Sub-fertility Flashcards
What percentage of infertility is idiopathic (unexplained)
25%
What is Kallman’s syndrome
A condition in the hypothalamus that stops sexual development
Why can cystic fibrosis cause infertility?
Associated with absence of vas deferens
When should investigations into infertility start?
After 12 months of actively trying to conceive because over half of couples take over 6 months)
What 5 things do blood tests into sub-fertility look for?
- Progesterone
- Anti-mullerian horman (measures egg reserve)
- FSH/LH (detect pituitary axis)
- Oestrogen (also detects pituitary axis)
- Testosterone (increased levels of androgens is associated with PCOS in women)
State 3 investigations that can be performed to investigate sub-fertility
- Pelvic ultrasound scan (Can’t be used to look at Fallopian tubes)
- Hysterosalpingogram (looks at Fallopian tubes and can test for tubal patency (if the tubes or not blocked))
- Laparoscopy
When is best to check female hormones?
Second part of cycle after egg released because progesterone is released by corpus luteum so check porgesterone in middle of luteal phase of cycle on day 21
Why is it important to screen for chlamydia and gonorrheoa when investigating sub-fertility?
Because they are associated with blocked Fallopian tubes (anything that causes inflammation so also check for surgery, infection, ruptured appendix)
What three factors contribute to male sperm fertility?
- Motility (more than a third need to swim forwards)
- Concentration (15 to 200 million per millilitre)
- Morphology (More than 4% need to appear normal)
State three male causes of infertility
- Obstructive azoospermia
- Hypogonadotrophic hypogonadism (lack of hormones that stimulate testes)
- Ejaculatory or erectile problems
How is obstructive azoospermia corrected?
Surgery
How is hypogondaotrophic hypogonadism treated
Gonadotrophin drugs
What treatment is offered to induce ovulation?
Clomiphene citrate or anti oestrogens (taken orally)
Gonadotrophins
Contraindications of gonadotrophins to treat ovulation
Higher risk in older pregnancy so regular ultrasound monitoring
Why is ultrasound monitoring important in intrauterine insemination?
To ensure no more than 3 follicles develop in the ovaries
