Exam 3 Infertility

Question 1

Fecundability is?

Answer 1

Probability of achieving preg in once cycle

Question 2

Fecundity is?

Answer 2

Probability of achieving live birth in one cycle

Question 3

Infertility is?

Answer 3

No conception for 12 mo

Question 4

Causes of infertility: Female?

Answer 4

Ovulation dysf

Pelvic or cervical anatomy/occlusions

Question 5

Causes of infertility: Male?

Answer 5

Anatomy

Sperm dysf

Question 6

Fertility exam: F? (7)

Answer 6

Weight
Hirsutism
Galactorrhea
Cervical scarring
Uterine size/shape
Adnexal position, mobility, masses
Uterosacral ligament nodes, tender (endometriosis)

Question 7

Egg eval? (4)

Answer 7

Ovulation
Chromosomes
Basal body temp
LH surge

Question 8

Sperm eval? (5)

Answer 8

Prdxn
Chromosomes
Vas transport
Cervix delivery
Semen

Question 9

Fertilization eval? (4)

Answer 9

Tubal patency
Timing
Toxins
Hysterosalpingogram

Question 10

Early diagnostic cycle looks at? (3)

Answer 10

Basal body temp for entire cycle
Serum LH/FSH, E2, prolactin, TSH (days 1-3)
Sperm count, motility, morph, vol, WBC (days 1-8)

Question 11

Mid diag cycle looks at? (3)

Answer 11

Hysterosalpingogram (HSG) (d 6-10)
Urine ovulation (d 8-12)
Post coital test (day post urine LH surge)

Question 12

Late diag cycle looks at?

Answer 12

Mid-luteal serum progest (1 wks pre menses): >3 = recent ovulation
Endo bx (11 d post LH surge)

Question 13

Other tests? (2)

Answer 13

Endocrine w/u for polycyst

Hysteroscopy if abn HSG

Question 14

Female tx: ↓ ovulation?

BMI?

Cervical?

Answer 14

Clomid

↓ w/i 95% of IBW

Inseminate w/ washed sperm

Question 15

Male tx: Hyperprolactinemia?

Hypothalamic?

Answer 15

DA agonist

GnRH, hCG, FSH