Obstetrics and Gynecology: Infertility
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Questions and Answers

What percentage of infertile couples will conceive in the second year?

  • Half of them (correct)
  • More than 50%
  • All of them
  • Less than 10%

    • What is the definition of infertility?

  • Inability to conceive after one year of regular marital life and unprotected intercourse (correct)
  • Inability to conceive after two years of regular marital life and unprotected intercourse
  • Inability to conceive after six months of unprotected intercourse
  • Inability to conceive after three years of regular marital life and unprotected intercourse

    • What is the general incidence of infertile couples?

  • 20 to 25%
  • 5 to 10%
  • 10 to 15% (correct)
  • 15 to 20%

    • What happens if a couple has too frequent intercourse?

    <p>It produces immature sperm</p> Signup and view all the answers

    What is the chance of conceiving in any given menstrual cycle?

    <p>Less than 20%</p> Signup and view all the answers

    What is a type of sexual problem that may contribute to infertility?

    <p>All of the above</p> Signup and view all the answers

    What is the definition of primary infertility?

    <p>A couple who has never conceived</p> Signup and view all the answers

    What is the definition of secondary infertility?

    <p>A couple who has previously conceived</p> Signup and view all the answers

    What can interfere with sperm motion?

    <p>Both A and B</p> Signup and view all the answers

    What is a consequence of infrequent intercourse?

    <p>It carries the possibility of coitus away from the fertile time</p> Signup and view all the answers

    What is the name of the pain experienced during ovulation?

    <p>Mittelschmerz pain</p> Signup and view all the answers

    What is the investigation of choice for assessing the uterine factor in infertility?

    <p>Hysteroscopy</p> Signup and view all the answers

    What is the treatment for severe male factor infertility?

    <p>ICSI</p> Signup and view all the answers

    What is the investigation of choice for assessing tubal patency?

    <p>Hysterosalpingography (HSG)</p> Signup and view all the answers

    What is the term for the adhesions that form in the uterus following a uterine infection or surgery?

    <p>Asherman's syndrome</p> Signup and view all the answers

    What is the term for the artificial introduction of sperm into the female reproductive tract?

    <p>Artificial insemination by husband (AIH)</p> Signup and view all the answers

    What is the term for the visualization of the fallopian tubes and uterus using X-ray?

    <p>Hysterosalpingography (HSG)</p> Signup and view all the answers

    What is the term for the process of fertilization outside the body?

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

    What is the investigation of choice for assessing ovulation?

    <p>Folliculometry</p> Signup and view all the answers

    What is the term for the abnormal connection between the uterus and the fallopian tube?

    <p>Hydrosalpinx</p> Signup and view all the answers

    What is the minimum percentage of progressive motility required for normal sperm motility?

    <p>32%</p> Signup and view all the answers

    Which of the following is NOT a cause of female infertility related to the ovulatory factor?

    <p>Anti-sperm antibodies</p> Signup and view all the answers

    What is the minimum volume of semen required for normal semen analysis?

    <p>1.5 ml</p> Signup and view all the answers

    What is the primary method used to assess ovulation in females?

    <p>Ultrasound assessment of ovulation (folliculometry)</p> Signup and view all the answers

    What is the minimum percentage of live spermatozoa required for normal semen analysis?

    <p>58%</p> Signup and view all the answers

    Which of the following is a cause of male infertility related to impaired spermatogenesis?

    <p>Impaired spermatogenesis</p> Signup and view all the answers

    What is the minimum percentage of normal sperms required for normal semen analysis?

    <p>4%</p> Signup and view all the answers

    What is the minimum total sperm count required for normal semen analysis?

    <p>39 million per ejaculate</p> Signup and view all the answers

    Which of the following is a cause of female infertility related to the uterine factor?

    <p>Asherman's syndrome</p> Signup and view all the answers

    What is the minimum pH required for normal semen analysis?

    <p>7.2</p> Signup and view all the answers

    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.

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    Infertility PDF

    Description

    Learn about infertility, its definition, incidence, and types. Understand the chances of conceiving in a given menstrual cycle and the cumulative pregnancy rate.

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