Week 7.1 - Contraception and infertility Flashcards Preview

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Flashcards in Week 7.1 - Contraception and infertility Deck (29)
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1
Q

How does barrier contraception work?

A

-Prevents sperm reaching cervix

2
Q

How does a diaphragm work?

A

-Inserted across the cervix to hold the sperm in the acidic environment to reduce survival

3
Q

Name 4 hormonal contraceptions which prevent ovulation

A
  • Combined OCP
  • Depot progesterone
  • POP (may inhibit ovulation)
  • Progesterone implant (may inhibit ovulation)
4
Q

How does the combined OCP inhibit ovulation?

A
  • Negative feedback of oestrogen and progesterone inhibits follicular development
  • loss of +ve feedback of oestrogen -> no LH surge
5
Q

How often are depot injections?

A

-Every 3 months

6
Q

How does depot progesterone inhibit ovuation?

A

-Negative feedback of progesterone inhibits ovulation by preventing follicular development and LH surge

7
Q

Which contraceptions have producing a thick cervical mucus as there main method of action?

A
  • POP

- Progesterone implant

8
Q

How does producing thick cervical mucus act as a contraception?

A

-Prevents passage of sperm into cervix

9
Q

Which hormonal contraceptions act by altering receptivity of endometrium for implantation?

A
  • Emergency contraceptive pill

- Intrauterine devices

10
Q

How long after coitus does the emergency contraception work?

A

-upto 72 hours

11
Q

How do intrauterine devices work?

A

-Make endometrium hostile by interfering with endometrial enzymes

12
Q

Name 3 methods of surgical contraception

A
  • Ligation
  • Clips
  • Rings
13
Q

What is the emergency contraceptive pill?

A

-High dose of combined OCP

14
Q

Define infertility

A

-Failure to conceive within 1 year of trying

15
Q

How common is infertility?

A

-Affects ~ 15% of couples

16
Q

What % of infertility is due to male/female problems?

A
  • 20-25% male
  • 45-60% female
  • 20-30% unexplained
17
Q

Give 5 causes of infertility

A
  • Coital problems
  • Anovulation
  • PCOS
  • Tubal occlusion
  • Abnormal/Absent sperm
18
Q

When is anovulation normal?

A

-Occasional, especially at extremes of age

19
Q

List some causes of anovulation

A
  • Ovarian failure
  • Chemo/radiotherapy
  • Pituitary tumour
  • Weight loss
  • Stress
  • Exercise
  • Hyperprolactinaemia
20
Q

What is PCOS?

A

-Elevated androgen secretion from theca cells of unknown pathogenesis producing the PCOS phenotype of excessive hair, amenorrhea/menorrhagia, anovulation, cystic ovaries and insulin resistance

21
Q

Give 3 causes of tubal occlusion

A
  • Scarring from infection
  • Endometriosis
  • Sterilisation
22
Q

How is tubal occlusion diagnosed?

A

-Hysterosalpingogram

23
Q

Give 3 causes of absent/abnormal sperm

A
  • Testicular disease
  • Infection
  • Obstruction of ductus deferens
  • Hypothal/pituitary dysfunction
24
Q

How is anovulation diagnosed?

A
  • Serum progesterone in middle of luteal phase (~day 21)

- Differentiate between causes by looking at hormone levels

25
Q

Give the hormone profile of a women in menopause

A
  • High LH/FSH

- Low oestrogen

26
Q

Give the hormone profile of a women in ovarian failure

A
  • High LH/FSH

- Low oestrogen

27
Q

Give the hormone profile of a women with hypothalamic failure

A

-Low FSH/LS/oestrogen

28
Q

Give 2 methods of inducing ovulation and state how they work

A
  • Anti-oestrogen -> reduced -ve feedback to hypothal/pit -> increased GnRH/LH/FSH eg aromatase inhibitor
  • Gonadotropins -> stimulates FSH/LH
29
Q

Name 3 methods of barrier contraception

A
  • Condoms
  • Diaphragm
  • Cap