Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

MFSRH 2021 > Subfertility > Flashcards

Subfertility Flashcards

1
Q

% infertility due to male partner?

A

25%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

% infertility due to female partner?

A

40%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Mixed male and female infertility %?

A

15%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

% unexplained infertility?

A

20%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

If clomifene/tamoxifen failures to be successful in fertility tx in PCOS next line?

A

Metformin, ovarian drilling or gonadotrophins (drilling sometimes preferred as no risk of multiple pregnancy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Mechanism of action for clomifene?

A

Non-selective oestregen receptor antagonist (feedback loop disruption of oestrogen –> gonadotrophin release and ovarian stimulation).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Risk factors for OHSS?

A

PCOS, increased antral follicle count, high AMH, multiple pregnancy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Mechanism of action of metformin in subfertility in tx in PCOS?

A

Normalises response to FSH promoting ovulation by reducing insulin resistance and hyperandrogenism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

If a semen analysis is abnormal what should be the next step in subfertility investigation?

A

Repeat 3/12 (spermatogenesis 90 days)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

% IVF success rate for <35?

A

30%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

% success rate for IVF 36-38yo?

A

15%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

% success rate for IVF 39 yo?

A

10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

% success rate IVF >40 yo?

A

6%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Risk factors for ovarian hyperstimulation syndrome?

A

Previous OHSS, PCOS, Low BMI.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Pathophysiology of OHSS?

A

Fluid shift to extravascular space resulting in peritoneal and pleural fluid, fluid shift results in haemoconcentration and increased VTE risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Risk of OHSS in IVF?

A

0.5-10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Features of OHSS?

A

Abdo pain, ascites, hypovolaemic shock, pleural effusion, thrombosis, renal failure, death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

% OHSS severe?

A

0.5%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Treatment of OHSS?

A

Supportive and discontinue IVF cycle, VTE prophylaxis (TEDs/LMWH), hydrate appropriately, analgesia, antiemetics.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the most common sex chromosome disorder associated with infertility?

A

Klinefelter’s syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Questions to ask man when couple is struggling to conceive?

A

Previous children, time TTC, frequency of SI, contraception use, any infections in past esp mumps/C4, previous genital surgery, systemic illnesses, medications, ejaculation/erectile dysfunction, occupation, lifestyle (smoking, ETOH, drugs, steroids, BMI).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What to examine in a male when couple is struggling to conceive?

A

Secondary sex characteristics, genitals (esp testicular size), gynaecomastia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

First ix of male when couple if struggling to conceive?

A

Semen analysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

If 2 x semen samples are abnormal what ix next for male?

A

Testosterone/LH/FHS/prolactin, consider imagining genital tract/karyotyping

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
In a male with oligospermia and a low testosterone and raised LH/FSH what is likely to be the causes of the oligospermia?
Primary problem with spermatogenesis – primary hypogonadotrophic hypogandism
26
Causes of primary hypogonadotrophic hypogandism in males?
Genetic (Klienfelters, y chromosome microdeletion), Cryptorchidism, acquired (mumps, medications, radiation)
27
If a male with subfertility has a low FSH/LH and testosterone what is the likely cause?
Secondary hypogonadotrophic hypogandism (pituitary level). Pituitary adenoma (ACTH, cortisol, TSH, ILGF-1, prolactin), congenital GnRH deficiency (Kellmanns, usually reduced/absent smell), head trauma/surgery/tumour
28
Tx of Secondary hypogonadotrophic hypogandism in a male?
External GnRH (3 x weekly with monitoring of testosterone levels and sperm count) if tx of underlying cause doesn’t improve sperm count in 6/12
29
Likely cause of infertility in a male with normal FSH/LH/testosterone and azoospermia?
Sperm transport disorder eg obstructive azoospermia (anywhere in the transport) or congenital absence of vas, USS and testicular biopsy.
30
Risk factors for retrograde ejaculation?
Surgery diabetes spinal cord injury psych meds (chlorpromazine, thioridazine and antihypertensives (doxazosin)
31
How to diagnose retrograde ejaculation?
Sperm present in urine
32
Medical tx for retrograde ejaculation?
Symopathomemetic (ephedrine sulphate or phyylpropanolamine) if meds failed assisted conception
33
% chance of fatherhood in a person with bilateral cryptorchism?
35-50%
34
% chance of fatherhood in a person with unilateral cryptorchism?
94%
35
3 categories of male infertility causes?
Congenital, acquired, idiopathic
36
Causes of genetic male infertility?
Klinefelter’s, Kallman, AIS
37
Testicular causes of male subfertility?
Genetic (Kleinfelters, Noonan's, Kallman’s) Cryptorchidism Acquired (injury, varicocele, tumours, chemo / radiotherapy, idiopathic)
38
Causes of pre-testicular male subfertility?
Hypothalamic disease (Kallmans, Prader-Willi, CHARGE) Pituitary pathology (Tumours, Brain injury including iatragenic)
39
Post testicular causes of male subfertility?
Can't get through or can't swim Congenital (congenital absence of the vas deferens, CF, Youngs) Acquired (Infection, vasectomy), ``` Sperm dysmotility (Immotile cilia syndrome, Maturation defects, Immunological infertility, Globozoospermia, Sexual dysfunction) ```
40
What hormone controls spermatogenesis?
FSH (LH controls testosterone production)
41
Which cells produce testosterone in males?
Leydig
42
Which cells are the location of spermatogenesis?
Sertoli
43
For people using artificial insemination to conceive what is the usual conception rate?
using artificial insemination to conceive for woman <40; > 50% women conceive within 6 cycles IUI. A further half will conceive with a further 6 cycles. cumulative pregnancy rate ~ 75%
44
% of couples of will conceive within 1 year of trying?
80%
45
% of couples of will conceive within 2 years of trying?
90%
46
Semen analysis normal total sperm/ejaculate?
>39 million
47
Semen analysis normal sperm/ml?
>15 million
48
Where does sperm maturation take place?
Epididymis
49
Normal pH of sperm?
>7.2
50
Normal ejaculate volume?
>1.5ml
51
Normal motility or progressive motility on semen analysis?
>40% motile, >32% progressively motile.
52
Normal vitality of semen analysis?
>58%
53
Normal morphology on semen analysis?
>4%
54
How long trying to conceive until referral for ix?
12/12 if <35, no menstrual or structural problems (PID/fibroid), or undescended testes. 6/12 otherwise.
55
Low and high BMI of women impacting on fertility?
<19 and >29
56
Initial investigation for a couple with infertility?
Semen analysis and assessment of ovulation status.
57
Initial assessment of ovulation (for infertility ix) in women with regular cycle?
Mid luteal phase progesterone (day 21 if 28 day cycle)
58
% infertility due to tubal patency?
20%
59
% infertility due to ovulatory disorders?
21%
60
Initially assessment of ovulation (for fertility ix) in women with irregular cycles?
FSH, LH, prolactin, TFTs (add in testosterone and oestradiol if suspecting PCOS, if hirsute/virilised)
61
Method to assess for tubal damage?
Lap and dye if comorbidities (ectopic/pid/endometriosis) if no comorbidities HSG. HyCoSY also possible
62
Is an endometrial biopsy indicated in infertility investigation
? No
63
Assessment of ovarian reserve?
Day 3 of cycle: AMH, antral follicle count, FSH
64
1st line induction of ovulation in infertility?
Clomifene for 6/12 (if PCOS USS in first month to assess response)
65
Risk of multiple pregnancy in clomifene use?
5-10%

MFSRH 2021 (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions