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DU PA Infertility
Duke PA Infertility
| Question | Answer |
|---|---|
| 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
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