30 Questions
Mittelschmerz pain is a symptom of premenstrual syndrome
False
Hysteroscopy can diagnose intrauterine adhesions
True
Serum FSH levels are not relevant to infertility investigations
False
Laparoscopy is used to diagnose hydro-salpinx
True
ICSI is a treatment option for unexplained infertility
True
Hystero-salpingography is used to diagnose tubal blockage
True
Artificial insemination by husband is a treatment option for male factor infertility
True
Ovulation spotting is a symptom of premenstrual syndrome
False
A semen analysis parameter is a volume of ≥ 1 ml.
False
Hysteroscopy can diagnose intrauterine septum
True
Induction of ovulation is a treatment option for unexplained infertility
True
Uterine anomalies are a cause of male infertility.
False
A hormonal profile is used to assess ovulation.
True
A semen analysis parameter is a total sperm count of ≥ 10 million per ejaculate.
False
Pelvic infection is a cause of male infertility.
False
Anti-sperm antibodies are a cause of female infertility.
False
A semen analysis parameter is a motility of ≥ 20% total motility.
False
Ultrasound assessment of ovulation is used to assess ovulation.
True
Regular menstrual cycles are a sign of abnormal ovulation.
False
Asherman’s syndrome is a cause of male infertility.
False
A couple who has previously conceived is considered to have primary infertility.
False
The general incidence of infertile couples is around 5-10%.
False
The chances of conceiving in any given menstrual cycle is more than 50%.
False
Impotence is a coital difficulty that may contribute to infertility.
True
Vaginal wash before intercourse can interfere with sperm motion.
False
Infertility is defined as the inability to conceive after six months of regular marital life and unprotected intercourse.
False
Dyspareunia is a type of infertile couple.
False
Half of the couples who do not conceive in the first year will conceive in the third year.
False
Too frequent intercourse produces immature eggs.
False
Lubricants can enhance sperm motion.
False
Study Notes
Infertility
- Inability to conceive after one year of regular, unprotected marital life and intercourse.
Background
- General incidence of infertile couples is 10-15%.
- Half of those who do not conceive in the first year will do so in the second year (cumulative pregnancy rate over 90%).
- Chances of conceiving in any given menstrual cycle are less than 20%.
Types of Infertility
- Primary: a couple who has never conceived.
- Secondary: a couple who has previously conceived, regardless of the pregnancy outcome.
Causes of Infertility
Sexual Problems
- Too frequent intercourse produces immature sperms.
- Infrequent intercourse carries the possibility of coitus away from the fertile time.
- Coital difficulties: impotence, vaginismus, dyspareunia.
- Vaginal wash after intercourse.
- Use of lubricants interferes with sperm motion.
Male Factor Infertility
- Impaired spermatogenesis.
- Anti-sperm antibodies.
- Obstruction of seminal tract.
- Defective delivery of sperm.
Female Factor Infertility
- Ovulatory:
- Polycystic ovary syndrome (PCOS).
- Luteal phase defect.
- Premature ovarian failure.
- Resistant ovary syndrome.
- Uterine:
- Congenital anomalies.
- Anatomical abnormalities.
- Cervical:
- Chronic cervicitis.
- Antisperm antibodies.
Investigations
- Semen analysis:
- Normal parameters: volume ≥ 1.5 ml, pH ≥ 7.2, sperm count ≥ 15 million/ml, etc.
- Assessment of ovulation:
- History.
- Hormonal profile.
- Ultrasound assessment of ovulation (folliculometry).
- Tubal factor assessment:
- Hystero-salpingography (HSG).
- Laparoscopic assessment.
- Uterine factor assessment:
- Hystero-salpingography (HSG).
- Hysteroscopy.
Basic Workup for Infertility
- Detailed history and physical examination.
- Evidence of ovulation.
- Semen analysis.
- Hormonal profile:
- Serum FSH.
- Serum LH.
- Serum prolactin.
- Thyroid function tests.
- Trans-vaginal ultrasound and folliculometry.
- Hystero-salpingography (HSG).
Treatment
- Sexual problems: advise and correct.
- Artificial insemination by husband (AIH).
- Male factor:
- Mild to moderate: medical treatment then AIH.
- Severe: intracytoplasmic sperm injection (ICSI).
- Ovulatory factor:
- Induction of ovulation.
- IVF / ICSI.
- Tubal factor:
- IVF / ICSI.
- Unexplained infertility:
- Induction of ovulation ± AIH.
- IVF / ICSI.
Learn about infertility, its definition, background, and types. Discover the general incidence of infertile couples and the chances of conceiving in a given menstrual cycle.
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