Definitions
Inability to conceive after 1 year of unprotected intercourse of reasonable frequency
What is infertility?
Ovulatory dysfunction is responsible for this percent of cases of infertility
What is 27 percent?
These symptoms may suggest tubal obstruction, pelvic adhesions or both
What is chronic pelvic pain, severe dysmenorrhea?
This is the most common congenital uterine anomaly
What is a uterine septum?
Normal range for total sperm count
What is >15 million/mL ?
Infertility following at least one prior conception
What is secondary infertility?
This class of ovulatory dysfunction is characterized by low levels of FSH, LH, and estrogen.
Examples include anorexia, eating disorders, overexercise, female athlete triad.
Nutritional support in addition to estrogen is beneficial. To conceive, injectable gonadotropins are required.
What is hypogonadotropic hypogonadal anovulation?
In the US this is the most common cause of tubal disease
What is infection with chlamydia or gonorrhea?
Most experts recommend the removal of these types of fibroids
submucosal fibroids (especially if they distort the endometrial cavity)
This procedure is performed in those with congenital bilateral absence of the vas deferens for whom there is no surgical treatment.
Testicular sperm extraction (TESE)
Infertility affects this percent of reproductive aged couples
What is 10-15%?
This type of ovulatory dysfunction is characterized by gonadotropin amplitude or pulse frequency disturbances.
Examples include PCOS, hyperprolactinemia, hypothyroidism, and nonclassical congenital adrenal hyperplasia.
Treatment includes ovulation induction (ie, letrozole, clomid).
What is eugonadotropic anovulation?
This procedure is usually performed on cycle days 5-10 to assess tubal patency
a) HSG
b) SIS
c) both options are correct
Treatment of Asherman syndrome involves this
Hysteroscopic lysis of scar tissue
This procedure consists of injecting a single sperm through the zona pellucida and oocyte cell membrane
ICSI (intracytoplasmic sperm injection)
The probability of conception in a month or within a menstrual cycle
What is fecundability?
This class of ovulatory dysfunction is characterized by elevated levels of gonadotropins and absent ovarian function.
Examples include POI, Turner's, iatrogenic causes (ie pelvic radiation, chemotherapy, prior ovarian surgery).
Treatment includes donor eggs if basal FSH > 15 and egg retrieval impossible.
What is hypergonadotropic hypogonadal anovulation?
True or false: Prior ectopic pregnancy, even if treated medically with methotrexate, implies the likelihood of significant tubal damage.
What is true?
A pt has HSG deomstarting a banana like uterine cavity. TVUS shows bilateral adnexal structures with a single uterine canal and a noncommunicating mass with a thick stripe. Hysteroscopy shows a single uterine cavity with deviation to the right and a single tubal ostium.
1. The patient has this anomaly. 2. This event can happen in less than 20 weeks.
1. What is a unicornuate uterus with a noncommunicating horn?
2. What is rupture of the horn?
1. Dilation of the pampiniform plexus of the spermatic vein that is usually left sided
2. The treatment for this condition
1. varicocele
2. surgical ligation of the internal spermatic vein
The capacity to conceive and produce offspring
What is fecundity?
1. Normal cycle day 3 FSH, E2 levels
2. Predictor of ovarian reserve
1. What is FSH <9-10 mIU/mL and E2 <50-80 pg/ml?
2. What is AMH?
Women with hydrosalpinges undergoing IVF have approximately this amount of pregnancy rate of other women with unaffected tubes
What is half?
What are endometrial polyps?
A 35 yo male presents with his wife after a SA is consistent with azoospermia. On exam by a urologist, he is found to have bilateral absence of the vas deferens. The most likely inherited genetic disorder related to this condition is this.
What is cystic fibrosis?