Reproductive System Flashcards
How is testosterone replaced?
Testosterone Replacement: Daily Gel (eg Tostran). Care not to contaminate partner. 3 weekly intramuscular injection (eg Sustanon) 3 monthly intramuscular injection (eg Nebido) Less Common (Implants, oral preparations)
What are the symptoms of low tstesterone - hypogonadism?
loss of early morning erections, libido, decreased energy, shaving
What is easier to treat primary or secondary hypogonadism?
Secondary ( deficiency of gonadotrophins so can give LH FSH to induce spermatogenesis
What does LH and FSH do in men? when it is given as treatment
LH :stimulates Leydig cells to increases intratesticular testosterone to much higher levels than in circulation (x100).
FSH : stimulates seminiferous tubule development and spermatogenesis
Would you give a man with Low Testosterone and low LH/FSH testosterone if they are trying to concieve?
No, would lower LH/FSH
Not given to men wanting to conceive
What is hypothalamic Amenorrhoea?
Insufficient energy for fertility so Amenohhrea:
Low body weight
Excessive excersize
Genetic susceptibility
Stress
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What is Ovulation induction?
Aim to develop one ovarian follicle
If >1 follicle develops this risks multiple pregnancy e.g. twins / triplets which can have risks on mum and baby
Ovulation induction aims to cause a small increase in FSH
- used in PCOS
How to restore ovulation in PCOS?
. Lifestyle / Weight Loss / Metformin
2. Letrozole (Aromatase inhibitor) 3. Clomiphene (Oestradiol receptor modulator) 4. FSH stimulation
How does clomiphene work?
Antagonist = reducing negative feedback from estradiol increasing GnRH –> LH/FSH
How does IVF treatment work?
Ooctye retrivel after giving FSH for multiple follicles
- Fertilisation in vitro
Embryo incubation
Embryo transfer
- Can to in vitro fertilisation or intra-cytoplasmic sperm injection
Describe the hormones involved in IVF?
- understand agonist methodology and desensitization
- Superovulation through FSH
- prevent premature rise in LH that would cause ovulation too soon with GnRH antagonist OR GnRH agonist which causes desensitization and acts as antagonist
- Use HCG to trigger LH release to turn diploids into haploid to become a mature egg
4.
What types of contraception are there?
- Methods:
Barrier: male / female condom / diaphragm or cap with spermicide
Combined Oral Contraceptive Pill (OCP)
Progestogen-only Pill (POP)
Long Acting Reversible Contraception (LARC)
Emergency Contraception - Permanent methods:
Vasectomy
Female sterilisation
Pros of Condoms?
Protect against STI’s
Easy to obtain – free from clinics
/ No need to see a healthcare professional
No contra-indications as with some hormonal methods
Cons of Condoms?
Can interrupt sex Can reduce sensation Can interfere with erections Some skill to use eg correct fit. Two are not better than one
How does the oral contraceptive pill work?
Oestogen and progesterone causing negative feedback
Decreased LH FSH
+ thickening of cervical mucus
Thinning of endometrial lining to reduce implantation
What are the pros of OCP?
- One pill a day - easy
Effective - Doesn’t interrupt sex
- Can take several packets back to back and avoid withdrawal bleeds
- Reduce endometrial and ovarian cancer
- Weight Neutral in 80%
(10% gain, 10% lose)