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53 Cards in this Set
- Front
- Back
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Zika can live in semen for ______ |
6 months |
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Ebola can live in semen for _____ |
9 months |
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Infertility is defined as ___ |
One year of unprotected sex or 6 months >35 yo or H/O issues that resulting in infertility |
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___% women age 15-44 |
12 |
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After age 30, the chance of live birth is ____ per menstrual cycle without infertility issues |
5% |
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Male fertility declines after age ___ |
35 |
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What are some conditions that are associated with infertility |
Amenorrhea Endometriosis PID |
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An ___ is often used to assess ovulation |
Ovulatory function assessment |
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What are the most common causes of anovulation |
Thyroid dysfunction Hyperprolactinemia PCOS |
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Ovarian function is suppressed with certain procedures such as ___ |
Chemo Radiation Abdominal surgery |
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Home ovarian diagnostic tests measure ____ |
LH |
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Being overweight may be a sign of ____ |
PCOS |
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Progesterone levels > ___ ng/mL may cause infertility issues |
3 |
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An endometrial biopsy looks at _____ |
Progestin stimulated growth of the uterine lining |
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Being underweight or exercising extensively may result in ____ |
Anovulation |
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Elevated testosterone in females can be a sign of ____ |
PCOS |
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An assessment of ovarian reserve in patients over age 35 is done by measuring ___ |
FSH because there is an FSH INCREASE with DECREASING ovarian function Also- sEstradiol levels >80 pg/mL is a poor prognosis |
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Low ______ , secreted from ovarian granulosa cells, with high ______ shows a decline in ovarian function |
Inhibin b FSH |
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Clomiphene citrate challenge test is____ |
100 mg on days 5-9 of cycle
It is typically given and if patient gets pregnant woohoo and if it doesnt work after 3 months look for other causes |
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What anatomical issues can lead to infertility? |
Structural abnormalities of uterus and fallopian tube Scar tissue Thick cervical mucus |
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How can cervical mucus affect fertility |
It can alter the motility of sperm |
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What drugs can affect fertility in women |
NSAIDS Antibiotics- cervical Antidepressants Antipsychotics ACE-I (cat X) Hydroxychloroquine Warfarin Diuretics Seizure meds(phenytoin, carbamazepine, valproate) Isotretinoins Cimetidine (alter prl levels) |
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What things can cause male infertility |
Impaired sperm production or function Genetic conditions Pituitary tumors Weight Hypogonadism Medications that reduce sperm count, cause ED or affect hormones |
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What can cause impaired sperm production or function |
Varicoceles Elevated temperatures |
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How can weight affect male fertility |
Obese men have higher estrogen levels and lower testosterone levels |
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What can cause hypogonadism in men |
Testicular trauma Radiation Medications (chemo, anti androgens, androgens, estrogens) |
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What medications can reduce sperm count or affect hormones |
Beta blockers CCBs Alcohol Illicit drugs Spironolactone Nitrofurantoin Gentimicin (lower sperm motility) Erythromycin Cimetidine Cyclosporine Sulfasalazine |
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Drugs that cause ED include |
Thiazides Beta blockers Spironolactone CCBs Antidepressants Antipsychotics |
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Clomiphene citrate is given to men to improve sperm parameters if they have ____ |
Preexisting hypogonadism |
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What dose of clomiphene has been given to men to improve sperm counts |
50 mg qd or 4xd |
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___% of infertility cases have no identifiable cause |
30 |
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Patients who are infertile should avoid |
Alcohol Caffeine Illicit drugs Tobacco |
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What is the goal of ovulation induction |
The development of a single dominant follicle |
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Clomiphene citrate works by |
Inhibiting estrogen binding in the hypothalamus to stimulate release of GnRH |
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___% of patients respond to clomiphene citrate |
80 |
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There is a concern for increase in ___ with long term clomiphene use |
Ovarian cancer |
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If clomiphene proves unsuccessful for 3 months, switch to _____ |
Letrozole |
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Anastrozole is an ____ investigated for use in ovulation induction |
Oral aromatase inhibitor |
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What is the dosing schedule for anastrozole |
2 mg daily for 5 days starting day 3-5 of cycle |
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Letrozole is an _____ being investigated for use as an ovulation inductor |
Oral aromatase inhibitor |
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What is letrozole's dosing schedule |
2.5 or 5 mg daily for 5 days starting on day 3-5 of cycle |
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What are some side effects of oral aromatase inhibitors |
Vasomotor SEs |
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Do aromatase inhibitors have a pregnancy warning |
Yes |
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Do OAIs affect cervical mucus |
No |
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The goal of Continuous ovulation induction is to ____ |
Develop multiple oocytes |
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Some recent data suggests that there is no additional benefit in using COI after 3 unsuccessful clomiphene citrate cycles with IUI BUT _____ |
There is a 25% higher pregnancy rate if treated with IVF |
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What is the primary type of ART used |
In vitro fertilization |
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What are the main points of IVF |
Stim egg, retrieve egg, support endometrium with progesterone |
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What progesterone products are safest in pregnancy |
Anything that is a topical or is vaginally inserted |
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What are different progesterone ART products in order of most to least preferred |
Crinone 8% vaginal gel Endometrin 100 mg vaginal insert FIRST- progesterone VGS 25,50,100,200, 400 mg vaginal suppository compounding kit Progesterone 50 mg/mL in oil injection IM Prometrium 100, 200 mg capsule PO |
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What are symptoms of ovarian hyperstimulation syndrome |
Bloating Diarrhea Nausea Weight gain Abdominal pain Distention |
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When Can ovarian hyperstimulation syndrome occur in IVF |
1-2 weeks after oocyte retrieval |
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What are key counseling points to help monitor for and prevent ovarian hyperstimulation syndrome |
Avoid physical activity Maintain at least one liter of fluid per day Monitor weight and urine output |
