Which 2 organisms are common causes of Pelvic Inflammatory disease (PID)
- Chlamydia
2. Gonorrhoea
Main complications of PID
- Infertility
- Ectopic pregnancy
- Chronic pelvic pain
Investigations for PID
- abdo exam + bimanual palpation
- swabs
- FBC, CRP, ESR
When should PID patients be reviewed
4 weeks later (check therapy compliance + confirm screening of sexual contacts)
Treatment for PID if woman is at LOW risk of gonoccocal infx
- Ofloxacin
2. Metronidazole
Treatment for PID if woman is at HIGH risk of gonoccocal infx
- Ceftriaxone
- Doxycycline
- Metronidazole
What is normal
- Sperm volume
- Sperm count
- Progressive motility
- Sperm volume: >1.5mL
- Sperm count: >15 million/ mL
- Progressive motility: >32%
What is oligospermia
Sperm count less than 15 million/ mL
What is asthenospermia
Absent/ low motility
Common causes of abnormal semen analysis
- Unknown
- Smoking, alcohol, drugs, chemical, inadequate local cooling
- Genetics
- Antisperm antibodies
What 2 types of drugs commonly cause abnormal semen analysis
- Sulfasalazine
2. Anabolic steroids
What genetic conditions are associated with abnormal semen analysis
- Klinefelter’s syndrome (XXY) -> azoospermia
2. Cystic fibrosis -> absent vas deferens + azoospermia
What hormones are tested to find endocrine causes of subfertility
- FSH, LH
- Testosterone
- Prolactin
- TSH
How does hyperprolactinaemia cause ovulatory dysfunction
Increased prolactin causes reduced GnRH release
Risk factors for hypothalamic hypogonadism
- Anorexia nervosa
- Extreme diet
- Atheletes
Pathology of Kallman’s syndrome
Congenital hypothalamic hypogonadism
GnRH secreting neurones fail to develop
