Day 06

Infertility and IVF Review

By Dr Bijoy Kar
Compiled by Dr Habtamu Gebeyehu
Sep, 2020
Infertility and IVF Review
1. What is the conclusive evidence of ovulation has occurred?

Pregnancy

2. Incidence of multiple pregnancy with Clomiphene?

A. 1

B. 8

C. 15

D. 25%

3. HMG (Human menopausal Gonadotropin) contains?

A. FSH

B. LH

C. LH + FSH

D. HCG
4. Name of this instrument?

A. Uterine manipulator

B. Fertiloscope

C. 3 way uterine irrigation canula

5. Antral follicles count less than ............... indicates poor ovarian reserve

A. 3

B. 4

C. 5

D. 6
6. Name of the procedure used to look for tubal patency in which methylene dye is injected in
intrauterine cavity ?

Answer
7.

Figure A

Figure B

Which one is IVF? And Which one is ICSI?

Fig A … IVF

Fig B … ICSI
8. Name of the procedure?

Intrauterine insemination

9. Left below corner inset there is a picture

Look at the tip of the plastic catheter

Is it spermatozoa?

Answer

IVF –ET: In vitro fertilization and embryo transfer

10. Name of this instrument used for tubal potency?

Falloposcope
11. Name of this procedure?

Could be Gamate, Embryo, Ovarian tissue Or any tissue

What is the name of this storage procedure?

Cryopreservation
12. Sir are there any indications to store ovarian tissue ?

In cancer patient when she has not attained puberty

13. How would that help sir ?

Preservation of primordial follicles for later invitro maturation or later autotransplantation

14. Give 1 example of WHO class Il Cause of Female infertility?

PCOS

15. There is a new group called class IV. What comes under it?

Hyperprolactinemia

16. Please remember it

WHO classification is only for Anovulatory causes of infertility

17. Ideal condition for giving hCG trigger in ovulation induction is?

A. E2 level 450-1000 pg/ml

B. 1-2 follicles > 16 my size

C. Endometrial thickness = 8mm

D. All of the above

18. Most important factor for causation of ovarian hyperstimulation syndrome OHSS is VEGF.

True

Or

False

19. Increased estrogen leading to increase VEGF causing increased vascular permeability

Shouldn't we say sir that main reason is estrogen increase

But it doesn't make the above sentence wrong if you consider how estrogen acts in causation
of OHSS

20. Definition of Premature ovarian Failure. According to ESHRE guideline👇

Repeat of FSH should be done after 4 weeks

21. Level of AMH can be measured any day of cycle

True

Or

False

 As it is produced by granulosa cells Of preantral small follicles

22. Incidence of multiple pregnancy with HMG?

A. 5

B. 10

C. 30%

23. First investigation for tubal patency?

HSG

24. When it should be done?

10th -11th day of cycle

After menstruation but by day 10

25. Best result of reversal of tubal canalization is achieved if tubectomy was done in which part
of Fallopian tube?

Isthmo-ishthmic

26. Final length of tube after recanalization should be?

4 cm
27. Most common fibroid leading to subfertility?

Submucous fibroid

28. Most common congenital malformation leading to infertility?

Septate

29. Sperm agglutination test is a screening test to detect antisperm antibody.

True

Or

False

 It is a confirmatory test not screening test

30. Name One screening test for antisperm antibody?

Postcoital test

What is the other name of this test?

Sims n huhners test

31. For presence of antisperm antibody condom should be used for how many months?

A. 1

B. 2

C. 3

D. 6

32. Test used to know study tail function of spermatozoa is?

Hypoosmotic swelling test

33. Swim up is one of the procedure for sperm preparation

34. Score used for sperm permeability of cervical mucus is?

Insler score

35. Management for severe distal tubal block is?

IVF

 If severe fimbrioplasty won't help

36. Name one clinical tubal patency test which is no longer used for chances of spreading of
infection in presence PID? Here is the clue Name of this cannula?

So the answer is Rubin's insufflation test

37. In Luteal phase defect or LPD, level of midluteal serum progesterone is?

A. <5

B. <10

C. <20ng/ml

38. Most common cause of bilateral proximal tubal block is ?

Physiological spasm

On hsg

41. 32yrs under ovulation induction develops 9cm ovarian cyst with ascities within few days.
Which grade of OHSS?

A. 1

B. 2

C. 3

D. 4

E. 5

 3 ... It's moderate or grade 3

39.

Here grade 1 is minimal which is not mentioned on the table

Grade 2 mild

Grade 3 moderate

Grade 4 severe

Grade 5 critical

But follow this table only because you will get maximum information
40. Estrogen (E2) > 3500 pg/ml increases chances of OHSS

True

Or

False

41. Major contribution of human seminal fluid is from?

Prostate

Or

Seminal vesicle

42. Distal block most commonly caused by organism?

Neisseria gonorhea

43. Cornual block by which organism?

TB

44. Full form of ART procedures like SUZI & POST

SUZI- Subzonal insemination

&

Post- Peritoneal oocyte and sperm transfer

45. Full form of TESA, MESA, PESA, TESE

TESA Transepididymal sperm aspiration

PESA-percutaneous epididymal sperm aspiration

TESE Testicular sperm extraction-tese

MESA micropepididymal sperm aspiration

MESA microsurgical epididymal sperm aspiration

46. Repeated IVF failure is an indication of ICSI

True

Or

False

47. Temperature of liquid nitrogen for cryopreservation?

-196degC

48. Normal Sperm liquefaction time?

20-30minutes

49. Time taken to reach Fallopian tube?

Only 2 minutes

50. Normal capacitation time?

7 hrs
51. Incidence of multiple pregnancy with letrozole?

5%

52. Which dye in HSG can increase pregnancy rate but increases rate of granuloma formation?

Water bases dye

Or

Oil based dye

53. Most common time of embryo transfer is?

A. Day 2

B. 3

C. 4

D. 5

 And the best time for transfer is Day 3

54. Miller Kurzko test used for detection Of cervical hostility

True

Or

false

 For sperm mucus interaction < 3 CM of sperm penetration of cervical mucus in

30min means abnormal
55. Most common cause of Asherman syndrome?

Postpartum curettage

56. What is the full form of PGD & PGS

Pregestational Genetic

D-Diagnosis

S-Screening

57. Treatment for Asherman Syndrome?

Hysteroscopic adhesiolysis +Balloon catheter inflation or IUCD insertion +combined OCPs

58. Name some testicular cause of male infertility?

Mumps orchitis

Trauma

Vericocele

Torsion