Baby- Makin Pharm and Misc.
IVF & Co
SHOW ME THE MONEY
OH MY OHS
ICSI Miami
100
What the difference between a-HCG and b-HCG?
Alpha- HCG is the alpha subunit of HCG and b subunit is the active subunit that gives HCG its unique physiologic effects
100
What is the main difference between IVF and IUI?
IUI takes place internally while IVF has fertilizations happen artificially outside the uterus
100
Are large employers (20000+ employees) more likely or less likely to cover fertility benefits on their insurance plans than small employers (500+ employees)?
More likely
100
What hormone is the main cause of OHSS?
exogenous Human chorionic gonadotropin (hCG)
100
What percentage of eggs are fertilized with ICSI?
50- 80% of eggs
200
Name 1 contraindication of Pitocin
-Hyperactice or hypertonic uterus
-Oxytocin allergies
-Unfavorable fetal position or presentation
-previous C- section
200
Explain the steps of IVF
- Involves hormonal follicular stimulation followed by a transvaginal follicular puncture for oocyte retrieval with ultrasound monitoring
- The recovered oocytes are mixed with processed spermatozoa and incubated.
- Two (in young women) to five embryos (in women over 40 years of age) are transferred into the uterus.
200
How much is an IVF on average?
$15000 - $20000
200
Name 2 diagnostic tools for OHSS? (100 points if you can give 2 predicted findings)
Laboratory analysis (leukocytosis, increase hemotocrit, liver function test, and electrolyte concentrations)
Transvaginal ultrasound (as cites and ovarian enlargement)
200
What procedure is used to obtain follicles from the ovary?
Follicular puncture
300
What drug is an estrogen receptor antagonist used to increase GnRH —> LH and FSH —> Ovulation
Clomiphene Citrate
300
What are the major complications of IUI?
Infection
Spotting
Multiple Parity (100 points if you know the percentile increase in incidence)
300
Which demographics are more likely to seek infertility treatment?
Age >35, white, > average FPL, insured
300
What mediator is released in Ovarian hyperstimulation syndrome
VEGF
300
How much does ICSI cost in addition to IVF cost
$1400 to $2000
400
What hormone is monitored prior to initiation of COH?
Estradiol
400
At what times are embryos frozen for frozen embryo transfer?
Day 1 fertilization, Day 3 cleavage stage, Day 5 blastocyst stage
400
Which states’ Medicaid program covers IUI, IVF, and cryopreservation?
None.
400
Name 4 of the 9 clinical presentations of OHSS
- Abdominal pain and distention
- Nausea and/or vomiting
- Weight gain
- Ascites
- Oliguria or anuria
- Dyspnea
- Syncope
- Venous thrombosis
- Pleural effusion
400
Name 3 indications for ICSI-IVF (Bonus 50 points if you can name the diagnostic name for one of the sperm defects)
- Very low sperm count (also known as oligospermia)
- Abnormally shaped sperm (also known as teratozoospermia)
- Poor sperm movement (also known as asthenozoospermia)
- Previous IVF cycle had few or no fertilized eggs
- Frozen sperm are being used
- Frozen oocytes are being used
- PGD is being done
- IVM (in vitro maturation) is being used
500
What‘s the difference between Ovarian Hyper-stimulation syndrome and Controlled Ovrian Hyper-stimulation?
COH is controlled and OHS is a side effect of uncontrolled OHS.
500
What is the percentage of birth defects in normal births versus IVF births?
3-5 percent versus 1.5 %
500
Name at least 2 states that mandate some infertility service coverage by insurance and name ONE state that requires at least one plan for infertility services and one state that does not mandate coverage?
500
Name 2 of the 6 complications of OHSS
- Sepsis
- Thromboembolism
- Pericardial effusion
- Arrhythmias
- Acute respiratory distress syndrome
- Acute kidney injury
500
What complication arises from a sperm duplicating inside an empy ovum?
Complete hydatidiform mole (can happen with ICSI)