of primary and secondary amenorrhea?
Primary = no periods before 16 Secondary = cessation of periods > 6 months
What is the main cause of primary amenorrhea + name two examples.
Congenital disease
Turner’s syndrome
Kallman’s syndrome
What is Turner’s syndrome + inheritance + karyotype + does it affects men/women more?
Missing X chromosome
Sporadic mutation
45 X
Only women affected
What is Kallman’s syndrome and example of + inheritance + mutation + does it affect men/women more?
idiopathic hypogonadotrophic hypogonadism
X-linked recessive
ANOS1
Men
High prolactin or hypopituitarism can both cause amenorrhea. True or False?
True
Triad of amenorrhea and oestrogen deficiency?
Flushing
Decreased libido
Painful sex
Name 5 tests for ovulatory disorders.
LH/FSH/oestrogen TFT PFT Prolactin Ovarian US
Where is the origin of the problem in primary (hypergonadotrophic) vs. secondary (hypogonadotrophic) hypogonadism in females + males?
Primary = ovaries or testes Secondary = hypothalamus/pituitary
How does ovarian failure work?
Ovarian dysfunction
Low oestrogen
High gonadotrophins
What is the key symptoms of Kallman’s syndrome?
Inability to smell
What is the identified defect in idiopathic hypogonadotrophic hypogonadism?
Mutation of GnRH receptor
What is kisspeptin and what does it do?
GPCR ligand
Controls release of GnRH
What is the profile of primary and secondary hypogonadism in males in terms of LH/FSH and testosterone?
Primary = high FSH/LH, low testosterone Secondary = low FSH/LH, low testosterone
What is the profile of primary and secondary hypogonadism in females in terms of LH/FSH and oestrogen?
Primary = high FSH/LH, low oestrogen Secondary = low FSH/LH, low oestrogen
What are the main congenital causes of primary hypogonadism in males + females?
Males = Klinefelter's syndrome Females = Turner's or Kallman's syndrome
What is Klinefelter’s + inheritance + karyotype + does it affect men/women more?
Extra X chromosome
Sporadic mutation
47 XXY
Only men affected
What is the main cause of female + male infertility?
Female = ovarian failure Male = varicocele
What is hydrosalpinx?
Blockage casing fluid overload in fallopian tube
What is endometriosis + key US sign?
Endometrium growing outside uterus
Chocolate cysts
What is varicocele?
Testicular varicose veins
Name 2 infections which can cause female infertility?
Chlamydia
Rubella
