MRCOG - Part 2 > Infertility > Flashcards

Infertility Flashcards

(46 cards)

Study These Flashcards
1
Q

Most gonadotoxic chemotherapy

A

Cyclophosphamide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What porportion of infertility is thought to be attributable to male factor

A

Up to 50%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How much of couples investigated for subfrrtility are unexplained

A

25%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

When to get pregnant after taking rubella vaccine

A

At least 1 month

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

When to measure FSH investigating infertility

A

D2-5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Normal AFC- FSH- AMH

A

AMH: 5-25 pmol/l
FSH: 4-8 IU/l
AFC: 4-16

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

The most used ovarian reserve testing

A

FSH D2-5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Most important factor affecting ovarian reserve

A

Age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

The test that most predicts ovarian response

A

FSH- AMH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Difference between premature ovarian failure and aging

A

If AFC POOR + young age= aging
If associated w/ menopausal symptoms= failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

When to repeat abnormal semen analysis

A

If abnormal: after 3 months
If azoospermia or severe abnormality: ASAP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When to test progesterone to confirm ovulation

A

Midluteal progesterone
(7 days before menses)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Do TFTs or prolactin routine testing investigating infertility

A

Not routine
Prolactin: ovulatory disorder, glactorrhea or pituitary tumor
TFT: sym of thyroid disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

People undergoing ivf should be offered testing for

A

HIV
HEB B AND C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Criteria where reduce HIV transmission from +ve male to female

A
  1. the man is compliant with (HAART)
  2. the man has had a plasma VL less than 50 copies/ml for more than 6
    months
  3. no other infections present
  4. UPSI is limited to the time of ovulation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Classification of ovualtory disease

A

Griup 1: ⬇️GN hypogonadotropic hypogonadism( ttt with GN or Pulsatile GNRH)
Group 2: NORMAL GN PCOs 80%
Group 3: ⬆️ GN : POI (ttt w egg donation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Rotterdam PCO CRITERIA

A
  1. Androgenemia
  2. 12 or more follicles in 1 ovary
  3. Oligomenorrhea (oligoovulation)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Testing of tubal patency

A

Hx of PID or tubal morbidity?
Yes: laparoscopy and dye
No: HSG or Hystersalpingo ultrasonography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Which cases of ohss should be reported to the HFEA

Study These Flashcards
A

Severe and critical OHSS

20
Q

Most common chromosomal abnormality that may cause to azoospermia

21
Q

Indication to double embryo transfer in the 1st IVF cycle

22
Q

Portion of patient with pco tagt has metabolic syndrome

Study These Flashcards
A

1/3
-PCOS
- obesity
- high androgen
- atherosclerosis

23
Q

Risk factor for OHSS

Study These Flashcards
A

✔️ Previous OHSS,
✔ PCOS
✔ increased (AFC)
✔ high (AMH)

24
Q

When to admit patient with OHSS

Study These Flashcards
A

unsatisfactory pain control
• unable to maintain adequate fluid intake due to nausea
• worsening OHSS .
• unable to attend for regular outpatient follow-up
• Who have critical OHSS

25
Risk of Ohss on pregnancy
Pre eclampsia Preterm labor
26
Surgical management of OHSS
Only if adnexal torsion Ovarian rupture Ectopic pregnancy
27
What to give women of OHSS going paracentesis
- IV colloid should be considered for women who have large volumes of fluid removed by paracentesis (e.g Albumin 25% 50–100 g, infused over 4 hours and repeated 4- to 12-hourly + Strict fluid balance recording should be followed for these patients)
28
When to start investigations of infertility?
1. UPSI >1 y (if woman >36y: 6m) 2. after 6 cycles of assisted insemination 3. partner with apparent cause of subfertility
29
1st step investigations of infertility?
1. semen analysis 2. confirm ovulation: midluteal P4 3. tubal patency: HSG 4. Reserve: AMH- AFC
30
semen analysis parameters
Semen volume: 1.4 Normal forms: 4 Concent.: 16 mil/ml progressive motility: 30 total sperm number: 39 total motility 42 vitality: 54
31
when to perfrom midluteal progesterone test
before menses with 7 days if irregular cycle: day 28 of 35 then weekly till menses.
32
How do we test for tubal patency
Hx of PID or tubal morbidity? NO: 1. HSG 2. hystersalpingo-contrast ultrasonography YES: 1. Lap & dye
33
HOw to do induction with CC
CC 50-100mg D2-5 for 5 days for 6 months and not more than 1 year - Ovulatory: no pregn -> CC failure -> IVF - Non ovulatory: no preg. -> CC resistance | makes hypothalmus thinks E2 is low -> inc GnRh->inc Gn-> egg production
34
what to do in case of CC resistance
Failure: IVF Resistance: Another method of induction 1. Drilling 2. Gn 3. Metfromin +CC for another 6 months
35
Max period to used induction with CC
not more than 1 year
36
How to ttt ovulatory dirorders due to hyperprolactinemia
Treat with dopamin agonists: Is she trying to concieve? 1. yes: Bromocriptine (parlodel) 2. No : Cabergoline (dostinex)
37
How to ttt hydrosalpinx
laparoscopic salpingectomy esp. before IVF (improves live birth chance)
38
when to offer IVF to woman with unexplained infertility
after 2 years of regular UPSI
39
IUI indications
1. if IVF indicated but refused 2. same sex partner 3. need sperm washing (if HIV partner) 4. Azoospermia (obst. or non)
40
How many cycle of IUI do we offer
6 cycles then another 6 cycles before IVF
41
what is better with IUI fresh or frozenthawed sperms?
fresh
42
What is the most common cause of testicular failure
Idiopathic
43
Which cases of ohss should be reprted to HFEA
Only cases of severe and critical ohss
44
Which analgesic should be avoided in woman presenting with OHSS
NSAIDs
45
Most appropriate management of hydrosalpinx prior to ivf ttt
Laparoscopic salpingectomy
46
When in the cycle to perform endometrial scratching
7 days prior to menses, immediately before start of ovarian stimulation
MRCOG - Part 2
flashcards
Decks in class (75)
# Cards
Brainscape helps you reach your goals faster, through stronger study habits.
© 2026 Bold Learning Solutions. Terms and Conditions