Treatments For Infertility - Ovarian Pathology (Part 2)

treatments for infertility - ovarian pathology (part 2) Study online at https://quizlet.com/_8ap6ef what is assisted conception? any technique that is used to assist conception slight assistance is used for infertility caused by X anovulation what does 'slight assistance' induce? ovulation •intercourse must also be timed what are the least invasive interventions for anovulation? pharmacological interventions what drug is commonly given to treat anovulation? clomiphene what type of drug is clomiphene? oral anti-oestrogen drug how long is clomiphene taken for and when? it is taken for 5 days at the start of the cycle how does clomiphene work? •agonist at oestrogen receptors in the hypothalamus •reducing oestrogen reduces inhibition of FSH production •FSH can stimulate formation of follicles using ultrasound scan how are the number of follicles monitored? the woman should use contraception and if there are too many follicles in the fetry again during the next cycle male reproductive tract, what does the •could result in a high nº of births, which clinician advise? is high risk for the patient and the foetuswhy? es intrauterine insemination what does IUI stand for? 1/6 treatments for infertility - ovarian pathology (part 2) Study online at https://quizlet.com/_8ap6ef obtain the sperm from a donor of the male partner what is the first step of an IUI? semen is high in prostaglandin why is the semen produced washed in a •prostaglandin can cause uterine conlab? tractions, which are painful how can an IUI be perfectly timed? following the natural cycle of the woman or stimulating ovulation using clomiphene give 2 advantages of the use of IUIs •fairly non-invasive •bypasses cervical mucus, which acts a barrier to sperm why are IUIs not offered routinely? •low success rate •probability of multiple pregnancies is high •expensive give one reason why IUIs are expensive: requires sperm washing in the lab, which can be highly expensive 50-100k motile sperm are added to an oocyte and left to fertilise summarise the process of IVF: IntraCytoplasmic Sperm Injection if the IUI, IVF and the slight assistance do not induce fertility, what is the final thing that is used? 2/6 treatments for infertility - ovarian pathology (part 2) Study online at https://quizlet.com/_8ap6ef •severe male factor e.g. man has erectile what are the 2 indications for an ICSI? dysfunction •failure at IVF in cases where there is a low sperm count in the ejaculate, where is sperm extracted from? •epididymis •testes a highly convoluted mass of thin tubes that transfer sperm from testes to ductus deferens what is the epididymis? in an ICSI, how many sperms are given per egg? one sperm per egg in order to produce eggs in the female, what process is done? ovarian stimulation prior to stimulating the ovaries, what gland must be suppressed? the pituitary gland (H-P-G) what are the 2 types of drugs that can be used to suppress the pituitary? GnRH antagonist or agonist GnRH is released in a pulsatile fashion how does a GnRH agonist work in sup•increased GnRH levels down-regulates pressing the pituitary? its production agonist: stimulatory 'flare' followed by down-regulation of GnRHR, so it is longer compare a GnRH agonist and a GnRH antagonist in terms of onset of action: antagonist: gonadotrophin release is immediately suppressed (ovarian stimulation) what is the step after pituitary suppression? ovarian stimulation rFSH (r = recombinant) 3/6 treatments for infertility - ovarian pathology (part 2) Study online at https://quizlet.com/_8ap6ef what hormone is given to stimulate the ovaries? what is the aim when giving rFSH? the development of many follicles monitor the follicular growth using an ultrasound scan after ovarian stimulation, what do clinicians do? if the patient has enough follicles, what hormone is given? hCG (to bring about the LH surge) why is hCG given (to mimic the LH surge) and not LH? hCG has a longer half life than LH stimulates follicle to complete meiosis 1 why do we give hCG to the woman, once and begin meiosis 2 she has enough follicles? •in a state where it can be fertilised how long after giving hCG are eggs collected? 24 hours later an ultrasound scan + a needle used to suck the eggs out of each follicle how are oocytes collected? after egg collection, what do we do? insemination/injection for how long do we culture the embryos (in vitro)? day 5/6 1 or 2 embryos how many embryos are transferred? 4/6 treatments for infertility - ovarian pathology (part 2) Study online at https://quizlet.com/_8ap6ef after the embryo has been transferred, progesterone to encourage formation of what hormone is given and why? corpus luteum summary of the steps of infertility treatment: 1. pituitary suppression 2. ovarian stimulation 3. monitoring follicular growth 4. hCG triggering 5. 24 hours later, eggs are collected 6. insemination/injection 7. embryo culture 8. embryo transfer 9. luteal support what is the chance of success via IVF/ICSI? 1 in 4 chance what is blastocyst culture? culture of embryos 5-6 days before transfer at the blastocyst stage: 1. the embryonic genome is switched on 2. embryo is no longer totipotent but has what are 2 advantages of culturing em- undergone first differentiation bryo to blastocyst stage, rather than an earlier stage? (link to embryogenesis) 1. men with severe infertility 2. women w/premature ovarian failure or name 3 groups of people who may conTurner's syndrome sider using donor gametes? 3. a couple where one or both people are carriers of a heritable disease Preimplantation Genetic Testing what is PGT? outline the process of PGT: 5/6 treatments for infertility - ovarian pathology (part 2) Study online at https://quizlet.com/_8ap6ef one or two cells are removed from the early embryo for genetic analysis couples that have genetic disorders in what couples may consider carrying out the family a PGT? •healthy embryos can be selected and why? transferred - ethics? name two examples of genetic diseases CF, Huntington's disease name 4 risks of IVF/ICSI: 1. multiple pregnancies 2. ovarian hyperstimulation syndrome (PCOS) 3. invasive for women 4. risk of congenital abnormalities/long term maternal risks the follicles release VGF, which increases vascular permeability describe how VGF can lead to fatalities > leads to more fluid in the lungs + abin the mother: domen >can lead to reduced blood volume if there is a severe male factor causing infertility, what consequences could this have on future generations? the inheritance of male infertility > ethics 6/6