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DU PA Infertility

Duke PA Infertility

Infertility is defined as the failure to achieve a successful pregnancy after __ or more of regular unprotected intercourse 12 months
When do you evaluate earlier for infertility Age >35, irregular period suggesting anovulation, history of endometriosis or tubal disease, known male factor
What is evaluated to determine cause of infertility Eggs (ovulation, ovarian reserve), tubes (HSG, laparoscopy), sperm (semen analysis, urology evaluation)
When is the placenta formed 7-10 weeks
Progesterone coming from the corpus luteum accomplishes what Keeps the endometrium in a receptive state (keeps it ready for implantation)
Problems with ovulation account for __% of female infertility factors 40
WHO I classification of anovulation No Estrogen, low/normal FSH, normal prolactin, no hypo-pituitary lesion (hypothalamic amenorrhea)
WHO II classification of anovulation Estrogen, normal FSH, normal prolactin (PCOS)
WHO III classification of anovulation Low estrogen, high FSH, normal prolactin (ovarian insufficiency)
High prolactin will shut down __ axis Ovarian
If FSH is high it is __ failure Ovarian
What is the most common reason a woman might not be ovulating PCOS
Two out of three findings are needed for the diagnosis of PCOS. What are the three findings Oligo- and or anovulation, hyperandrogenism, US with polycystic ovaries
How do oral medications such as Clomid and tamoxifen stimulate ovulation They trick the brain into thinking there is no estrogen in the body so it stimulates the ovaries into producing more
What egg changes happen as a woman ages Quantity, quality, recruitment
About how many follicles are present at birth 1 million
About how many follicles are present at menarche 400,000
About how many follicles are actually taken all the way to ovulation 400
About how many follicles remain at menopause 1000
As egg number decreases, there is less feedback from the ovaries, which causes a rise in __ FSH
As FSH levels increase, likelihood of pregnancy __ Decreases
What is an HSG Hysterosalpingogram (tests for tubal patency)
Why would you do a laparoscopy for an infertile woman Abnormalities on HSG, pelvic pain, high suspicion for endometriosis
What affect do most vaginal lubricants have on sperm motility Decreased
Where does spermatogenesis take place Seminiferous tubules
How many days prior to semen analysis does the man need to stay abstinent 2-5 days
How soon should the semen sample make it to the lab for analysis Within 1 hour
What does the WHO consider as a normal sperm count >20 x 10(6)/ml
What does the WHO consider as a normal semen volume >2ml
What is asthenospermia Low motility
What is teratospermia Low morphology
What is oligospermia Low count
What is azoospermia No sperm in ejaculate
Tubal/ peritoneal factors responsible for ____% of infertility problems 35%
Infertility & Endometriosis: Possible mechanisms Distorted pelvic anatomy; Altered peritoneal fn (peritoneal fluid tox to sperm, embryos); Altered hormonal & cell-mediated fn; Endocrine/ ovulatory abnormalities; impaired implantation
Testosterone is produced in: Leydig cells
Sertoli cells: ABP to concentrate T and DHT in seminiferous epithelium and epididymis
LH function stimulates testosterone synthesis/secretion
FSH function increases LH receptor numbers
Created by: bwyche