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Endocrine Week 5 2017/18 > 5: Management of infertility > Flashcards

Flashcards in 5: Management of infertility Deck (59)
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1

What is the definition of infertility?

Failure to become pregnant despite 12+ months of unprotected sexual intercourse (without a known reason)

2

What is

a) primary

b) secondary infertility?

a) Primary - couple has never conceived

b) Secondary - couple has conceived before (but stillborn or ectopic)

3

The incidence of infertility is (increasing / decreasing).

increasing

4

What percentage of couples experience infertility?

15%

5

A BMI over ___ increases your likelihood of infertility.

over 30

6

As a woman, the older you are, the (more / less) fertile you are.

After puberty, older = less fertile

7

Under female causes of infertility, what are the two broad categories of disease?

Tubal disorders

Ovulatory disorders

8

Where in the Fallopian tubes does fertilisation occur?

Ampulla

9

Where do fertilised eggs implant?

Uterine wall

10

Which STI causes infertility?

Chlamydia

11

When in the luteal phase are progesterone levels usually checked?

Mid-phase

i.e a week after ovulation / a week before menstruation

as this is when progesterone levels should peak

12

A progesterone level of more than ___ nmol/L suggests that ovulation has occurred.

30 nmol/L

13

Which hormones should be checked in a woman who has oligo- or amenorrhoea?

GnRH

FSH and LH

Oestradiol, testosterone

Prolactin

TSH (for thyroid problems)

14

Which virus causes either miscarriage or severe congenital disease in babies whose mothers are infected?

Rubella virus

15

What disease does the Rubella virus cause in unborn babies?

Congenital rubella syndrome

16

What are the characteristic signs of congenital Rubella syndrome?

Rash

Microcephaly (smaller head circumference than normal)

Patent ductus arteriosus

Cataracts

17

How is congenital Rubella syndrome prevented?

MMR vaccine

measles, mumps, rubella

18

What is a bacterium which commonly causes pelvic inflammatory disease, leading to female infertility?

Chlamydia trachomatis

19

Chlamydia trachomatis is a Gram (positive / negative) coccobacillus.

Gram negative

20

What are two reproductive consequences of Chlamydia infection?

Infertility

Ectopic pregnancy

21

Which antibiotics are used to treat Chlamydia infection?

Azithromycin

OR

Doxycycline

22

What is a possible acute consequence of pelvic inflammatory disease?

Peritonitis

23

What type of menstrual cycle indicates that ovulation is occurring normally?

Regular cycles

24

What types of menstrual cycle indicate that ovulation isn't occurring?

Prolonged cycles (oligomenorrhoea, >35 days)

No period (amenorrhoea)

25

Ovulation, indicated by regular cycles, is confirmed by which test?

Midluteal progesterone test

26

Anovulation, indicated by irregular/no cycles, is confirmed by which tests?

Hormone tests

(GnRH, gonadotrophins, oestradiol, testosterone, PRL, TSH)

27

Why is TSH tested in women with anovulation?

Hyper/hypothyroidism both cause ovulatory disorders

28

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

29

What is the first line treatment for PCOS?

Clomifene citrate

30

How does clomifene citrate work?

SERM

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