Reproductive treatments Flashcards
What are the 4 types of testosterone replacement?
Daily gel
3 weekly Intramuscular injection
3 monthly intramuscular injection
Implant
Why is LH and FSH needed for male fertility?
To help in spermatogenesis
LH stimulates leydig cells to increase intratesticular testosterone levels
FSH stimulates semifernous tube development
What injections does a man that wants fertility require?
HCG for 6 months then FSH injections
What are the two most common causes of irregular periods and what treatments would you give them each to restore ovulation?
PCOS: lose weight, metformin, letrozole, clomiphene, FSH stimulation
Hypothalamic amenorrhea: weight gain, FSH stimulation, GnRH pump
Don’t give letrozole or clomiphene as it reduces oestradiol levels which are already low in amenorrhea
How many follicules do you want to develop in an ovarian induction and why?
1
Avoid multiple pregnancies
Safer for mother and baby
What are the 4 steps in IVF?
Oocyte retrieval
Fertilisation in vitro/intra cytoplasmic (inject sperm into egg rather than on agar plate)
Embryo incubation
Embryo transfer
How does the oral contraceptive pill impact FSH and LH levels?
How does it prevent pregnancy?
They decreased due to the administered oestrogen and progesterone causing a negative feedback loop
Causes anovulation, thickening of cervical mucus, thinning of endometrial lining (less implantation)
What are the advantages and disadvantages of the COC?
What are potential side effects?
What are the contraindications for it?
Advantage: once a day and effective
Disadvantage: have to remember to take it
Nausea, mood changes, diarrhoea, blood clots
Risk of migraines, smoking, CVD, breast cancer
What can be given instead of the COC?
What are its disadvantages?
POP
must be taken at same time everyday
Less reliable
What are the three emergency contraceptives available?
Copper IUD- valid for 5 days after unprotected sex
Ulipristal acetate- 5 days
Levonorgestrel- 3 days
What are two benefits of hormone replacement therapy (HRT)?
Symptom relief eg sweating, disturbed sleep, decreased libido, low mood
Less osteoporosis fractures
What can HRT cause, and which one is more prone to cause VTE and why?
Venous thromboembolism, cancer (breast, ovarian, endometrial), CVD
Oral oestrogen more likely than transdermal as it goes to liver first increasing clotting factors
What must you give a woman with an endometrium before HRT?
Why?
Progesterone
Prevent endometrial hyperplasia secondary to oestrogen dose
What are LARCS?
What are the two types of coils?
Long acting reversible contraception- coils, implants and injection
Copper coil- no hormone released
Mirena coil- progesterone secreting
