Infertility

Question 1

define

Answer 1

inability to conceive after 12 months of regular intercourse without conception

Question 2

classification of infertility

Answer 2

1. primary

2. secondary

Question 3

what is primary infertility

Answer 3

never conceived

Question 4

what is secondary infertility?

Answer 4

unsuccessful

Question 5

what three things to consider in a couple presenting with infertility?

Answer 5

ovulation
tubal patency
sperm count

Question 6

commonest cause of infertility?

Answer 6

PCOS

Question 7

diagnosis of infertility

Answer 7

confirm regular cycles with mid-luteal serum progesterone
TSH
rubella, chlamydia screen
smear check
semen analysis
TVUS
HSG
diagnostic laparoscopy

Question 8

what is normal sperm concentration?

Answer 8

15 x 10^6 per ml

Question 9

normal sperm motility

Answer 9

32%

Question 10

define azoospermia

Answer 10

no sperm in ejaculate

Question 11

define asthenozoospermia

Answer 11

%progressive motile sperm below reference limit

Question 12

define oligozoospermia

Answer 12

total number/ concentration of sperm below reference

Question 13

define teratozoospermia

Answer 13

% morphologically normal sperm below reference limit

Question 14

lifestyle advice for infertility

Answer 14

stop smoking
BMI
alcohol
caffeine
drugs/ methadone
folic acid

Question 15

ovulation induction methods

Answer 15

1. clomifene citrate (alternatives are tamoxifen, letrozole)
2. gonadotrophin injections (FSH)
3. laparoscopic ovarian diathermy (risks destruction)

Question 16

management of tubal disease

Answer 16

IVF

cannulation

Question 17

ART options

Answer 17

IUI
IVF
ICSI

Question 18

criteria for ART treatment

Answer 18

stable relationship for 2 years
<40
BMI 18.5-30
non-smokers
no child
no substance use
no sterilisation
duration of infertility for 2 years