Term
|
Definition
| No conception after 1 year of frequent, unprotected intercourse |
|
|
Term
| What percentages are associated with a male factor? Female? Both? |
|
Definition
| 40 % male, 40% female, 20% male and female |
|
|
Term
| Which three hormones act in a negative feedback fashion on the Hypothal-Pit-Gonadal axis, and where does each act? |
|
Definition
1. Progesterone - acts on both hypothalamus and pituitary
2. Estrogen - acts at pituitary
3. Inhibin - acts at pituitary |
|
|
Term
| Name 3 structural causes of male infertility? |
|
Definition
1. Bilateral absence of vas deferens
2. Varicose veins in the spermatic cord
3. Undescended testes |
|
|
Term
| Which structural cause is cystic fibrosis associated with? |
|
Definition
| Absence of the vas deferens |
|
|
Term
| Name 2 environmental causes of male infertility |
|
Definition
1. Temperature
2. Chemical toxins |
|
|
Term
| What are the two causes of drug induced male infertility? |
|
Definition
1. Anabolic androgenic steroids
2. Finasteride (for alopecia treatment) |
|
|
Term
| What are signs of hypogonadotropic-hypogonadism caused by anabolic androgenic steroids? |
|
Definition
- Decreased testosterone
- Testicular atrophy
- Impaired spermatogenesis
- Lowered intratesticular testosterone levels |
|
|
Term
| What does finasteride do? |
|
Definition
| Inhibits the conversion of testosterone to dihydrotestosterone by 5alpha-reductase, which means there is more negative feedback on the pituitary gland. This means less FSH, and thus, reduced spermatogenesis |
|
|
Term
| What are the 5 aspects of semen that are tested in a semen analysis? |
|
Definition
1. Volume
2. Viscosity
3. Sperm density
4. Sperm motility
5. Sperm morphology |
|
|
Term
|
Definition
|
|
Term
| What density is considered normal? |
|
Definition
|
|
Term
| What motility is considered normal? |
|
Definition
|
|
Term
| What morphology is considered normal? |
|
Definition
|
|
Term
| List the positive feedback hormones of the MRS and what they do? |
|
Definition
1. GnRH - trigger FSH and LH release
2. LH - survival of leydig cell
3. FSH - induces spermatogenesis
4. Testosterone - supports spermatogenesis |
|
|
Term
| List the negative feedback hormones of the MRS and where they act? |
|
Definition
1. Testosterone - pituitary and hypothalamus
2. Inhibin - pituitary |
|
|
Term
| What are two treatments for male infertility? |
|
Definition
1. Lifestyle changes
2. Fertility enhancement |
|
|
Term
| Describe 3 fertility enhancement procedures |
|
Definition
1. Intrauterine insemination of concentrated sperm
2. In vitro fertilization
3. Intracytoplasmic sperm injection combined with IVF |
|
|
Term
| (T/F) Medical therapies exist for male infertility |
|
Definition
|
|
Term
| Name 4 causes of female infertility |
|
Definition
1. Anovulation
2. Structural
3. Immunologic
4. Age |
|
|
Term
| What are two immunological causes? |
|
Definition
1. Ab production against sperm
2. Immune response to fetus (ie rhesus) |
|
|
Term
|
Definition
|
|
Term
| What are 3 causes of primary amenorrhea (anovulation)? |
|
Definition
1. Menarche never occured
2. Genetic disorders (Tuners syndrome)
3. Congenital disorders of brain/pituitary/ovary/uterus |
|
|
Term
| What is seen with secondary amenorrhea? |
|
Definition
| Cesseation of menstrual cycles after a period of regular cycles |
|
|
Term
| What are the causes of secondary amenorrhea? |
|
Definition
1. CNS or pituitary tumours
2. Inhibition of GnRH secretion
3. Obstruction of outflow tract |
|
|
Term
|
Definition
| A benign tumour (fibroid) in the myometrium |
|
|
Term
| What is ashermans syndrome? |
|
Definition
| Scarring of the uterine lining |
|
|
Term
| How is secondary amenorrhea treated? |
|
Definition
1. Surgical resection of tumours
2. Education
3. Oral contraceptive (if not trying to conceive)
4. Endocrine therapy |
|
|
Term
| How is bromocryptine used in endocrine therapy? |
|
Definition
|
|
Term
| How is clomiphene used in endocrine therapy? |
|
Definition
| Stimulates gonadotrophin to proper levels |
|
|
Term
| What is exogenous gonadotrophin therapy used for? |
|
Definition
|
|
Term
| What is the cause of endometriosis, a structural cause of female infertility? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| What is the primary goal for treatment of endometriosis? |
|
Definition
|
|
Term
| What 3 things are used to accomplish this? |
|
Definition
1. GnRH agonist
2. Androgenic steroid (danazol)
3. Oral contraceptive |
|
|
Term
| What is another structural cause of female infertility? |
|
Definition
|
|
Term
| What causes pelvic inflammatory disease, and what is the consequence of this disease? |
|
Definition
Causes: STI or ruptured appendix
Consequence: blocked fallopian tubes |
|
|
Term
| What treatments are used for structural causes of female infertility? |
|
Definition
1. Surgical ranastomosis
2. Resection of endometriosis
3. In vitro fertilization |
|
|
Term
| What percent of women are affected by polycystic ovary syndrome? |
|
Definition
|
|
Term
| List characteristics of PCOS |
|
Definition
- Anovulation or oligo-ovulation
- Hyperandrogenism
- Polycystic ovaries
- Elevated LH:FSH (not always)
- Insulin resistance
- Obecity |
|
|
Term
| (T/F) The cause of PCOS is known |
|
Definition
|
|
Term
| What are some treatments for PCOS, when fertility is not a concern? |
|
Definition
|
|
Term
| What are some treatments for PCOS, when fertility is a concern? |
|
Definition
1. Weight loss
2. Clomiphene
3. Metformin
4. Gonadotropin |
|
|
Term
| What is the function of clomiphene? |
|
Definition
| Stimulates ovulation by stimulating FSH |
|
|
Term
| What is the function of metformin? |
|
Definition
| Induces weight loss and menstrual activity |
|
|
Term
| What is the function of gonadotropin? |
|
Definition
| Induces ovulation in vitro |
|
|
Term
| What are two surgical management tactics used to overcome female infertility? |
|
Definition
1. Ovarian wedge resection (no longer used)
2. Laparoscopic ovarian diathermy (ovarian drilling) |
|
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