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15 Cards in this Set

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  • Back
What is the relationship of hCG and ectopic pregnancy?
90% of ectopics have a falling or abnormally rising hCG level.
What is the relationship of progesterone and ectopic pregnancy?
Progesterone levels less than 15 ng/ml are seen in about 80% of ectopics.
What is the usual finding for ectopic pregnancy on ultrasound? What does conclusive Dx require?
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.
What are the treatments for ectopic pregnancy?
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.
What are the major indications for IVF?
1. Tubal Factor
2. Endometriosis
3. Male Factor
4. Idiopathic Infertility
5. Immunologic Infertility
6. Diethylstilbestrol Exposure
What is the "Tubal Factor" indication for IVF?
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.
How can IVF help with idopathic infertility?
IVF may be of diagnostic value, as an intrinsic ovum or sperm defect may be uncovered by fertilization failure.
How can we identify an immunologic factor with IVF?
Abnormal postcoital testing confirmed by the identification of antisperm antibodies.
How is ovarian stimulation used with IVF?
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.
What is the most common procedure to retrieve oocytes?
Ultrasound-directed Transvaginal Needle Aspiration
Describe the procedure to fertilize the oocyte.
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.
How is normal IVF fertilization confirmed?
By the presence of two pronuclei (male & female).
How are the embryos placed in the uterus?
They are loaded into a narrow catheter that is inserted inot the endometrial cavity thru the cervix. No anesthesia required.
What is GIFT?
The transfer of oocytes & spermatozoa directly inot the Fallopian tube.
What is ZIFT?
The transfer of pronuclear-stage zygotes into the Fallopian tube.