Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Gen Med (Endocrine) > Reproductive - Subfertility & Assisted Conception > Flashcards

Reproductive - Subfertility & Assisted Conception Flashcards

1
Q

What is the most common cause of subfertility?

A

Male factor subfertility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the three groups of female factors causing subfertility?

A

Anovulation, tubal disease, uterine/peritoneal disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are some examples of commonly used ‘drugs’ which can cause semen abnormalities?

A

Alcohol and nicotine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

When should subfertility be investigated?

A

When couples have not conceived after one year of regular unprotected sex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

In a couple with subfertility, investigations are carried out in the female to establish what two things?

A

Is she ovulating, and are the Fallopian tubes patent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

In a couple with subfertility, investigations are carried out in the male to establish what?

A

That the semen is of sufficient quality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

A mid-luteal phase progesterone concentration of greater than what confirms that a woman is ovulating?

A

30nmol/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

When should a progesterone measurement be taken in order to confirm that a woman is ovulating?

A

7 days before the next expected period

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Measurements of gonadotrophins and sex hormones should be taken at what stage in the menstrual cycle when investigating subfertility in a female?

A

Days 2-5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

In addition to gonadotrophins and sex hormones, what other hormones should be measured when investigating both males and females for subfertility?

A

TFTs and prolactin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

High testosterone and a high LH: FSH ratio in a woman with subfertility suggests what underlying diagnosis?

A

PCOS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

High FSH and low anti-Mullerian hormone in a woman with subfertility suggests what problem?

A

Low ovarian reserve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

When investigating for subfertility, what infection should a woman’s immunity status be checked for, and she should be vaccinated against if not immune?

A

Rubella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What infection should always be tested for when investigating both males and females for subfertility?

A

Chlamydia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What imaging investigation is used to diagnose abnormalities of the ovaries and uterus in women with subfertility?

A

Transvaginal US

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

When investigating a woman for subfertility, if uterine abnormalities are suspected or found on ultrasound imaging, what investigation should be done next?

A

Hysteroscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How should tubal patency be confirmed in low risk women (i.e. those with no history of pelvic infection/disease or abdominal surgery)?

A

Hysterosalpingography (HSG)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What side effect do many women experience after an HSG investigation?

A

Period like cramps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How should tubal patency be confirmed in high risk women (i.e. those with a history of pelvic infection/disease or abdominal surgery)?

A

Laparoscopy and dye

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What investigation is the gold standard test for confirming tubal patency in women with subfertility?

A

Laparoscopy and dye

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How long should a male abstain from ejaculation from before providing a semen sample?

A

3-4 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

If there is a reduction in any variable tested in a semen sample, what is the next step?

A

Repeat the sample in 3 months time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Couples with subfertility are advised to have sex how often?

A

2-3 times per weeks throughout the menstrual cycle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are some lifestyle measures that are advised in both men and women with subfertility?

A

Stop smoking, cut back alcohol, lose/gain weight as appropriate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

All women aiming to get pregnant should take which supplement?

A

Folic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the treatment for subfertility if semen analysis is normal, tubal patency has been confirmed and the female partner has a BMI < 30?

A

Ovulation induction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

If a patient is amenorrhoeic, what should be done before starting ovulation induction?

A

Progesterone challenge test

28
Q

What is the first line ovulation induction agent?

A

Clomifene citrate

29
Q

When in the menstrual cycle is clomifene citrate given?

A

Days 2-6

30
Q

What type of drug is clomifene citrate?

A

Anti-oestrogen

31
Q

What are some fairly common side effects of clomifene citrate?

A

Hot flushes and labile mood

32
Q

Treatment with clomifene citrate should be stopped if what symptoms develop?

A

Severe headache or visual disturbance

33
Q

How is treatment with clomifene citrate monitored?

A

Regular transvaginal ultrasound scans

34
Q

What surgical treatment option is available for ovulation induction in women with PCOS?

A

Ovarian drilling

35
Q

Other than clomifene citrate, what are some other medications that can be used for ovulation induction?

A

Gonadotrophins and metformin

36
Q

Tubal surgery is only offered to women under what age?

A

37 years

37
Q

How are women with moderate-severe tubal disease with subfertility managed?

A

Assisted conception

38
Q

In the UK, do individuals who donate their sperm or oocytes to help others conceive have the right to remain anonymous?

A

No

39
Q

What age should the female partner be at the beginning of assisted conception treatment?

A

< 40 years

40
Q

What age should the female partner be at the time of frozen embryo transfer in assisted conception?

A

< 41 years

41
Q

In order to be eligible for assisted conception, couples must have been infertile for how long?

A

2 years

42
Q

What are the rules regarding sterilisation and assisted conception?

A

Neither partner can have been sterilised

43
Q

What are the rules regarding smoking and assisted conception?

A

Both partners must be non-smoking for at least 3 months pre-treatment and during treatment

44
Q

What are the rules regarding alcohol and assisted conception?

A

Neither partner should drink alcohol prior to or during the treatment

45
Q

What are the rules regarding previous children and assisted conception?

A

Couples are eligible if one partner has no biological children

46
Q

How many cycles of assisted conception will a woman aged < 40 years recieve?

A

Three

47
Q

How many cycles of assisted conception will a woman aged 40-42 receive?

A

One

48
Q

Which type of assisted conception is this describing: fast moving spermatozoa are separated from sluggish ones and injected directly into the uterus after ovulation?

A

Intra-uterine insemination

49
Q

What is the single greatest predictor of success in IVF?

A

The woman’s age

50
Q

What is the overall success rate for IVF?

A

25%

51
Q

What medication is used first in the ovarian hyperstimulation phase of IVF to achieve pituitary downregulation and prevent premature ovulation?

A

GnRH agonist

52
Q

In the ovarian hyperstimulation phase, after a GnRH agonist has been given, what medication is given next to stimulate follicular growth and development?

A

Daily FSH or hMG injections

53
Q

During the ovarian hyperstimulation phase of IVF, when should transvaginal ultrasound scans be taken?

A

On day 8, and every 2 days thereafter

54
Q

During the ovarian hyperstimulation phase of IVF, when should the beta hCG injection be given?

A

When one leading follicle reaches 18mm and two further follicles are 16mm+

55
Q

In the ovarian hyperstimulation phase of IVF, what medication is given to replicate the LH surge and trigger ovulation?

A

Beta hCG

56
Q

In IVF, when is ultrasound guided transvaginal oocyte recovery carried out?

A

34-36 hours after hCG administration

57
Q

A maximum of how many embryos can be transferred into the uterus in IVF treatment?

A

Two

58
Q

What medication is given as luteal phase support in IVF treatment?

A

Progesterone supplements

59
Q

How long is progesterone given for as luteal phase support in IVF?

A

10 weeks

60
Q

When should women who are undergoing IVF treatment take a pregnancy test?

A

After two weeks of progesterone supplementation

61
Q

In surrogacy, the surrogate cannot hand over legal parental responsibility until the child is how old?

A

6 weeks

62
Q

What is the most significant risk of assisted conception to the mother?

A

Ovarian hyperstimulation syndrome

63
Q

What are the three main risk factors for the development of ovarian hyperstimulation syndrome?

A

Low BMI, PCOS, younger age

64
Q

What are some examples of significant complications of ovarian hyperstimulation syndrome?

A

Pericardial/pleural effusion, ascites, intravascular volume depletion

65
Q

How is ovarian hyperstimulation syndrome managed?

A

Fluids, thromboprophylaxis and drainage of fluid collections

66
Q

What is the most significant risk of assisted conception to the foetus?

A

Multiple pregnancy and its associated risks

Gen Med (Endocrine) (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions