Subfertility

Question 1

Most women under 40 with no known cause of infertility generally become pregnant within what period?

1 - within 3 months
2 - within 6 months
3 - within 1 year
4 - within 2 years

Answer 1

4 - within 2 years

Question 2

When assessing a females reasons for subfertility we measure a hormone that is secreted, present at the highest concentrations during the luteal phase of the menstrual cycle. What hormone is this?

1 - oestrogen
2 - LH
3 - progesterone
4 - FSH

Answer 2

3 - progesterone

Question 3

Progesterone is secreted in high amounts during the luteal phase. The luteal phase of the menstrual cycle refers both to the secretion of progesterone from the corpus luteum and to the secretion of a clear fluid by the endometrium during this phase. What time period should this be measured to assess a females fertility?

1 - day 14 of menstrual cycle
2 - day 30 of menstrual cycle
3 - day 6 of menstrual cycle
4 - day 21 of menstrual cycle

Answer 3

4 - day 21 of menstrual cycle

- following ovulation the corpus luteal secretes progesterone that peaks at 21 days

Question 4

In addition to progesterone, what other hormones that are directly related to fertility should be measured to assess a females cause of infertility?

1 - LH, FSH and testosterone
2 - LH, FSH and oestrogen
3 - LH, FSH and thyroid
4 - LH, FSH and prolactin

Answer 4

1 - LH, FSH and testosterone

Question 5

In addition to progesterone, what other hormones that are NOT directly related to fertility should be measured to assess a females cause of infertility?

1 - thyroid and insulin
2 - thyroid and prolactin
3 - prolactin and insulin
4 - prolactin and parathyroid hormone

Answer 5

2 - thyroid and prolactin

Question 6

In males semen can be investigated to assess male reasons for infertility. What are the 3 measures of semen that are conducted?

Answer 6

1 - count (>15ml sperm/ml)
2 - morphology (>4% normal)
3 - motility (>40% motile)

Question 7

In males that are suspected to be infertile, what measure of a metabolic disorder should be measured to rule out this disease?

Answer 7

• HbA1c

Question 8

What micronutrient are women who are trying to get pregnant and then when they are pregnant advised to take?

1 - iron
2 - vitamin D
3 - folic acid
4 - fish oil

Answer 8

3 - folic acid

- 400ug/day

Question 9

What are the 6 main lifestyle factors that can be modified to reduce the risk of subfertility in both men and women?

Answer 9

1 - alcohol
2 - smoking
3 - high BMI
4 - occupation
5 - diet and exercise
6 - drug use

Question 10

Why is age a risk factor for subfertility in women?

Answer 10

• female fertility naturally declines with age

Question 11

What BMI cut offs can increase the risk of subfertility?

1 - <25 and >35
2 - <10 and >30
3 - <19 and >30
4 - <19 and >35

Answer 11

3 - <19 and >30

Question 12

Is IVF offered to everyone?

Answer 12

• no

Question 13

What is the number of rounds of IVF that the NICE guidelines recommend?

1 - 1
2 - 2
3 - 3
4 - 4

Answer 13

3 - 3

Question 14

NICE guidelines recommend that potential parents who are infertile should be offered up to 3 rounds of IVF, however, only 1 in 10 areas of the UK offer this, with 60% of PCNs now offering only 1 round of IVF. What factors are taken into account when deciding who should be given IVF?

1 - age, BMI, chance of success, already with children and previous IVF
2 - age, gender, chance of success, previous IVF
3 - gender, BMI, already with children and previous IVF
4 - age, BMI and chance of success

Answer 14

1 - age, BMI, chance of success, already with children and previous IVF