PCOS
Endometriosis
POI
General Risk Factors
Stats
100

What does PCOS stand for?

Polycystic Ovary Syndrome

100

What is endometriosis?

Endometriosis is a disease in which tissue similar to the lining of the uterus grows outside the uterus. It can cause severe pain in the pelvis and make it harder to get pregnant.

100

What does POI stand for?

Primary Ovarian Insufficiency

100

What are general risk factors for infertility? (name at least 3)

Advanced maternal age, weight, smoking, alcohol, STIs

100

What proportion of infertility cases are caused by female reproductive issues?

1/3

200

PCOS occurs due to disruption to which axis?

The Hypothalamic-Pituitary-Ovarian (HPO) Axis

200

What are some treatment options for endometriosis?

- Surgery

- GnRH-analogues and contraceptive (birth control) methods

- NSAIDs to reduce pain


200
Before what age is it considered POI?

40

200

How does alcohol affect fertility in females?

Alcohol use is associated with altered levels of estrogen and progesterone and irregularities in the menstrual cycles and ovulation. It is unclear how the volume of alcohol consumed will affect fertility.

200

Failure to ovulate occurs in about ??? of women with infertility issues.

Failure to ovulate occurs in about 40% of women with infertility issues.

300

What is the Rotterdam Criteria?

  • Follicle count on pelvic ultrasound

  • Anovulation → oligo/amenorrhea

  • Androgen excess (hirsutism, male-pattern balding, acne)

  • Need 2/3 at least

300

Why does endometriosis make it harder to get pregnant?

  • Endometrial tissues implants around ovaries and fallopian tubes → scar tissue, inflammation

  • Prevent eggs from reaching uterus

300

What are some risk factors of POI? (name at least 3)

  • Genetic disorders such as Fragile X syndrome and Turner syndrome
  • A low number of follicles (familial component?)
  • Autoimmune diseases, including thyroiditis and Addison disease
  • Chemotherapy or radiation therapy
  • Metabolic disorders
  • Toxins, such as cigarette smoke, chemicals and pesticides
300

How does smoking affect fertility in females?

Impairs function of cilia that sweep egg through fallopian tubes (same with gonorrhoea and chlamydia)

Increases risk of miscarriage and ectopic pregnancy

300

Females above 35 have a ??? chance of having infertility issues.

Females above 35 have a 1/3 chance of having infertility issues.

400

What is the pathophysiology of PCOS that makes it hard for affected females to get pregnant?

  • Normally, hypothalamus secretes GnRH in pulsatile manner → pituitary responds by releasing FSH and LH

  • Exaggerated frequency and amplitude of GnRH secretions → higher LH:FSH ratio → LH hypersecretion stimulates theca cells to produce excess androgens → androgens overburden granulosa cells which use FSH to convert androgens to estrogen → estrogen inhibits FSH via negative feedback loop → insufficient FSH causes granulosa cell degeneration, follicular development is impaired

  • Increased LH:FSH ratio → LH is already so high that LH surge doesn’t occur → no ovulation; instead primary follicles arrest, accumulation of small antral follicles

400

Key signs and symptoms of endometriosis

(name at least 5)
- Early age of menarche

- Dysmenorrhoea

- Dyspareunia

- Dysuria

- Pelvic pain

- Bleeding between periods

- Anxiety/depression
400

How many repeats of CGG is required for Fragile X Syndrome?

More than 200 repeats of CGG (Cytosine-Guanine-Guanine) [Normal Repeats: 5-44], found in the FMR1 Gene in the X Chromosome, which is responsible for producing Fragile X Mental Retardation Protein.

400

How does weight influence fertility; i.e. via which hormone?

  • Estrogen!

  • Excess weight - fat cells convert androstendione into estrogen → too much estrogen

  • Underweight - body stops making estrogen – causing irregular menstrual cycles

400

Infertility affects ??? Australian couples of reproductive age.

Infertility affects 1/6 Australian couples of reproductive age.

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