Podcast
Questions and Answers
Which hormone is NOT typically assessed for confirming ovulation in females?
Which hormone is NOT typically assessed for confirming ovulation in females?
- LH
- FSH
- Progesterone
- Testosterone (correct)
What is the minimum sperm concentration considered normal in a semen analysis?
What is the minimum sperm concentration considered normal in a semen analysis?
- 10 million/ml
- 20 million/ml
- 15 million/ml (correct)
- 25 million/ml
Which procedure is specifically used to evaluate the patency of the fallopian tubes?
Which procedure is specifically used to evaluate the patency of the fallopian tubes?
- Semen Analysis
- Laparoscopy
- Hysterosalpingography (correct)
- Transvaginal Ultrasound
Which condition is NOT typically evaluated during the male genital examination?
Which condition is NOT typically evaluated during the male genital examination?
What is an example of assisted reproductive technology (ART)?
What is an example of assisted reproductive technology (ART)?
What is the primary difference between primary infertility and secondary infertility?
What is the primary difference between primary infertility and secondary infertility?
Which of the following conditions is NOT classified under male factors contributing to infertility?
Which of the following conditions is NOT classified under male factors contributing to infertility?
Which of the following best explains unexplained infertility?
Which of the following best explains unexplained infertility?
What percentage of infertility cases are classified as caused by both male and female factors?
What percentage of infertility cases are classified as caused by both male and female factors?
Which condition is specifically associated with compromised sperm number or quality?
Which condition is specifically associated with compromised sperm number or quality?
What type of disorder is endometrial polyps categorized as?
What type of disorder is endometrial polyps categorized as?
Which of the following is a reversible male infertility condition?
Which of the following is a reversible male infertility condition?
Which of the following histories would NOT typically be considered during infertility evaluations?
Which of the following histories would NOT typically be considered during infertility evaluations?
Flashcards
Infertility
Infertility
The inability to conceive after one year of regular, unprotected intercourse.
Primary Infertility
Primary Infertility
A type of infertility where a couple has never conceived.
Secondary Infertility
Secondary Infertility
A type of infertility where a couple has conceived before but cannot get pregnant again.
Oligospermia
Oligospermia
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Azoospermia
Azoospermia
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Teratospermia
Teratospermia
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Hypogonadism
Hypogonadism
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Obstructive Azoospermia
Obstructive Azoospermia
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Semen Analysis
Semen Analysis
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Hysterosalpingography (HSG)
Hysterosalpingography (HSG)
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Antimullerian Hormone (AMH)
Antimullerian Hormone (AMH)
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General and Gynecological Examination (Female)
General and Gynecological Examination (Female)
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General and Gynecological Examination (Male)
General and Gynecological Examination (Male)
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Study Notes
Infertility Definition
- Infertility is defined as the failure to conceive within one or more years of regular unprotected intercourse.
Types of Infertility
- Primary infertility: Couples who have never been able to conceive.
- Secondary infertility: Difficulty conceiving after already having conceived.
Causes of Infertility
- Male factor: 25% of cases
- Female factor: 30% of cases
- Both factors: 5% of cases
- Unexplained infertility: 30% of cases
Female Subfertility Causes
- Ovulatory disorders:
- Polycystic ovary syndrome (PCOS)
- Hypothalamic disorders
- Pituitary disease
- Tubal damage:
- Pelvic inflammatory disease (PID)
- Endometriosis
- Abdominal surgery
- Uterine disorders:
- Fibroids
- Endometrial polyps
- Endometrial scarring (Asherman's syndrome)
Possible Causes of Infertility
- Blockage of uterine tube
- Uterine septum
- Adhesions
- Polycystic ovaries
- Polyps
- Endometriosis or endometrioma
- Fibroids
- Infection
Causes of Male Infertility
- Compromised sperm quality or number:
- Oligospermia (reduced sperm count)
- Azoospermia (no sperm)
- Teratospermia (abnormal sperm shape)
- Reversible conditions:
- Varicocele
- Obstructive azoospermia
- Non-reversible conditions:
- Ejaculatory dysfunction
- Inoperative obstructive azoospermia
- Non-reversible, no viable sperm:
- Hypogonadism
- Genetic abnormalities
- Testicular or pituitary cancer
History
- General history:
- Occupation and background
- Tobacco, alcohol, and drug use
- History of abdominal surgery and prior diseases/infections
- Sexual history:
- Sexual dysfunction (vaginismus, dyspareunia, erectile dysfunction)
- Sexually transmitted infections
Obstetric and Gynecological History
- Reproductive history
- Gynecological history
- Age at menarche
- Menstrual periods (duration and intervals)
- Previous contraceptive use
- Previous testing and treatment for infertility
General and Gynecological Examination
- Women: Visual evaluation and pelvic exam to rule out:
- Endocrinopathy
- Congenital anomalies
- Uterine hypoplasia
- Cervical lesions
- Dyspareunia
- Men: Visual evaluation and penile exam to rule out:
- Hypogonadism
- Tumors (epididymal cysts)
- Cryptorchidism
- Hydrocele
- Varicocele
Investigation - Male Partner: Semen Analysis
- Semen volume (1.5 to 5.0 cc)
- Number of sperm (˃ 15 million/ml)
- Sperm motility (˃ 32%)
- Sperm morphology (˃ 4% normal forms)
Investigation - Female
- Confirm ovulation:
- FSH, LH (cycle day 2 or 3)
- AMH (anti-Müllerian hormone) (ovarian reserve)
- Luteal phase progesterone (day 21)
- Transvaginal ultrasound (TVUSS) (antral follicle count [AFC])
- Tubal assessment:
- Hysterosalpingography (HSG) (using X-ray)
- Hysterocontrast sonography (HyCoSy) (using ultrasound)
- Laparoscopy and hysteroscopy
Treatment - Female
- Fertility restoration drugs
- Fertility restoration surgeries
- Assisted reproductive technologies (ART)
Management (Medical)
- Ovulation induction
- Intrauterine insemination (IUI)
- In-vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI)
- Cases: PCOS ovulatory problems, unexplained infertility, mild male factor, cervical mucus issues, unexplained infertility, male factor, tubal pathology, unexplained infertility
Management (Surgical)
- Minimal access surgery (MAS):
- Laparoscopic ablation of endometriosis
- Adhesion removal
- Ovarian drilling for PCOS
- Laparotomy approach for myomectomy
Assisted Reproductive Technologies (ART)
- Removing eggs from the woman's body and mixing them with sperm in the laboratory.
Common ART methods
- Intrauterine insemination
- In-vitro fertilization
- Zygote intrafallopian transfer (ZIFT)
- Gamete intrafallopian transfer (GIFT)
- Intracytoplasmic sperm injection (ICSI)
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