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OBG > USMLE > Flashcards

USMLE Flashcards

1
Q

What is the definition of infertility?

A
  1. Inability to conceive after 12 months of regular, unprotected sexual intercourse in women <35 years of age
  2. Inability to conceive after 6 months of regular, unprotected sexual intercourse in women >35 years of age
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2
Q

What are the 4 male causes of infertility?

A
  • Primary hypogonadism (Increase FSH) - 30% - 40%
  • Secondary hypogonadism (decreased FSH, LH) - 2%
  • Disordered sperm transport - 10% - 20%
  • Unknown - 40% - 50%
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3
Q

What are the 4 female causes of infertility?

A
  1. Amenorrhea/ovulatory dysfunction
    - Hypothalamic/Pituitary cause
    - PCOS
    - Premature ovarian failure
    - Uterine or outflow tract disorders
  2. Tubal defect
  3. Endometriosis
  4. Others
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4
Q

What possible history you will get for male factor infertility?

A
  • Testicular injury or infection
  • Medications
  • Pituitary, thyroid or liver disease
  • Signs of hypogonadism
  • Varicocele
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5
Q

What investigations can be done to diagnose diagnose male factor infertility?

A
  • Semen analysis
  • TSH
  • Prolactin
  • Karyotyping (TRO Klinefelter syndrome)
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6
Q

What treatment can be given to treat male factor infertility?

A
  • Treat hormonal deficiency
  • Intrauterine insemination
  • Donor insemination
  • In vitro fertilization (IVF)
  • Intracytoplasmic sperm injection
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7
Q

What possible history you will get for ovulatory factor infertility?

A
  • Increase incidence with age
  • Symptoms of hyperthyroidism/hypothyroidism
  • Galactorrhea
  • Menstrual cycle abnormalities
  • Pituitary tumours
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8
Q

What investigations can be done to diagnose diagnose ovulatory factor infertility?

A
  • Menstrual history -> Menstrual cycle abnormalities
  • Basal body temperature -> hypothyroidism/hyperthyroidism
  • TSH, prolactin, androgens
  • Ovarian sonography (antral follicle count)
  • Endometrial biopsy (luteal-phase defect)
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9
Q

What treatment can be given to treat ovulatory factor infertility?

A
  • Treatment depends on the etiology
  • Induction of ovulation with CLOMIPHENE, GONADOTROPINS
  • Intrauterine insemination
  • IVF
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10
Q

What possible history you will get for tubal factor infertility?

A

History of:
- PID
- Appendicitis
- Endometriosis
- Pelvic adhesion
- Tubal surgery

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11
Q

What investigations can be done to diagnose tubal factor infertility?

A
  • Hysterosalpingogram
  • Potential laparoscopy
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12
Q

What treatment can be given to treat tubal factor infertility?

A
  • Laparoscopic resection or ablation of endometriomas or fibroids
  • IVF
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13
Q

What possible history you will get for uterine factor infertility?

A
  • Polyp
  • Fibroids
  • Congenital anomalies
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14
Q

What investigations can be done to diagnose uterine factor infertility?

A
  • Ultrasound
  • Hysterosalpingogram
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15
Q
A
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OBG (4 decks)

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