Module 2 C

Question 1

1. Which physiologic indicators might tell someone that they will soon ovulate?

Answer 1

a. Thin clear vaginal mucous

Question 2

2. Which physiologic indicators might indicate that they have already ovulated?

Answer 2

Increase basal body temperature

Question 3

Which hormone is responsible for which event

Answer 3

a. GnRH: Causes the anterior pituitary gland to stimulate FSH and LH
b. FSH stimulates follicles to grow and produce estrogen: FSH- follicles-estrogen.
c. LH promotes ovulation: LH-ovulation

Question 4

a. What does a regular cycle indicate about ovulatory status?
b. What does an irregular cycle indicate about ovulatory status?
c. WHY?

Answer 4

a. That all of the hormones are balanced to support natural conception
b. The body does not release an egg
c. An underlying fertility or hormonal issue

Question 5

5. How often and when during the menstrual cycle should clinicians advise intercourse when a couple desires pregnancy?

Answer 5

a. 1-2 times during the 18-

Question 6

6. How long does an oocyte survive if not fertilized?

Answer 6

12-24 hours

Question 7

a. How long do sperm remain capable of fertilizing an egg?

Answer 7

up to 5 days

Question 8

a. In addition to intercourse timing, what other counseling should the clinician provide to a couple who desires pregnancy?
b. What are the pros and cons (logistically, emotionally, financially) of those methods of determining the fertile window?

Answer 8

a. Estimating ovulation based on the number of cycle days.
Measuring the basal body temperature.
Monitoring cervical mucus.
Using ovulation predictor kits.

Question 9

8. What are the general timeframes for fertilization, traveling toward implantation, and implantation

Answer 9

It’s more helpful to consider that the blastocyst starts the process of implantation around day 6-7 and is fully implanted by day 10-12.

Question 10

a. What are the general timeframes for the embryonic vs. fetal periods?
b. For organogenesis?

Answer 10

b. Organogenesis begins at around the time of the first missed period, when many people are unaware of a pregnancy. This is the period of highest vulnerability to exposures that can affect embryonic development.

Question 11

10. What is the definition of teratogen?

Answer 11

a. A teratogen is any substance that can compromise normal embryonic/fetal development and result in a change in embryonic/fetal growth, structure, or function.

Question 12

11. How are teratogens usually identified?

Answer 12

a. Most teratogens are identified by observations of affected individuals’ post-exposure

Question 13

a. What are some common teratogens and how can clinicians assess for potential exposure in the preconception period?
b. What resources are available to assist in determining workplace environmental exposures?

Answer 13

a. Some substances that can be teratogenic are medications, drugs, alcohol, tobacco, some viruses and bacteria, certain health conditions such as uncontrolled diabetes, and environmental agents such as mercury, lead, Pesticides, arsenic, air pollution, anesthetic gases and endocrine-disrupting compounds.
b. The OSHA mandates that the names and health effects of all chemicals be available to workers on site via the material safety data sheet (MSDS)

Question 14

13. What is considered the most critical time for teratogenesis, particularly for harm to the embryonic/fetal central nervous system?

Question 15

14. What is the “all-or-nothing” period in early pregnancy?

Answer 15

This pre embryonic period, beginning with fertilization and ending with full implantation about 2 weeks later
This means that exposures during this period will usually result in EITHER damage to all cells and early pregnancy loss OR no significant effects on the pregnancy.

Question 16

15. In a preconception setting, how can you communicate with patients about vulnerable periods in embryologic development?
    How can you provide accurate information that they can use to make decisions but without being unnecessarily alarmist?

Question 17

Compare Postconceptual weeks vs Menstrual week

Answer 17

postconceptual weeks 1 and 2 = menstrual weeks 3 and 4.

Question 18

The embryonic period

Answer 18

a. The embryonic period begins 2 weeks after fertilization and ends 6 weeks later.
b. Thus the embryonic period is weeks 3-8 in post-conceptual weeks and weeks 5-10 in post-menstrual weeks

Question 19

When does organogenesis begin

Answer 19

Around of the first missed period, when people are unaware of pregnancy.

This is the period of highest vulnerability to exposure that can affect embryonic development.