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19 Cards in this Set

  • Front
  • Back
this is regular sexual activity with no pregnancy >12 mo
infertility
if over 35 years when should you seek treatment for infertility
6 months
what are causes of male infertility
sperm production - low or abnormal
anatomy - varicocele, blockage, scar tissue, birth defects
immune - antibodies to sperm
febrile illness <90 days

unknown
what medications affect male fertility
5 alpha reductase
alpha antagonists
CCB
chemo
LH - antiandrogen
Aldactone
Testosterone
SSRI or TCAs
Antibiotics - gent, erythro, macrobid
*anabolic steriods
what are causes of female infertility
Uterine - endometrosis or fibroids
Ovarian - PCOS, ovulary disfunction, amenorrhea
Tubal - block or damaged
Pelvic adhesions, surgeries, ectopic, advanced age, recurrent miscarriages
who do you refer immediately for infertility
>35 y
menstraul or ovulatory irregularities
known tubal issue
history of thyroid or miscarriages
men with known sperm deficiencies or scrotal surgery
what factors affect pregnancy
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
what diagnostic tests are needed in infertility
complete H and P, esp menstraul history
Basal Body Temp
Gonadotropin level, FSH, LH, estradiol
LH
Progesterone

Hysterosalpingogram: check ovaries, cervix, uterus, fallopian tubes,
this takes temp daily for 5 min after minimum of 3 hours sleep before rising
BB temp
how do you know your ovulating with a BB temp
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
how can you use BB temp to see if ovulating
if no rise in temp in the luteal phase - estrogen suppresses preovulatory temps
what diagnostic tests are used in males for infertility
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
if male had fever or on meds, how long until you should check sperm
90 days - takes that long to mature
what is step one for infertility
Clomid - stimulate FSH and LH release
Clomid 50mg daily on day 5-9 after last dose
what are SE of Clomid
flush, abdominal distension, ovary enlarged, ovarian hyperstimulation
what does the HCG have to be to see a gestational sac on US
at least 1500
rule out ectopic - 50% cannot see, follow up in 48 hours
if pregnancy terminated, the half life hcg is what
3-7 days
what level should progesterone levels be to rule out ectopic
>25
what does ovulation occur after taking Clomid
5-9 days after stopping Clomid