Term
infertility is not concieving for how long if no contraceptives?
what about if prior oral contraceptives? |
|
Definition
|
|
Term
| what is primary infertility? |
|
Definition
| not concieving any children |
|
|
Term
| what is secondary infertility? |
|
Definition
| have had 1 child but cant convcienve now |
|
|
Term
| _% of US women have some sort of infertility? |
|
Definition
|
|
Term
| 30-35% of infertility is related to _ abnormailites |
|
Definition
|
|
Term
| contraception rates decrease for 2 age groups |
|
Definition
|
|
Term
| how much do male partners contribute to infertility? |
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Definition
|
|
Term
| estrogen needs to be suffieicnet in what phase? |
|
Definition
|
|
Term
| has infertility increase or decreased? |
|
Definition
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|
Term
| contributing factors to increased infertility-4 |
|
Definition
older age
contraceptives
sexual practices
increase in therapeutic abortions |
|
|
Term
| infertility occus when you block dopamaine or serotonin? |
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Definition
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|
Term
| most common cause of anovulation and menstrual problwem with women of normal hormone levels? |
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Definition
|
|
Term
| what causes hypothalmic disorders |
|
Definition
eating disorder/weight loss>15%
stress
exercise |
|
|
Term
hyperanadrogenicity is oftentime diagnosed as what?
these people have chronic increase in what hormone? |
|
Definition
PCOS
LH- whcih stimulate follicla aproduction of androgen |
|
|
Term
| what is PCOS often associated with? |
|
Definition
| metabolic syndrome obesity, insulin resitance |
|
|
Term
| whcih endocrine disorder decreases GnRH |
|
Definition
|
|
Term
| which endocrine disorder leads to hyperprolacitnemia |
|
Definition
|
|
Term
| why is a dopamine blocker not good? |
|
Definition
| blocks the inhibiton of prolactin |
|
|
Term
most evals of infertility dont occur until _ months of trying?
unless what? |
|
Definition
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|
Term
| during the medical/surgical etc history eval what kind of disorder are you looking for? |
|
Definition
|
|
Term
| during the female eval what 2 disease do you screen for |
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Definition
|
|
Term
| what is a hysterosalpinogogram? |
|
Definition
| fluro and radioscopic visual of the upper gential tract of female |
|
|
Term
pateint counseling for Basal temperature:
what day do you take first measurement, an what time of day? |
|
Definition
| 1st day of menstrual cycle- in morning befoer get out of bed |
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Term
normallt your temperature is lwoer before_ and then hgiher after.
this is also called? |
|
Definition
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|
Term
what temp indicated ovulation is about to happen?
what temp says it already occured? |
|
Definition
.1 decrease
.4-.6 increase |
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|
Term
the littple spike of temp before it lowers for ovulation is a spike in what hormone?
what about the huge spike after ovulation? |
|
Definition
|
|
Term
| when do you being testing for ovulation kits? |
|
Definition
| 3-4 days before ovulatoin- day 10 of menstruaiotn cycle |
|
|
Term
| once ovulation kit is positive- how long do you ahve to have sex? |
|
Definition
|
|
Term
| male infertility can be due to- |
|
Definition
| hyperproloactinemia, DM, nutrition defic, low count/ immotile sperm |
|
|
Term
| what drugs cna impair spermatogeniss? |
|
Definition
| cocaine, majuirnaa, cafeeine, alcohol, nicotine |
|
|
Term
for semen analysis- how long do you ahve to abstain from ejaculation ebfore hand?
then abnormla results should be confirmed with _ other times |
|
Definition
|
|
Term
| what are the nonpharm options for infertility? |
|
Definition
intruterine insemination- IUI
assisted reproductive therapy ART |
|
|
Term
| what are the 3 forms of assisted reproductive therapy? |
|
Definition
in vitro fertilization/embryo trnasfer
gamete tranfer
zygote trnasfer |
|
|
Term
|
Definition
reduce BMI <30
females no NSAIDS or ASA around ovulation
meds that cause hyperprolactin, impair sperm |
|
|
Term
| what do NSAIDS or ASA do to ovulation? |
|
Definition
| prevent release of oocyte |
|
|
Term
| why do you not want to use vaginal lubricants? |
|
Definition
|
|
Term
| when is intruterine insemination perfeormed? -2 |
|
Definition
on the day after urinary surge of LH
or
36 hours after injection of hCG |
|
|
Term
|
Definition
| direct retrival of oocytes and mainuplating sperm to get preggo |
|
|
Term
is ART common?
whaht is the most ocmmon form of ART? |
|
Definition
no
in vitro fertilization/ test tube babies |
|
|
Term
in which nonpharm procudure is more than 1 embroy trnasfered to uturus?
why? |
|
Definition
ART
increase lieklihood of preggo |
|
|
Term
| who created invitro fertilization? |
|
Definition
|
|
Term
| what is the estrogen recptor antagonist? |
|
Definition
|
|
Term
|
Definition
blocks feedback inhibiton of hpyothalmus
reiases FSH and LH
raised HPG function |
|
|
Term
| what are some pharmacologic therapies? |
|
Definition
gonadotropins
orals contraceptives/estrogen
GnRH blockers, agonists |
|
|
Term
| this is the treatment for infertility in anovulatory women |
|
Definition
|
|
Term
| what do the effects of clomiphene lead to? -2 |
|
Definition
enlarges ovaries
drug induced ovulation for ppl with PCOS or amenorrhea |
|
|
Term
primary site of action for clomiphene
secodnary site fo action? |
|
Definition
estrognen recptors in the ovaries
direct effect on ovaries |
|
|
Term
Clomiphene
-absorption:
distribution:
t 1/2: |
|
Definition
|
|
Term
| which med is metabolized by CYP 2D6 |
|
Definition
|
|
Term
clomiphene essntial puts women in-
so this means? |
|
Definition
|
|
Term
|
Definition
| hot flash (vasomototr flush), abdomnial disocmfort, visual blurring, reversible ovary enlarge/cysts |
|
|
Term
| infrequent effects of clomiphene-3 |
|
Definition
|
|
Term
whcih med enhances the chance of triplets, twins?
why? |
|
Definition
clomipehene
creates mutliple ovulation |
|
|
Term
| more people ovulate than actually get preggo once on clomipehen- why? -3 |
|
Definition
antiestrogen effect on uterus
ednometiral thinning and produciton of thick cervicla mucus |
|
|
Term
| when do you start clomiphene? |
|
Definition
| on cycle day 2-5 (use for 5 days) |
|
|
Term
| what counts as clomiphene thera[y failure |
|
Definition
| no preggo within 6 months |
|
|
Term
| t med is first line for PCOS? |
|
Definition
|
|
Term
| what med is first line for women with nromal GnRH |
|
Definition
|
|
Term
| what med is first line for ovulation induction with timed intercourse/IUI |
|
Definition
|
|
Term
| what med is the aromatase inhibitor |
|
Definition
|
|
Term
MOA of letrazole
what surge does this lead to? |
|
Definition
inhbitis conversion of testosterone to esttradiol;
LH and FSH |
|
|
Term
| side effects of letrazole-3 |
|
Definition
| hot flashes, headahce, breast tender |
|
|
Term
| letrazole therapy is started what day |
|
Definition
|
|
Term
|
Definition
| clomiphene fail, but before gonadotropins |
|
|
Term
clomipehene vs letrazole
whihc has less anti-estrogen effects
which has longer half life
which has higher conception rate in first cycle? |
|
Definition
lestrogen
clomipehen
letrazole |
|
|
Term
clomiphene and lestrogen
when is ovulation expected?
when should intercourse be? |
|
Definition
5-10 days after last dose
every other day for 1 week beginnging 4-5 days after last dose |
|
|
Term
clomipehen and lestrogen
what should you report to doctor-4
monitor ovulation with? -2 |
|
Definition
vomiting, nasuea, pain, bloating
kits or ultrasound |
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|
