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Gynaecology and Obstetrics > Subfertility > Flashcards

Subfertility Flashcards

1
Q

Subfertility?

A

Delayed conception after 12 months of regular unprotected sex

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2
Q

Causes of subfertility

A

Female (ovarian, uterine and tubal)
Male causes

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3
Q

Ovarian causes

A

PCOS
Hyperprolactinemia
Endocrine problem

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4
Q

Uterine causes

A

Intramural and submucosal fibroids
Ashermann syndrome
Polyp

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5
Q

Tubal disorders?

A

PID
Endometriosis
Hydrosalpinx

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6
Q

__________ fibroids dont cause subfertility

A

Subserosal

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7
Q

Male causes

A

Stress, ED, smoking, age, cancer, diabetes, mumps, epididymitis, previous surgery

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8
Q

SFA

A

Semen fluid analysis

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9
Q

Investigation

A

CBC
LFT
UCE
TFT
FSH
LH
Prolactin
AMH
AFC
HBA1C
Testosterone
TVUS
Hysterosalpingography

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10
Q

Male investigation

A

SFA (repeat it after 3 months)
Baseline
Karyotyping
Total Motile Count
Sperm count

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11
Q

Abstinence from intercourse for ______ before SFA

A

2-4 days

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12
Q

Treatment

A

Clomiphene citrate
Metformin
IVF
Adoption
Ovarian drilling
Intrauterine insemination

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13
Q

Fecundability

A

Likelihood of conceiving within one menstrual cycle

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14
Q

% of fecundability

A

18-20% in a young healthy couple
70% within 6 months
80% within 12 months
90% within 24 months

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15
Q

Single most important factor for subfertility

A

Female age

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16
Q

A person with subfertility also has symptoms of visual field defects

A

Prolactinoma

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17
Q

A person with subfertility also has symptoms of acne, hair growth

A

PCOS (hyperandrogenism)

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18
Q

If a person has regular cycle then we will investigate for

A

FSH
LH
AMH

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19
Q

If a person has irregular cycles then we will investigate for

A

TFT
Prolactin
Testosterone

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20
Q

Infection screening for subfertility

A

Chlamydia
HIV
Hep B and C

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21
Q

Progesterone is tested on the ______________ day to confirm ovulation

A

21th day of the cycle or mid-luteal phase

22
Q

AMH is used to check _____________

A

ovarian reserve

23
Q

__________ is the best biomarker of ovarian reserve

A

AMH

24
Q

AFC >16 is _________ response

A

high

25
Q

AFC <4 is ___________ response

A

low

26
Q

Complication of using clomiphene citrate

A

Multiple pregnancies

27
Q

Laparoscopic ovarian drilling is used only when there is _______________

A

no response to clomiphene citrate

28
Q

Tx of hypothalamic disorder

A

injectable pulsatile gonadotrophins

29
Q

Tx of hyperprolactinemia

A

Surgery
Dopamine agonist

30
Q

What tests are used for tubal patency?

A

Hysterosalpingogram
Hysterocontrastsynography
Laparoscopy and Dye Insufflation

31
Q

Hysterosalpingogram is performed during ____________

A

follicular phase
Exposed to Xrays

32
Q

Hysterocontrastsynography uses _____________

A

ultrasound

33
Q

_________________ is gold standard for tubal patency assessment

A

Laparoscopy

34
Q

Explain the procedure of laparoscopy and dye insufflation

A

Pneumoperitoneum is created
Methylene blue is injected into uterine cavity.
Normal = When the dye distends the tube and spills out into the abdominal cavity
Abnormal = When the dye doesn’t enter either tube

35
Q

Tx of adhesion

A

laparoscopic adhesiolysis

36
Q

Tx of blocked tube

A

tubal surgery

37
Q

Tx of endometriosis (surgical)

A

laparoscopic ablation

38
Q

Tx of fibroid

A

Myomectomy
Hysteroscopy
Embolization

39
Q

Oligozoospermia means

A

Sperm conc less than 15 million/ml or less than 39 million per ejaculate

40
Q

Asthenozoospermia means

A

Sperm motility less than 32%

41
Q

Teratozoospermia means

A

Sperm morphology less than 4%

42
Q

Azoospermia mean

A

No sperms in ejaculate

43
Q

Aspermia mean

A

no ejaculate

44
Q

What is oligoasthenoteratozoospermia?

A

Low concentration
Low motility
Poor morphology

45
Q

pH of semen

A

more than 7.2

46
Q

Vitality of sperm

A

58%

47
Q

What are the antispermatogenic drugs?

A

Alcohol
Anabolic steroid

48
Q

What are antiandrogenic drugs?

A

Cimetidine
Spironolactone

49
Q

What drugs cause ejaculatory dysfunction?

A

alpha and beta blockers
Antidepressants

50
Q

Tx of Retrograde ejaculation

A

Sympathomimetics

51
Q

Abnormal SFA then perform

A

FSH
LH
Testosterone

Gynaecology and Obstetrics (13 decks)

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