w5 - management of infertility

Question 1

diet and lifestyle advice for couples suffering from infertility 6

Answer 1

stop smoking 
bmi - 18.5 - 30, normal best 
reduce/stop alcohol 
reduce caffeine 
stop recreational drugs 
stop methodone

Question 2

general advice for infertility

Answer 2

reassure - 84% preggers in 1yr
sex every 2-3d
consider underlying psychosexual problems
if pre-existing med condition, consider preconception counselling

Question 3

folic acid is useful in aiding conception, how much shd be given daily before pregnancy, and for first 12wks?

5mg is recommended if they …(4)

Answer 3

400mcg

neural tube defect
prev baby with neural tube defect
fam history of neural tube defects
diabetes

Question 4

vitamin D is also recommended, 3 groups that should

Answer 4

pregnant
lactating
vit D deficiency

Question 5

what is rubella syndrom?

Answer 5

group of physical abnormalities, developed in an infant due to maternal infection (and subsequent fetal infection with rubella virus)

Question 6

characteristics of rubella syndrome

Answer 6

rash at birth 
low birth weight 
small head size/abnoromalities 
visual problems 
bulging fontanelle

Question 7

ovulatory disorders are classified depending on area affected. 1 = Hypothalamic, 2= hypothal-pit dysfunction, 3 =ovarian. For each group state the differences in gonadotrophins and gonadism

Answer 7

1 - hypogonadotrophin + hypogonadism

2- normogonadotrophin + hypogonadism

3- hypergonadtrophin, hypogonadism

Question 8

ovulatory disorder, which does not fit into criteria for any group

Answer 8

hyperprolactinaemia

Question 9

treatment for anovulatio

Answer 9

(no ovulation, oocyte not moving)

repro surgery - primary, or enhance IVF

Question 10

when is repro surgery primary treatment 4

Answer 10

pelvic adhesions
grade 1/2 endometriosis
chocolate cysts
tubal block

Question 11

women as proximal tubal obstruction, treatment

Answer 11

salphinography + tubal catheterisation
or
hysteroscopic tubal cannulation

Question 12

women has hydrosalpinges, treatment

Answer 12

salpingectomy (laparoscopy better), before IVF

Question 13

if contraindicated for laparoscopy, what then?

Answer 13

hysteroscopic essure - blocks tubal ostea

Question 14

define fibroids

Answer 14

non-cancer growth in/around uterus

Question 15

which type of fibroids are unlikely to hav an impact on fertilitty

Answer 15

subserosal

Question 16

if submucosal fibroid, treatment

Answer 16

hysteroscopical srugeyr