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Questions and Answers
What percentage of reproductive couples are affected by infertility?
What percentage of reproductive couples are affected by infertility?
- 15% (correct)
- 5%
- 10%
- 20%
What is the primary cause of male infertility?
What is the primary cause of male infertility?
- Abnormal spermatogenesis (correct)
- Varicocele
- Radiation/Chemotherapy
- Environmental factors
What is the ideal temperature for sperm production?
What is the ideal temperature for sperm production?
- 17ºC less than body temperature (correct)
- 37ºC
- 25ºC
- 22ºC
What is the percentage of women who have their first child after age 30?
What is the percentage of women who have their first child after age 30?
What is the definition of secondary infertility?
What is the definition of secondary infertility?
What is the percentage of azoospermia caused by Klinefelter's syndrome?
What is the percentage of azoospermia caused by Klinefelter's syndrome?
What is the normal range for sperm concentration?
What is the normal range for sperm concentration?
What is the purpose of hysterosalpingogram in infertility evaluation?
What is the purpose of hysterosalpingogram in infertility evaluation?
What is the primary cause of retrograde ejaculation?
What is the primary cause of retrograde ejaculation?
What is the percentage of infertility cases caused by unexplained factors?
What is the percentage of infertility cases caused by unexplained factors?
What is the primary function of the corpus luteum?
What is the primary function of the corpus luteum?
What is the reason for performing semen analysis?
What is the reason for performing semen analysis?
What is the typical duration of a menstrual cycle?
What is the typical duration of a menstrual cycle?
What is the primary indicator of ovulation?
What is the primary indicator of ovulation?
What is the primary function of LH in the menstrual cycle?
What is the primary function of LH in the menstrual cycle?
What is the primary symptom of anovulation?
What is the primary symptom of anovulation?
What is the primary test for seminiferous tubule failure?
What is the primary test for seminiferous tubule failure?
What is the primary cause of Leydig cell failure?
What is the primary cause of Leydig cell failure?
What is the primary indicator of pregnancy?
What is the primary indicator of pregnancy?
What is the primary test for hypothalamus/pituitary disorder?
What is the primary test for hypothalamus/pituitary disorder?
What is the primary diagnosis of women undergoing ART in 1998?
What is the primary diagnosis of women undergoing ART in 1998?
What is the estimated live birth rate per cycle for healthy couples?
What is the estimated live birth rate per cycle for healthy couples?
What is the name of the surgical procedure to repair adhesions?
What is the name of the surgical procedure to repair adhesions?
What is the common emotional burden on infertile couples?
What is the common emotional burden on infertile couples?
When should infertility be evaluated?
When should infertility be evaluated?
What is the goal of Assisted Reproductive Technology (ART)?
What is the goal of Assisted Reproductive Technology (ART)?
What is the method of administration for Pergonal?
What is the method of administration for Pergonal?
What is a potential adverse effect of Pergonal therapy?
What is a potential adverse effect of Pergonal therapy?
What is the purpose of administering ovulation inducing agents?
What is the purpose of administering ovulation inducing agents?
What is the maximum dose of clomiphene citrate that is usually administered?
What is the maximum dose of clomiphene citrate that is usually administered?
What is the risk of multiple births with clomiphene citrate?
What is the risk of multiple births with clomiphene citrate?
What is the success rate of clomiphene citrate in inducing ovulation?
What is the success rate of clomiphene citrate in inducing ovulation?
What is the diagnostic accuracy of a hysterosalpingogram?
What is the diagnostic accuracy of a hysterosalpingogram?
What is the primary mechanism of action of clomiphene citrate?
What is the primary mechanism of action of clomiphene citrate?
What is the percentage of infertile couples who will have a completely normal workup?
What is the percentage of infertile couples who will have a completely normal workup?
What is the spontaneous abortion rate with clomiphene citrate?
What is the spontaneous abortion rate with clomiphene citrate?
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Study Notes
Infertility
- Defined as the inability to conceive following unprotected sexual intercourse for one year (for women under 35) or six months (for women over 35)
- Affects 15% of reproductive couples, with men and women equally affected
- 6.1 million couples are affected in the United States
Reproductive Age for Women
- 15-44 years of age
- Fertility is approximately halved between 37th and 45th year due to alterations in ovulation
- 20% of women have their first child after age 30
- 1/3 of couples over 35 have fertility problems due to decreased ovulation, poor egg health, and increased health problems
Types of Infertility
- Primary infertility: a couple that has never conceived after one year
- Secondary infertility: infertility that occurs after previous pregnancy, regardless of outcome
Causes of Infertility
- Male factors (40%): abnormal spermatogenesis, varicocele, idiopathic, obstruction, genetic abnormalities
- Female factors (30%): anovulation, anatomic defects of the female genital tract
- Unexplained infertility (10-20%)
Male Fertility
- Semen analysis: examines sperm quantity, quality, and motility
- Normal semen analysis: volume ≥ 2.0 ml, sperm concentration ≥ 20 million/ml, motility ≥ 50%, morphology ≥ 30% normal forms
- Abnormal semen analysis: azoospermia, oligospermia, abnormal volume, retrograde ejaculation
Female Fertility
- Ovulation detection: basal body temperature, serum progesterone, endometrial biopsy
- Normal ovulation: biphasic shift in basal body temperature, serum progesterone ≥ 10 ng/ml, endometrial biopsy confirms ovulation
Diagnostic Tests
- Semen analysis
- Ovulation detection
- Hysterosalpingogram (HSG): evaluates the internal female genital tract
- Endometrial biopsy: confirms ovulation and evaluates endometrial lining
Treatment Options
- Ovulation induction: clomiphene citrate, gonadotropins
- Intrauterine insemination (IUI)
- In vitro fertilization (IVF)
- Surgical treatments: lysis of adhesions, septoplasty, tuboplasty, myomectomy
Emotional Burden of Infertility
- Infertility can lead to emotional distress and relationship strain
- It is essential to address the emotional needs of infertile couples
- Infertility should be evaluated after one year of unprotected intercourse
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