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15 Cards in this Set
- Front
- Back
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What is the relationship of hCG and ectopic pregnancy?
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90% of ectopics have a falling or abnormally rising hCG level.
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What is the relationship of progesterone and ectopic pregnancy?
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Progesterone levels less than 15 ng/ml are seen in about 80% of ectopics.
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What is the usual finding for ectopic pregnancy on ultrasound? What does conclusive Dx require?
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A mass on one side, some fluid in the pelvis, and no normal pregnancy structures in the uterus. Conclusive Dx requires seeing a fetus or fetal cardiac motion outside the uterus.
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What are the treatments for ectopic pregnancy?
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Surgical Tx = laparoscopic managment, which offers an alternative to laparotomy in conservatively treating unruptured tubal pregnancies less than 3 cm in size.
Non-surgical Tx = expectant management and medical managment. |
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What are the major indications for IVF?
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1. Tubal Factor
2. Endometriosis 3. Male Factor 4. Idiopathic Infertility 5. Immunologic Infertility 6. Diethylstilbestrol Exposure |
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What is the "Tubal Factor" indication for IVF?
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IVF is the only therapeutic option for women w/ absent Fallopian tubes and is appropriate for women w/ severe tubal dz and those who have experienced failed tuboplasty.
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How can IVF help with idopathic infertility?
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IVF may be of diagnostic value, as an intrinsic ovum or sperm defect may be uncovered by fertilization failure.
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How can we identify an immunologic factor with IVF?
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Abnormal postcoital testing confirmed by the identification of antisperm antibodies.
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How is ovarian stimulation used with IVF?
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It is routinely used. The regimen entails initial "down-regulation" of the pt's pituitary thru administration of GnRH analog. The ovaries are then stimulated w/ gonadotropins for 7-10 days. When follicular development has reached the stage where an optimum number of mature folicles are present, hCG is administered to trigger ovulation.
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What is the most common procedure to retrieve oocytes?
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Ultrasound-directed Transvaginal Needle Aspiration
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Describe the procedure to fertilize the oocyte.
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It takes place in the lab. A semen sample is processed first by separating the sperm from the seminal plasma and then enriching for motile, morphologically normal sperm. The sperm & oocytes are incubated together for 12-18 hrs. The embryos are transferred to growth media and incubated for another 24 to 60 hrs.
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How is normal IVF fertilization confirmed?
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By the presence of two pronuclei (male & female).
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How are the embryos placed in the uterus?
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They are loaded into a narrow catheter that is inserted inot the endometrial cavity thru the cervix. No anesthesia required.
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What is GIFT?
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The transfer of oocytes & spermatozoa directly inot the Fallopian tube.
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What is ZIFT?
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The transfer of pronuclear-stage zygotes into the Fallopian tube.
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