What is the definition of infertility?
Failure to become pregnant despite 12+ months of unprotected sexual intercourse (without a known reason)
b) secondary infertility?
a) Primary - couple has never conceived
b) Secondary - couple has conceived before (but stillborn or ectopic)
The incidence of infertility is (increasing / decreasing).
What percentage of couples experience infertility?
A BMI over ___ increases your likelihood of infertility.
As a woman, the older you are, the (more / less) fertile you are.
After puberty, older = less fertile
Under female causes of infertility, what are the two broad categories of disease?
Where in the Fallopian tubes does fertilisation occur?
Where do fertilised eggs implant?
Which STI causes infertility?
When in the luteal phase are progesterone levels usually checked?
i.e a week after ovulation / a week before menstruation
as this is when progesterone levels should peak
A progesterone level of more than ___ nmol/L suggests that ovulation has occurred.
Which hormones should be checked in a woman who has oligo- or amenorrhoea?
FSH and LH
TSH (for thyroid problems)
Which virus causes either miscarriage or severe congenital disease in babies whose mothers are infected?
What disease does the Rubella virus cause in unborn babies?
Congenital rubella syndrome
What are the characteristic signs of congenital Rubella syndrome?
Microcephaly (smaller head circumference than normal)
Patent ductus arteriosus
How is congenital Rubella syndrome prevented?
measles, mumps, rubella
What is a bacterium which commonly causes pelvic inflammatory disease, leading to female infertility?
Chlamydia trachomatis is a Gram (positive / negative) coccobacillus.
What are two reproductive consequences of Chlamydia infection?
Which antibiotics are used to treat Chlamydia infection?
What is a possible acute consequence of pelvic inflammatory disease?
What type of menstrual cycle indicates that ovulation is occurring normally?
What types of menstrual cycle indicate that ovulation isn't occurring?
Prolonged cycles (oligomenorrhoea, >35 days)
No period (amenorrhoea)
Ovulation, indicated by regular cycles, is confirmed by which test?
Midluteal progesterone test
Anovulation, indicated by irregular/no cycles, is confirmed by which tests?
(GnRH, gonadotrophins, oestradiol, testosterone, PRL, TSH)
Why is TSH tested in women with anovulation?
Hyper/hypothyroidism both cause ovulatory disorders
What are the three broad causes of ovulatory disorders?
I: hypothalamic - stress, anorexia, exercise, Kallmann syndrome
II: pituitary - PCOS, hyperprolactinaemia
III: ovarian failure - menopause, premature
What is the first line treatment for PCOS?
How does clomifene citrate work?
Selective oestrogen receptor modulator
Blocks oestrogen receptors in the ovaries, leading to perceived low oestrogen levels, leading to increased secretion of GnRH > FSH & LH by negative feedback, causing more follicles to develop
... increasing your chances of pregnancy