Shared Flashcard Set

Details

Gamete Transport & Infertility/IVF
Reproductive Module Lectures
22
Medical
Professional
03/04/2011

Additional Medical Flashcards

 


 

Cards

Term

 

Where does sperm maturation happen?

capacitation? 

Definition

 

sperm maturation happens outside the testes in the caudal epididymis; capacitation occurs in females (f. tubes??) 

Term

 

What are the 3 parts of capacitation? 

Definition

 

1. ability to undergo acrosome reaction

2. ability to find zona pellucida

3. acquisition of hypermotility

Term

 

 Acrosome Reaction

Definition

-breakdown of merging of plasma membrane & outer acrosomal membrane

-proteases release to help penetrate egg

-inner acrosomal membrane fuses w/ oocyte plasma membrane

-hyperactivity and attachment/penetration to zona pellucida. 

Term

-cross-linking of structural proteins --> hardens extracellular layer

-inactivates ligands for sperm receptors

-depolarizes oocyte membrane (initial & transient)

-permanent block against sperm caused by Ca2+ release which releases enzymes

Definition

 

Zona Reaction

Term

 

What are pinopods? 

Definition

 

surface epithelial cells found in endometrium which lose microvilli & develop small protrusions & appear around day 21; blastocyst attach to this

Term

 

When does implantation happen? and what are the 3 stages? 

Definition

 

5 days after fertilization; 

1) apposition, 2) adhesion, 3) invasion/migration

Term

 

What are some players during apposition & adhesion in implantation? 

Definition

 

Heparin-binding epidermal growth factor, adhesion molecules (integrins & selectins), cytokines

Term

 

Basic process of trophoblast invasion in endometrium? 

Definition

  • wall of spiral arteries destroyed & sinusoidal sacs formed --> vasculature remodeled
  • intrusion of epithelium, and cells lift off BM and allow tropho to gain entry
  • fusion of tropho + uterine epithelial cells (1/3 of myometrium turns to cytotrophoblast). 

 

Term

 

major players in trophoblast invasion? 

Definition

 

Serine proteases and metalloproteinases & decidual cell layer [more info. on this]

Term

 

When is the maternal serum HCG detectable after implantation? 

Definition

 

10 days after ovulation; 

 

USMLE: no earlier than 6 days after and may require up to 11 days

Term

 

 

What is the triad of ectopic pregnancy?

Definition

 

Abdominal pain, vaginal bleeding, amenorrhea 

Term

 

Most common location of ectopic pregnancy? 

Definition

 

Ampulla of tube 

Term

 

Dx of ectopic pregnancy? 

Definition

 

  • serial Hcg levels: falling or abnl rising
  • transvaginal US: adnexal mass, free fluid in pelvis, no intrauterine pregnancy
  • progesterone < 5ng/ml 

Term

 

What are the 4 major categories of infertility? 

Definition

  • abnormal ovulation & oocyte production
  • D/Os of transport: cervix, uterus, fallopian tubes and peritoneum
  • abnormal sperm 
  • unexplained

Term

 

What hormone increases basal body temperature? what type of curve is indicative of ovulation? 

Definition

 

Progesterone, 

biphasic curve 

Term

 

What is the most common cause of anovulatory infertility? 

Definition

 

PCOS 

Term

 

What causes PCOS & what is the tx? 

Definition

*high insulin & androgens

 

  • tx: clomid: occupies estrogen receptors, alters feedback, increased FSH & LH --> ovulation! 
  • metformin: insulin sensitizer
  • weight loss 

 

Term

 

In regards to infertility, do increased FSH indicate poor or good pregnancy outcomes? 

Definition

Poor

 

increased FSH , less sensitive [ovaries] and thus require higher levels of FSH for follicular development --> not good :( 

Term

 

Three risk factors for anatomic abnormality that lead to infertility? 

Definition

 

Pelvic Inflammatory Disease (PID), Pelvic Surgery, Endometriosis 

Term

 

Diagnosis of anatomic abnormalities --> infertility? 

Definition

Hysterosalpingogram:X-ray test that examines the inside of uterus and fallopian tubes and the surrounding area.


Ultrasound: eval of uterus


Laparoscopy

Term

 

What is the gold standard for diagnosis of pelvic pathology and endometriosis? 

Definition

 

Laparoscopy

 

*I think this has been mentioned before. 

Term

 

For male infertility, what is the most important factor in predicting infertility 

Definition

 

Morphology of sperm in Semen Analysis (SA)

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