Infertility Overview and Causes
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Questions and Answers

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?

  • 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?

  • Semen Analysis
  • Laparoscopy
  • Hysterosalpingography (correct)
  • Transvaginal Ultrasound
  • Which condition is NOT typically evaluated during the male genital examination?

    <p>Uterine hypoplasia (B)</p> Signup and view all the answers

    What is an example of assisted reproductive technology (ART)?

    <p>In vitro fertilization (IVF) (A)</p> Signup and view all the answers

    What is the primary difference between primary infertility and secondary infertility?

    <p>Primary infertility involves couples who have never been able to conceive. (C)</p> Signup and view all the answers

    Which of the following conditions is NOT classified under male factors contributing to infertility?

    <p>Endometriosis (A)</p> Signup and view all the answers

    Which of the following best explains unexplained infertility?

    <p>Infertility where no specific cause can be determined. (C)</p> Signup and view all the answers

    What percentage of infertility cases are classified as caused by both male and female factors?

    <p>25% (A)</p> Signup and view all the answers

    Which condition is specifically associated with compromised sperm number or quality?

    <p>Hypogonadism (D)</p> Signup and view all the answers

    What type of disorder is endometrial polyps categorized as?

    <p>Uterine disorders (C)</p> Signup and view all the answers

    Which of the following is a reversible male infertility condition?

    <p>Ejaculatory dysfunction (D)</p> Signup and view all the answers

    Which of the following histories would NOT typically be considered during infertility evaluations?

    <p>Gender preference (D)</p> Signup and view all the answers

    Flashcards

    Infertility

    The inability to conceive after one year of regular, unprotected intercourse.

    Primary Infertility

    A type of infertility where a couple has never conceived.

    Secondary Infertility

    A type of infertility where a couple has conceived before but cannot get pregnant again.

    Oligospermia

    Reduced sperm count.

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    Azoospermia

    Absence of sperm.

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    Teratospermia

    Abnormally shaped sperm.

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    Hypogonadism

    A condition where the testes do not produce enough testosterone.

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    Obstructive Azoospermia

    A condition where the tubes that carry sperm are blocked.

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    Semen Analysis

    The process of analyzing semen to evaluate its volume, sperm count, motility, and morphology.

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    Hysterosalpingography (HSG)

    A test using X-rays to visualize the fallopian tubes and uterus.

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    Antimullerian Hormone (AMH)

    A hormone that indicates ovarian reserve and is measured to assess female fertility.

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    General and Gynecological Examination (Female)

    A visual evaluation and pelvic examination of women to identify any abnormalities or conditions that might affect fertility.

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    General and Gynecological Examination (Male)

    A visual evaluation and penile exam for men to identify any abnormalities or conditions that might affect fertility.

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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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    Description

    This quiz explores the definition of infertility, including its types, causes, and factors affecting conception. Learn about primary and secondary infertility, along with detailed causes related to male and female factors. Test your knowledge on the complex factors that can impact fertility.

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