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Endocrine Week 5 2017/18 > 4: Assessment of infertility > Flashcards

Flashcards in 4: Assessment of infertility Deck (51)
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1

What infection can cause infertility?

Chlamydia

2

The ___ you are, the less fertile you are.

older

3

A BMI over __ significantly increases your risk of infertility and complications of pregnancy.

30 kg/m2

4

What is the WHO definition of infertility?

Failure to achieve pregnancy after 12 months of unprotected intercourse in a couple who have never had a child (without a known reason)

5

What is primary infertility?

Infertility in a couple who have never conceived

6

What is secondary infertility?

Infertility in a couple who have previously conceived

7

Under which age are you more likely to conceive?

30

8

At which point in the menstrual cycle is conception most likely?

Ovulation

9

Which lifestyle factors affect the chances of conception?

Weight

Smoking

Caffeine intake

Recreational drugs

10

What are the three general causes of infertility?

Male factors

Female factors (i.e problems with tubes, reduced egg reserves, endometrosis)

Mixture of the two

11

What is the name for failure to release an egg?

Anovulation

12

When is anovulation normal?

Before puberty

During pregnancy

After menopause

13

Which eating disorders can cause anovulation?

Why?

Anorexia nervosa

Bulimia nervosa

associated low BMI

14

What are some clinical features of anorexia nervosa?

BMI < 18.5

Hair loss

Bradycardia, hypotension

Anaemia

15

Which endocrine gland functions abnormally in anorexia nervosa?

Hypothalamus

16

Which hormonal changes are seen in anorexia nervosa?

Low GnRH...

FSH, LH...

... and oestradiol release

17

Which pituitary tumour can cause anovulation?

Prolactinoma

producing hyperprolactinaemia

18

Which syndrome causes infarction of the anterior pituitary gland post-partum?

Sheehan syndrome

19

What is the commonest endocrine disorder in woman and causes anovulation?

Polycystic ovary syndrome (PCOS)

20

What are the clinical features of polycystic ovary syndrome?

Oligo- or amenorrhoea

Hyperandrogenism symptoms - acne, hirsutism, obesity

21

What hormone changes are seen in polycystic ovary syndrome?

High free testosterone

High LH

(Remember that PCOS causes insulin resistance > hyperinsulinaemia. That causes the inhibition of sex hormone-binding globulin, which usually mops up testosterone, and increases the levels of LH for some reason.)

22

What three factors are diagnostic of PCOS?

2 of Rotterdam criteria:

1. Oligo- or amenorrhoea

2. Ultrasound evidence of polycystic ovaries

3. Symptoms of hyperandrogenism - acne, hirsutism, obesity

23

What genetic syndrome causes premature ovarian failure and therefore infertility?

Turner's syndrome

24

What is the karyotype of Turner's syndrome?

45 XO

25

What are the clinical features of premature ovarian failure?

Amenorrhoea

Menopausal symptoms - hot flushes, night sweats, atrophic vaginitis (most commonly manifesting as dryness)

26

In premature ovarian failure, negative feedback of the HPO axis kicks in - what hormonal changes are seen?

High GnRH

High FSH and LH

in an attempt to compensate for ovarian failure

but low oestradiol

because the ovaries can't produce any

27

Which other endocrine diseases cause menstrual symptoms and can lead to infertility?

Hyper and hypothyroidism

28

Tumours producing ___ can cause virilisation and infertility.

testosterone

29

Which drugs are designed to cause infertility?

Contraceptives

30

In females, problems with the ___ tubes themselves can cause infertility.

Fallopian tubes