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19 Cards in this Set
- Front
- Back
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this is regular sexual activity with no pregnancy >12 mo
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infertility
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if over 35 years when should you seek treatment for infertility
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6 months
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what are causes of male infertility
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sperm production - low or abnormal
anatomy - varicocele, blockage, scar tissue, birth defects immune - antibodies to sperm febrile illness <90 days unknown |
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what medications affect male fertility
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5 alpha reductase
alpha antagonists CCB chemo LH - antiandrogen Aldactone Testosterone SSRI or TCAs Antibiotics - gent, erythro, macrobid *anabolic steriods |
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what are causes of female infertility
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Uterine - endometrosis or fibroids
Ovarian - PCOS, ovulary disfunction, amenorrhea Tubal - block or damaged Pelvic adhesions, surgeries, ectopic, advanced age, recurrent miscarriages |
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who do you refer immediately for infertility
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>35 y
menstraul or ovulatory irregularities known tubal issue history of thyroid or miscarriages men with known sperm deficiencies or scrotal surgery |
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what factors affect pregnancy
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age >35 bc fertility and SAB increase
body weight - obesity BMI <18 Vigorous exercise, decreased sperm ct and affects ovulation tight pants in men smoking - decrease sperm ETOH - affect fertility substance abuse caffiene enviromental hazards - lead, pesticides, landscaping, mercury |
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what diagnostic tests are needed in infertility
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complete H and P, esp menstraul history
Basal Body Temp Gonadotropin level, FSH, LH, estradiol LH Progesterone Hysterosalpingogram: check ovaries, cervix, uterus, fallopian tubes, |
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this takes temp daily for 5 min after minimum of 3 hours sleep before rising
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BB temp
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how do you know your ovulating with a BB temp
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temp rises within a day or 2 of ovulation and remain elevated until menses
most fertile 2-3 days b4 ovulation and for 12-24 hours after ovulation |
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how can you use BB temp to see if ovulating
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if no rise in temp in the luteal phase - estrogen suppresses preovulatory temps
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what diagnostic tests are used in males for infertility
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history and physical - children, new partner
palpate scrotal contents check varicocele semen analysis x2 - 2-5 days after abstinence, check volume, PH, motility and shape needs to be evaluated within one hour Labs: Testosterone, FSH, LH |
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if male had fever or on meds, how long until you should check sperm
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90 days - takes that long to mature
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what is step one for infertility
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Clomid - stimulate FSH and LH release
Clomid 50mg daily on day 5-9 after last dose |
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what are SE of Clomid
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flush, abdominal distension, ovary enlarged, ovarian hyperstimulation
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what does the HCG have to be to see a gestational sac on US
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at least 1500
rule out ectopic - 50% cannot see, follow up in 48 hours |
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if pregnancy terminated, the half life hcg is what
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3-7 days
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what level should progesterone levels be to rule out ectopic
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>25
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what does ovulation occur after taking Clomid
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5-9 days after stopping Clomid
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