Flashcards in Week 7.1 - Contraception and infertility Deck (29):
1
How does barrier contraception work?
-Prevents sperm reaching cervix
2
How does a diaphragm work?
-Inserted across the cervix to hold the sperm in the acidic environment to reduce survival
3
Name 4 hormonal contraceptions which prevent ovulation
-Combined OCP
-Depot progesterone
-POP (may inhibit ovulation)
-Progesterone implant (may inhibit ovulation)
4
How does the combined OCP inhibit ovulation?
-Negative feedback of oestrogen and progesterone inhibits follicular development
-loss of +ve feedback of oestrogen -> no LH surge
5
How often are depot injections?
-Every 3 months
6
How does depot progesterone inhibit ovuation?
-Negative feedback of progesterone inhibits ovulation by preventing follicular development and LH surge
7
Which contraceptions have producing a thick cervical mucus as there main method of action?
-POP
-Progesterone implant
8
How does producing thick cervical mucus act as a contraception?
-Prevents passage of sperm into cervix
9
Which hormonal contraceptions act by altering receptivity of endometrium for implantation?
-Emergency contraceptive pill
-Intrauterine devices
10
How long after coitus does the emergency contraception work?
-upto 72 hours
11
How do intrauterine devices work?
-Make endometrium hostile by interfering with endometrial enzymes
12
Name 3 methods of surgical contraception
-Ligation
-Clips
-Rings
13
What is the emergency contraceptive pill?
-High dose of combined OCP
14
Define infertility
-Failure to conceive within 1 year of trying
15
How common is infertility?
-Affects ~ 15% of couples
16
What % of infertility is due to male/female problems?
-20-25% male
-45-60% female
-20-30% unexplained
17
Give 5 causes of infertility
-Coital problems
-Anovulation
-PCOS
-Tubal occlusion
-Abnormal/Absent sperm
18
When is anovulation normal?
-Occasional, especially at extremes of age
19
List some causes of anovulation
-Ovarian failure
-Chemo/radiotherapy
-Pituitary tumour
-Weight loss
-Stress
-Exercise
-Hyperprolactinaemia
20
What is PCOS?
-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
Give 3 causes of tubal occlusion
-Scarring from infection
-Endometriosis
-Sterilisation
22
How is tubal occlusion diagnosed?
-Hysterosalpingogram
23
Give 3 causes of absent/abnormal sperm
-Testicular disease
-Infection
-Obstruction of ductus deferens
-Hypothal/pituitary dysfunction
24
How is anovulation diagnosed?
-Serum progesterone in middle of luteal phase (~day 21)
-Differentiate between causes by looking at hormone levels
25
Give the hormone profile of a women in menopause
-High LH/FSH
-Low oestrogen
26
Give the hormone profile of a women in ovarian failure
-High LH/FSH
-Low oestrogen
27
Give the hormone profile of a women with hypothalamic failure
-Low FSH/LS/oestrogen
28
Give 2 methods of inducing ovulation and state how they work
-Anti-oestrogen -> reduced -ve feedback to hypothal/pit -> increased GnRH/LH/FSH eg aromatase inhibitor
-Gonadotropins -> stimulates FSH/LH
29