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NURS 2156 OB 2 > Test 2 Infertility > Flashcards

Test 2 Infertility Flashcards

1
Q

Define infertility…

A

No conception >1 yr unprotected sex - 6 months if woman >35

Inability to carry a pregnancy to live birth

Involuntary ability to conceive when desired

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2
Q

Dif between Primary & Secondary Infertility…

A

Prime = never could

Secondary = have before, cant now

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3
Q

Is a lesbain considered infertile…

A

Yes.

She lacks the male partner

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4
Q

PGS

A

Preimplantation Genetic Diagnosis

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5
Q

Average sperm per ejaculation….

Normal conception requires ______ sperm / ml with normal motility

Sperm count & infertility

Mild
Mod
Severe

A

Average = 400 million

Conception requires 20 / ml Norm Motility

Mild 15 - 20 / ml 35 - 50 % Motility
Mod 5 - 10 / ml 20 - 35% Motility
Severe <5 / ml or <20% Motility

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6
Q

Illness, mumps, cirrhosis, renal failure
Genital infection
Varicocele
Exposure to Toxins
Drugs
Elevated scrotal temp, saunas, hot tubs
Autoimmune response

A

Factors that affect sperm

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7
Q

DM Peripheral vascular disease
Antihypertensive meds
CNS dysfunction, drugs, psych problems,
Surgery to spinal cord

A

Erection problems

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8
Q

Ab normal Ejaculation

Retrograde Ejaculation…
Hypospadias….

A

Retrograde Ejaculation: Ejaculation goes backwards into bladder

Hypospadias: Urethral opening on underside of penis

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9
Q

What can go wrong with seminal fluid to cause infertility…

A

Stay Coagulated.

Normally Coagulates then liquifies within 30 mins.

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10
Q

Test male or female first to determine infertility with couple…

How?

A

Male

Semen analysis (Structure, Volume, Motility)

Endocrine (Testosterone)
US Genital
Testicle biopsy

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11
Q

Women born with all their eggs

Decline in # through the lifetime

7 million at birth
300,000 at puberty
Few thkusand late 30’s

T or F

A

T

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12
Q

Normal ovulation

The following is the order of events in ovulation.

Hypothalamus (Secrets / Which Does)

Pituitary (Hormones)

A

Hypothalamus secrets GnRH Gonadotropin-Releasing Hormone

GnRH stimulates the Pituitary

Pituitary releases FSH (Follicle-stimulating hormone) & luteinizing hormone (LH)

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13
Q

Name the hormone

Stimulates maturity of several follicles - small fluid-filled sac in the ovaries. Contains an immature egg (oocyte).

As Follicles mature the ovary releases estrogen to thicken the endometrium

A

Follicle stimulating hormone
FSH

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14
Q

Follicle contains an immature egg which will mature with help from FSH.

As the Follicle matures the ovary secrets estrogen, why?

A

To thicken the endometrium

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15
Q

Luteinizing hormone

24 - 36 hrs prior to ovulation, LH increases

What is the purpose of LH…

A

Stimulates final maturation and release of the ovum (Mature female egg cell)

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16
Q

______ is a mature egg cell that is part of the female reproductive system.

It is the female gamete (reproductive cell) and carries half the genetic material needed for reproduction.

When fertilized by a sperm cell, the ovum can develop into a zygote, the first stage of a developing embryo.

A

An ovum (plural: ova)

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17
Q

Collapsed follicle from which the ovum was released.

Produces Progesterone & Estrogen which preparss the endometrium for implantation

A

Corpus luteum

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18
Q

Estrogen builds the house (uterine lining) during the first half of the cycle.

Progesterone keeps the house ready for a baby after ovulation.

A

True

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19
Q

Match to appropriate Structure.

GnRH (Stimulates Pituitary Gland to release FSH & LH)

FSH (Stimulates ovary which causes maturation of follicles) & LH (Stimulates ovary and final maturation and release of ovum)

As follicle matures Estrogen is released (thickens endometrium)

Progesterone & Estrogen (Prepares endometrium for implantation)

Ovary, Pituitary, Corpus luteum, Hypothalamus

A

Hypothalamus
GnRH (Stimulates Pituitary Gland to release FSH & LH)

Pituitary
FSH (Stimulates ovary which causes maturation of follicles) & LH (Stimulates ovary and final maturation and release of ovum)

Ovary
As follicle matures Estrogen is released (thickens endometrium)

Corpus luteum
Progesterone & Estrogen (Prepares endometrium for implantation)

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20
Q

GnRH ….
FSH….
LH….
Progesterone & Estrogen….

(Prepares endometrium for implantation)

(Stimulates ovary which causes maturation of follicles)

(Stimulates Pituitary Gland to release FSH & LH)

(Stimulates ovary and final maturation and release of ovum)

A

GnRH (Stimulates Pituitary Gland to release FSH & LH)

FSH (Stimulates ovary which causes maturation of follicles) & LH (Stimulates ovary and final maturation and release of ovum)

As follicle matures Estrogen is released (thickens endometrium)

Progesterone & Estrogen (Prepares endometrium for implantation)

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21
Q

Oligoovulation / Anovulation
Commonly, lack of FSH

Are common causes of female infertility

Tx…..

A

Clomiphen (Clomid)

Anti-estrogen - Blocks effects of estrogen

Pituitary notices lack of precieved estrogen & secrets more FSH & LH to índuce ovulation

22
Q

Purpose of Clomiphen Citrate (Clomid) - an Anti-estrogen medicine

A

Induce ovulation

It blocks body from sensing estrogen which makes body increase FSH & LH

23
Q

Partial fallopian tube obstruction may result in…

A

Ectopic pregnancies

24
Q

STD
Endometriosis
Scarring from PID,surgery, peritonitis
Ovarian cysts
Congenital anomalies

A

Fallopian tube problems

25
Q

AMA

Percent chance of getting preggers at
30
40

A

30- 20% chance
40- 5%

26
Q

Ovaries enlarged with multiple small cysts.

Irregular menstruation / impaired fertility

High Risk for miscarriage

Excessive testosterone production gives Hair & Skin (Acne) issues

Increased Risk of developing DM

Obesity/ Heart Disease

A

Polycystic Ovary Syndrome

PCOS

27
Q

TX for PCOS
Polycystic Ovarian Syndrome

A

Clomid / Femara

28
Q

Trouble ovulating. It is often prescribed for infertility and is considered one of the first-line treatments for women with conditions like polycystic ovary syndrome (PCOS) or other ovulation-related problems.

A

Clomid (Clomiphene citrate)

29
Q

Clomid blocks the effects of estrogen in the brain. This tricks the brain into thinking estrogen levels are low, prompting the pituitary gland to release more follicle-stimulating hormone (FSH) and luteinizing hormone (LH).

These hormones (2)

A

Help follicles in the ovaries grow.
Trigger ovulation (release of an egg).

30
Q

Causes of repeated pregnancy loss

A
  1. Abnormal fetal chromosomes - SAB 1st trimester

Chromosomal analycist frequently order on fetuses delivered 2nd / 3rd trimester

  1. Abnormalities of cervix or uterus
31
Q

Uterine myomas (Benign) and adhesions may have this affect on pregnancy (2)

A

Alter perfusion

Preterm labor

32
Q

Basal body temperature

Day 1: Your period starts.

Days 2–13: Your temperature stays around 97.2°F to 97.5°F.

Day 14: Ovulation happens (you don’t feel it). The next morning, your temp jumps to 98.0°F.

Days 15–28: Your temp stays high (98.0–98.3°F).

Day 29: If you’re not pregnant, your temp drops, and your period starts again.

What is your body temperature when you can get preggers…

A

A few days before the temperature increase (Ovulation)

33
Q

BBT is lowest rest body temperature

1st half menstrual cycle is lower than 2nd half (when ovulating / fertile)

BBT DROPS JUST SLIGHTLY BEFORE OVULATION & RISES DURING OVULATION/ PREGGERS

T or F

A

T

34
Q

Spinnbarkheit ….

A

How much cervical mucus can be stretched between fingers or slide / slip cover

Just before / after ovulation MUCUS IS SCANT, THICK, STICKY and opaque Stretches <6cm

Prior & 2-3 days after ovulation MUCUS IS THIN, SLIPPERY, AND CLEAR - resembles egg-white, stretches >6cm

35
Q

MUCUS IS SCANT, THICK, STICKY and opaque Stretches <6cm

MUCUS IS THIN, SLIPPERY, AND CLEAR - resembles egg-white, stretches >6cm

Which one is more likely to get preggers…

A

Just before / after ovulation MUCUS IS SCANT, THICK, STICKY and opaque Stretches <6cm

Prior & 2-3 days after ovulation MUCUS IS THIN, SLIPPERY, AND CLEAR - resembles egg-white, stretches >6cm

Egg whites gets preggers

36
Q

Antihistamine, vag infection, contraceptive foams, Sexual arousal, semen, Clomid

All hav3 an influence on….

A

Cervical mucus assessment

37
Q

Ovulation prediction (BBT, Cervical Mucus, Serum progesterone lvl)

Pelvic US

Postcoital test: Evaluate Cervical mucus / sperm function

Endocrine test

Hysterosalpingography: Patency verfied by contrast medium & US (Can unclog passage way & help with pregnancy)

Endometrial biopsy

Hysterscopy (go inside with a scope & clear out any scarring)

Laproscopy (go inside with a scope & clear out any scarring)

Used for…

A

Test for female infertility

38
Q

Infertility Meds

Corrects excessive prolactin secreted by the Anterior Pituitary & Increased ovulation & stimulates progesterone secretion by corpus luteum

Causes ovulation, increase GnHr secretion from the hypothalamus, thus increasing FSH & LH

Increased blood flow to the penis, Erection

Clomiphen citrate (Clomid)
Bromocriptine (Parlodel)
Sildenafil (Viagra)

A

Bromocriptine (Parlodel)
Corrects excessive prolactin secreted by the Anterior Pituitary & Increased ovulation & stimulates progesterone secretion by corpus luteum

Clomiphen citrate (Clomid)
Causes ovulation, increase GnHr secretion from the hypothalamus, thus increasing FSH & LH

Sildenafil (Viagra)
Increased blood flow to the penis, Erection

39
Q

Corrects excessive prolactin secreted by the Anterior Pituitary & Increased ovulation & stimulates progesterone secretion by corpus luteum

A

Bromocriptine (Parlodel)

40
Q

Causes ovulation, increase GnHr secretion from the hypothalamus, thus increasing FSH & LH

A

Clomiphen citrate (Clomid)

41
Q

Increased blood flow to the penis, Erection

A

Sildenafil (Viagra)

42
Q

Infertility meds

Stimulates ovulation in female/ sperm production in males. Stimulates production of progesterone by corpus luteum

Reduces endometriosis (2)

Leuprolide (Lupron)
Nafarelin (Synarel)
Chorionic Gonadotropin (hCG, Pergonal)

A

Chorionic Gonadotropin (hCG, Pergonal)
Stimulates ovulation in female/ sperm production in males. Stimulates production of progesterone by corpus luteum

Leuprolide (Lupron)
Nafarelin (Synarel)
Reduces endometriosis (2)

43
Q

Chorionic Gonadotropin (hCG, Pergonal)

A

Stimulates ovulation in female/ sperm production in males. Stimulates production of progesterone by corpus luteum

44
Q

Leuprolide (Lupron)
Nafarelin (Synarel)

A

Reduces endometriosis

45
Q

(First Line) artificial inseminación

Use clomiphen for best results

Hormone levels are closely monitored

US to evaluate follicle (goal 2-3)

Semen sample is obtained & washed, then inserted through cervix and placed high in the uterus

A

Interuterine Insemination (IUI)

46
Q

Putting sperm & egg together in the fallopian tube via Laproscopic procedure.

Give woman progesterone

Name process…

A

Gamete Intrafallopian Transfer

Rarely done

47
Q

Bypasses blocked or Absent fallopian tubes

Ova & Sperm are mixed together in lab

2 - 5 days later embryos are returned to the UTERUS

Give progesterone to promote implantation

Excess embryos maybe frozen

Issue of Concern: Multiple concpetions, may require selective reduction.

A

Im Vitro Fertilization IVF

48
Q

Intracytoplasmic Sperm Injection (ICSI)

Describe….

Required if you do Genetic Testing

A

IVF

But, single sperm is injected into egg

49
Q

BUFA

A

Baby up for adoption

50
Q

Open vs Closed adoption

A

Open = Regular contact with birth mother

Closed = NO Contact

51
Q

(Estrogen / Progesterone)builds the uterine lining.

( Estrogen/Progesterone) fine-tunes and maintains it, ensuring it’s ready for implantation and early pregnancy support.

If fertilization doesn’t happen, hormone levels drop, and the uterine lining sheds as a period.

A

Estrogen builds the uterine lining.

Progesterone fine-tunes and maintains it, ensuring it’s ready for implantation and early pregnancy support.

NURS 2156 OB 2 (12 decks)

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