Infertility
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Questions and Answers

What percentage of reproductive couples are affected by infertility?

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

    • What is the primary cause of male infertility?

  • Abnormal spermatogenesis (correct)
  • Varicocele
  • Radiation/Chemotherapy
  • Environmental factors

    • 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?

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

    What is the definition of secondary infertility?

    <p>Infertility that occurs after previous pregnancy regardless of outcome</p> Signup and view all the answers

    What is the percentage of azoospermia caused by Klinefelter's syndrome?

    <p>1 in 500</p> Signup and view all the answers

    What is the normal range for sperm concentration?

    <p>20 million/ml or more</p> Signup and view all the answers

    What is the purpose of hysterosalpingogram in infertility evaluation?

    <p>To evaluate fallopian tube patency</p> Signup and view all the answers

    What is the primary cause of retrograde ejaculation?

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

    What is the percentage of infertility cases caused by unexplained factors?

    <p>10-20%</p> Signup and view all the answers

    What is the primary function of the corpus luteum?

    <p>Secretion of progesterone</p> Signup and view all the answers

    What is the reason for performing semen analysis?

    <p>To evaluate sperm quality and quantity</p> Signup and view all the answers

    What is the typical duration of a menstrual cycle?

    <p>28 days</p> Signup and view all the answers

    What is the primary indicator of ovulation?

    <p>Serum progesterone level</p> Signup and view all the answers

    What is the primary function of LH in the menstrual cycle?

    <p>Regulation of ovulation</p> Signup and view all the answers

    What is the primary symptom of anovulation?

    <p>Absence of PMS symptoms</p> Signup and view all the answers

    What is the primary test for seminiferous tubule failure?

    <p>FSH level</p> Signup and view all the answers

    What is the primary cause of Leydig cell failure?

    <p>Low testosterone level</p> Signup and view all the answers

    What is the primary indicator of pregnancy?

    <p>Basal body temperature elevation for more than 16 days</p> Signup and view all the answers

    What is the primary test for hypothalamus/pituitary disorder?

    <p>Thyroid-stimulating hormone level</p> Signup and view all the answers

    What is the primary diagnosis of women undergoing ART in 1998?

    <p>Tubal factor and male factor</p> Signup and view all the answers

    What is the estimated live birth rate per cycle for healthy couples?

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

    What is the name of the surgical procedure to repair adhesions?

    <p>Lysis of adhesions</p> Signup and view all the answers

    What is the common emotional burden on infertile couples?

    <p>Mental anguish</p> Signup and view all the answers

    When should infertility be evaluated?

    <p>After one year of unprotected intercourse</p> Signup and view all the answers

    What is the goal of Assisted Reproductive Technology (ART)?

    <p>To help provide infertile couples with tools to bypass normal mechanisms of gamete transportation</p> Signup and view all the answers

    What is the method of administration for Pergonal?

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

    What is a potential adverse effect of Pergonal therapy?

    <p>Hyperstimulation of the ovaries</p> Signup and view all the answers

    What is the purpose of administering ovulation inducing agents?

    <p>To restore ovulation</p> Signup and view all the answers

    What is the maximum dose of clomiphene citrate that is usually administered?

    <p>150mg</p> Signup and view all the answers

    What is the risk of multiple births with clomiphene citrate?

    <p>7% risk of twins, 0.3% triplets</p> Signup and view all the answers

    What is the success rate of clomiphene citrate in inducing ovulation?

    <p>50% success rate</p> Signup and view all the answers

    What is the diagnostic accuracy of a hysterosalpingogram?

    <p>70%</p> Signup and view all the answers

    What is the primary mechanism of action of clomiphene citrate?

    <p>It blocks estrogen receptors at the hypothalamus and pituitary</p> Signup and view all the answers

    What is the percentage of infertile couples who will have a completely normal workup?

    <p>10%</p> Signup and view all the answers

    What is the spontaneous abortion rate with clomiphene citrate?

    <p>15%</p> Signup and view all the answers

    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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    Description

    This quiz covers the basics of infertility, including its definition, causes, and differences between male and female infertility. It also explores the pathophysiology and clinical symptoms of infertility, as well as laboratory investigations and the necessary factors for successful fertilization.

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