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Infertility - Coggle Diagram

- - - - THyroid screening, Prolactin, Day 3 FSH
    - - AMH (antimullericaan homrone)
        
        Secrteted by pre-antral, early antral follicles
        
        Reflects size of pool of primordial follicles
      - Antral Follicle count
      - Predicts response to external FSH stimulation
  - - - Unexplained infertility regardless of age, older than 35, family history of early menopause, previous chemo/radiation, smokers
  - - - Evaluate uterine contour and tubal patency
    - - Evaluate the tubal patency directly
    - - Assessment of uterine cavity, for polyps, fibroids, adhesions
- - - - Inhibin-B is prouced by granulosa cells, provides negative feedback to keep FSH low
      - Inhibit B declines with H, resulting in FSH levels early rise in mensutral cycle
      - First sign of voarian aging
  - - - Hypothalamic amenorrhea (Hypogonadotropic hypogonadism)
        
        Causes
        
        Stress, Congenital GnRH deficiency, Acquired GnRH deficiency
      - PCOS
        
        Rotterdam Criteria
        
        2/3: Multicystic ovaries, Hyperandrogenism, Oligo/Anovulation
      - Ovarian Failure (POI)
        
        Diagnositic Criteria
        
        <40, 4 monhts of amenorrhea, high FSH
        
        Causes
        
        Genetic, Iatrogenic, Auytoimmune
      - Prolactinoma, Thyroid Dysfunction, pregnancy, Uterine Adhesions
- - - - Good for thos with unexplained infertility, oligo/anovulation, moderately low sperm counts
    - - Time consuming, emotionally demanding, expensive
  - - - Severe tubal disease, severe endometriosis, Severe oligo/azoospermia
      - When donor egg is needed
    - - Gonadotropin stimulation to grow follicles, close ultrasound nad bloodwork monitoring, egg retrieval, embryo transfer
    - - Over-response to gonadotropins leading to vascular leak