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NURO733 Exam 2 Questions And Complete Answers
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NURO733 Exam 2 Questions AndComplete Answers
6 months - Answer if >35, start infertility evaluation after this many months of trying to
conceive
7.5-8 cm - Answer normal uterus length from fundus to cervix
4.5-5 cm - Answer normal uterus depth (AP)
2.5-3.0 cm - Answer normal uterus width (coronal view)
72 days - Answer how many days does it take sperm to develop from immature to
mature
infertility - Answer the following labs should be performed to evaluate what?
AMH
FSH
Thyroid Panel
Prolactin
Vitamin D
AMH - Answer shows the quantity of eggs in ovary/ovarian reserve. produced by
granulosa cells of early follicles independent of gonadotropin so levels remain
consistent
between 0.9 - 9.5
ideally > 1 ng/ml. high = PCOS, low = poor ovarian response/embryo quality
less cycle to cycle variation
can be checked any cycle day
wait 30 days after stopping BCM to check this
declines with age
fertility - Answer the following tests can be performed to evaluate what?
basic semenalysis with morphology, genetic carrier screening, hysterosalpingogram
,antral follicle count - Answer measures # of antral follicles in both ovaries during the
early follicular phase during transvaginal ultrasound. screens for poor ovarian response
to gonadotropin stimulation
low count < 6
2-9 mm follicles
some cycle to cycle variation
declines with age
measure on cycle days 2-4
8-10 - Answer average antral follicle count
follicle stimulating hormone - Answer ideally <10, shows how ovary is operating
cycle dependent (do cycle day 2-4)
produced by pituitary gland -pulsatile
>15 million - Answer normal sperm count is __________ per mL
40% - Answer normal sperm count motility percent
4% - Answer normal sperm count morphology percent
intrauterine insemination - Answer sperm must be washed because prostaglandins
cause allergic reaction with uterus
may use medications in conjunction i.e. clomid, femara, injectible gonadotropins
used to treat infertility or by women who wish to conceive but do not have a male
partner
clomid - Answer 1st line for ovulation induction in women w/out PCOS -- for women who
are anovulatory or have unexplained infertility (in combo with IUI)
eval baseline blood work on cycle day 2, 3, or 4 with estradiol, progesterone, LH, FSH,
beta
begin med on cycle day 3, 4, or 5 and take x 5 days. ovulation occurs 14 days after 1st
dse
MOA: cause increase in release of pituitary gonadotropins which results in growth of
ovarian follicle and increase in circulating amount of estradiol, gives multiple egg
containing follicles, higher rate of multiple gestation. increases secretion of GnRH
which stimulates pituitary to secrete FSH and LH which initiate an ovulatory menstrual
cycle
, AE: HA, nausea, irritability, night sweat, fatigue, vag dryness, thinning endometrium, hot
flashes, ovarian cysts
warning: visual disturbance
note: use for 3 cycles in women w/ unexplained infertility and 6 cycles for women who
are anovulatory
letrozole - Answer not FDA approved for ovulation induction, first line for PCOS to
induce ovulation or 2nd line for women who do not become preg with clomid
evaluate baseline blood work on cycle day 2, 3, or 4 (estradiol, progesterone, LH, FSH,
beta)
begin med on cycle day 3, 4, or 5 and take x5 days
BBW: Cat X
AE: fatigue, hot flash, dizziness
note: if conception does not occur after 3-5 cycles, refer to REI specialist
oral fertility medications - Answer reevaluate with bloodwork/sonogram to determine
response
possible imropoved endometrial response, fewer multiple gestation pregnancy
AE: hot flash, night sweats, irritability, HA
in vitro fertilization - Answer stimulate multiple eggs to maturation with FSH/LH
containing injectable meds for 12 days
ultrasound guided transvaginal egg retrieval under surgical anesthesia
external fertilization in lab, closely monitor x 3-5 days. embryos transferred to uterus
(similar to IUI)
rates of success 40-50%. per embryo transfer is 60-70%
ICSI - Answer is an in vitro fertilization procedure in which a single sperm is injected
directly into an egg. done when low sperm count or another factor of male infertility
2 ml - Answer normal semen volume
7.2-7.8 - Answer normal semen pH
menopause - Answer 1. number of follicles decrease with age
2. decreased estrogen from granulosa cells
3. inhibition of gnrh feedback loop
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