Term
Female Infertility Casue? Treatments? |
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Definition
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Term
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Definition
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Term
| Gonadotropins as Second Line Therapy for Infertility |
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Definition
• FSH: follicle-stimulating hormone – recombinant or ultra-purified forms – injected sq daily for 7-10 days – follicular development monitored by ultrasound – also used to mature multiple follicles to harvest many eggs for In Vitro Fertilization (Assisted Reproductive Technology) • LH: luteinizing hormone -adminster after the last day of FSH dose, to micmic the LH surge • hcg: human chorionic gonadotropin – recombinant or purified forms – produced by placenta, diagnostic for pregnancy – given one day after last dose of FSH – activates LH receptor, thus mimicking LH surge |
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Term
Menotropins as Second Line Therapy for Infertility |
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Definition
• menotropins – purified from urine of postmenopausal women – ~ equal content of LH and FSH *can be used instead of gonadotropins bc it contains FSH and LH |
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Term
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Definition
synthetic GnRH –To test activity of pituitary gland -will inject GnRH and it should stimulate Pituitary to release FSH and LH -so then measure amount of FSH and LH produced. |
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Term
| Adverse Effects of Gonadotropins |
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Definition
· 25% of the patients treatment with gondaotropins result in multiple births. · Anything that over stimulate the ovaries can lead to ovarian cysts. · A very important adverse effect that occur in the gonadotropin but not much in Clomiphene is called ovarian hyper-stimulation syndrome. o It is very serious and occurs in 6% of the patients. o So when the ovaries are stimulated by the gonadotropins, they secrete an uknown substance that increases the permeability of the blood vessels. o And then as a result fluid will accumulate in various cavities (the abdominal, the pericardium, the thorax) o So the patient starts to retent fluid in these cavities that leads to pain, distention and can lead to a thrombo-embolic event. o You can think of it will almost a congestive heart failure type of event especially if u have fluid around the heart. o So the patient has to be counseled to watch out for any fatigue, SOB, abdominal distention or other symptoms of heart failure. |
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Term
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Definition
GnRH Receptor Antagonists *its important that we don’t administer the LH until after the last day of the FSH dose. -GnRH Receptor Antag is used to prevent any early endogenous release of LH and release of FSH while giving exogenous administration |
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Definition
· Again the hypothalamus releases GnRH · and activates the GnRH receptors on the pituitary · and cause the release of FSH and LH. · But in the testes, when it is activated, it causes the release of Testosterone. o So the testes makes most of the testosterone and a little bit is produce by the adrenal gland in both males and females but the testes make the majority. |
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Definition
- converts testosterone to a more potent and efficacious agonist called “dihyrotestosteorne.”
- So dihydrotestosterone is more potent at the androgen receptor than is testosterone.
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Definition
o converts testosterone to estrogen. This is how males have circulating levels of estrogen. And estrogen in males is important for increasing bone and mineral density and can cause gynecomasty. And estrogen can also feedback and inhibit the production of testosterone. |
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Term
Male Infertility What cause it? How to treat? |
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Definition
Cause: due to insufficeint FSH and LH levels. -FSH stimulates production of proteins require for sperm growth -LH stimulates testosterone synthesis and sperm production
Treatment: -Clomiphene: increase FSH and LH levels -gonadotropins: spermatogensis and testes maturation |
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Term
| Clomiphene for Male Infertility |
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Definition
clomiphene increases male LH and FSH – used to evaluate male reproductive axis and treat infertility |
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Term
| Gonadotropins for Treating Male infertility |
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Definition
– induce testes maturation, testosterone production and spermatogenesis – 6 - 24 months for full effect – adverse effect: gynecomastia (via conversion of testosterone to estrogens) |
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