Definition
Etiology
Diagnostics
Treatment
100

What defines infertility? 

Inability to conceive despite regular unprotected sexual intercourse after 1 year in women under 35 and after 6 months in women 35 and over.

100

Uterine factors that lead to infertility?

  • Endometrial polyps

  • Leiomyoma

  • Uterine anomalies

  • Asherman syndrome




100

First thing to do when assessing infertility?

A detailed medical history!!

100

What lifestyle modifications can be done?

cessation of alcohol, nicotine, and recreational drugs

200

Difference between primary and secondary infertility?

- Primary: Infertility in people who have never achieved pregnancy.

- Secondary: Infertility in people who have achieved pregnancy before.


200

Cervical factors that lead to infertility?

  • Immune-related (Anti-sperm antibodies in cervical mucus)

  • Trauma

  • Diethylstilbestrol exposure in utero

  • Cervical anomalies (insufficient cervical mucus production).

200

What does unexplained infertility mean?

Infertility after all testing shows normal results

200

What can be used to treat underlying causes of infertility?

metformin for PCOS, Levothyroxine for hypothyroidism, Bromocriptine for hyperprolactinemia

300

How common is infertility in the U.S.?

  • Infertility is found in 10-15% of couples of reproductive age.

    • Estimated 5% of women ages 15-44.

    • Estimated 5-10% of men ages 15-44.

300

Tubal and pelvic factors that lead to infertility?

  • Fallopian tube adhesions/obstructions (could follow infection or surgery)

  • Endometriosis

  • PID

300

When is imaging indicated for infertility?

After all lab testing show no abnormalities and no history is indicative of anatomical abnormality/obstruction.

300

Ovulation induction drugs?

- Clomiphene citrate (Estrogen receptor antagonist)

- Menotropins (Gonadotropins from postmenopausal women)

- Letrozole (aromatase inhibitor)

400

Risk factors for infertility?

- Endometriosis

- History of PID

- History of pelvic surgery or tract malformations

- Known male factors

400

Ovarian factors that lead to infertility?

  • Hyperprolactinoma

  • Hypothyroidism

  • PCOS

  • Primary ovarian insufficiency

400

What labs can we use to assess ovulation in patients?

- FSH, LH, Estrogen, and progesterone levels 

- AMH levels

- Prolactin

- TSH

400

Most common form of assisted reproductive technology?

In vitro fertilization

500

What anatomical abnormalities could lead to infertility?

  • Uterine

  • Cervical 

  • Tubal 

  • Ovarian 

  • Sperm

500

Sperm factors that lead to infertility?

  • Reduced sperm count

  • Impaired motility

  • Testicular damage (scrotal injury, testicular torsion)

  • Immunologic (antisperm antibodies in response to damage to the blood-testis barrier can be caused by trauma or infection)

  • Medications (anabolic steroids)

500

What imaging modalities can we use to assess for infertility?

- Ultrasound

- sonohysterography

- chromopertubation

- hysterosalpingography


500

List 2 non-pharmacologic ways to treat infertility

- In vitro fertilization

- Intracytoplasmic sperm injection

- Intrauterine insemination

- Surgery

- oocyte donation

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