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23 Cards in this Set

  • Front
  • Back
Definition of infertility?
Hetrosexual couple who had had unprotected sex without (1) getting pregnant or (2) maintaining a pregnancy.
Percentage of married couples who are infertile?
Causes of couple infertility?
- 35% mom
- 35% dad
- 15% both
- 10% unknown
Percentages of female infertility?
20-24: 4.1%
30-34: 9.4%
35-39: 20%
Causes of female infertility?
1. Failure to ovulate
2. Tubal blockage
3. Absence of implantation
4. Miscarriage
5. Reduces sperm transport
6. Abs to sperm
Why failure to ovulate?
Hypothalamic (GnRH) or pituitary (LH/FSH) problem.
Treatment of failure to ovulate
- GnRH therapy
- clomid (= anti-estrogen) inhibits negative feedback est.
(30-35% succesful)

- human menopausal gonadopropin: contains LH/FSH. After: hCG
Causes of tubal blockage?
2nd leading reason.

- scarring due to STI
- endometriosis
Treatment tubal blockage?
- gas blown in
- transcervical balloon tuboplasy (like dotteren)
- surgical repair
Causes for absence of implantation?
- uterine surface not receptive
How make the uterine surface more receptive?
By priming uterus with right doses of est/pro.
Percentage of pregnancy loss/miscarriage
- 50-75% b/f or soon after implantation

- 15% of known pregnancies
Reason of loss pregnancy
- Mainly: chromosomal abnormality

- Immunological reasons? Perhaps parental MHC?
Define male infertility
- low sperm count (main cause)
- poor sperm transport
Causes of low sperm count
Hormonal (hyp/pit)
Treatment: GnRH angonist or clomiphene.

Damage to testes:
- physical injury
- cryptochodism
- past infection testes
- radiation/chemo
- toxins
Possible environmental factors influencing low sperm count in males?
- Smoking
- Xenoestrogens
- Anabolic steroids
- Excessive alcohol consumption
What could be an immunological explanation for low sperm count?
Due to exposure of other tissue to sperm after injury: autoimmunological.
In 8-13%
Chromosomal explanation for low sperm count?
1 out of 1000 men: miss part of Y chromosome
What does ART stand for?
Assisted reproductive techniques

- Artifical insemination (AI)
- preimplantation genetic diagnosis (PGD)
- Gamete or zygote intrafallopian transfer (GIFT)
- surrogate mothers and gestational carriers
Difference AI and IVF?
AI: sperm injected in vagina

IVF: in vitro + embryo placed back. Chance for twins.
What is the succesrate for IVF?

In 35-40% twins.
When is GIFT/ZIFT used
Oviduct blockage.

All imserted proximal from blockage.
What is the difference between a surrogate mother and a gestational carrier?
Surrogate: genetically related (sperm from father)

Gestational: embryo implanted