Reproductive Treatments Flashcards
How is primary hypogonadism in males treated?
Hard to treat via hormones
How is secondary hypogonadism in males treated? How does this help?
Gonadotrophins (LH/FSH)
Stimulates spermatogenesis
What hormone stimulates testosterone via what cells?
LH stimulates it via leydig cells
What hormone stimulates spermatogenesis in what structure?
FSH in seminiferous tubules
What injections for male infertility target LH receptors?
hCG injections
Does Congenital Secondary Hypogonadism have better, same or worse prognosis than Acquired Secondary Hypogonadism in males and why?
Worse- he has not gone through mini puberty
When is testosterone replacement given?
If not desiring fertility
What testosterone replacements are available?
Daily gel- tostran
3 weekly injection
3 monthly injection
What do we have to monitor when giving testosterone replacement?
Observe haematocrit (risk of hyperviscosity and stroke) Prostate (PSA levels)
How is fertility mainly improved for patients with PCOS?
Try to stimulate ovulation (ovulation induction) via development of one ovarian follicle (avoids multiple pregnancy)
How is ovulation induction encouraged?
- Lifestyle / Weight Loss / Metformin
- Letrozole (Aromatase inhibitor)
- Clomiphene (Oestradiol receptor antagonist)
- FSH stimulation (injection)
How does letrozole/ aromatase inhibitor/ oestradiol receptor antagonist work?
Reduces negative feedback from oestradiol
How does IVF work?
High dose of FSH to stimulate eggs
Prevent premature ovulation via GnRH agonist/antagonist
Give LH to allow egg maturation
Retrieve eggs from ovary
Fertilisation in vitro or intracytoplasmic injection of sperm
Embryo incubation
Embryo transfer
When is intracytoplasmic injection of sperm (ICSI) used and what is it?
When theres a problem with the sperm, inject one sperm into an egg
What do we do to ovulation in IVF?
Prevent it by giving medicine to prevent premature LH surge