Fertility and Reproduction Exam 2

Infertility (definition)

Inability to conceive after ___ months of unprotected, well-timed intercourse (or ___ months if woman >35) → 12

Infertility prevalence (conceptual)

Male factor accounts for ___%, female factor ___%, and remaining cases are ___ or unexplained → 30%

Infertility demographics (conceptual)

Infertility affects ___ races and demographics, but rates ___ between groups → all

Infertility services usage (data)

% of white women who have used infertility services → 15.8%

Infertility services usage (data)

% of Hispanic women who have used infertility services → 12.2%

Infertility services usage (data)

% of Black women who have used infertility services → 10.7%

Insurance coverage (conceptual)

Less than ___% of private insurance plans cover infertility services → 25%

Insurance policy (conceptual)

Medicare, Medicaid, and ACA ___ require infertility coverage → do NOT

US infertility prevalence (women)

Number of US women affected → 6.7 million

US infertility prevalence (men)

Number of US men affected → ~4 million

Infertility service seeking (data)

Number of US women who have sought services → 7.4 million

Treatment gap (conceptual)

% of women with difficulty conceiving who seek care → 44%

Causes of infertility (categories)

Three broad categories → misinformation, STI, lifestyle, and biological factors

Male infertility causes (list)

Key causes → smoking, STI, environmental toxins

Sperm trends (conceptual)

Sperm counts are ___ globally, especially in ___ countries → decreasing

Male infertility unknowns (conceptual)

Epidemiology of sperm decline is ___ → not well understood

Environmental contributors (conceptual)

Possible causes include increased heat from ___ and ___ in plastics → climate change

Female infertility trend (conceptual)

Female infertility is ___ increasing over time → not currently suspected

Female infertility main causes

Three primary sources → scarred fallopian tubes, PCOS, endometriosis

Fallopian tube damage (definition)

Caused by ___ leading to scarring → pelvic inflammatory disease

PCOS (definition)

Hormonal disorder affecting ovulation → Polycystic Ovary Syndrome

Endometriosis (definition)

Growth of uterine lining tissue ___ the uterus → outside

Endometriosis trend (conceptual)

Rates are ___ over time → increasing

STI infertility cause (conceptual)

1 STI leading to infertility → untreated chlamydia

Chlamydia prevalence (data)

Annual US cases → 4–5 million

Pelvic inflammatory disease (mechanism)

Causes ___ of fallopian tubes preventing fertilization or implantation → scarring

Birth control limitation (conceptual)

The pill does ___ protect against STIs → NOT

Smoking and infertility (data)

% of female infertility caused by smoking → 13%

Weight and infertility (data)

% of infertility due to abnormal weight → 12%

Weight factor (conceptual)

Weight-related infertility is nearly ___ reversible → 100%

Ovulatory issues (data)

% of infertility caused by ovulation problems → 25%

Fertility health behaviors (list)

Key behaviors → don’t smoke, moderate alcohol, healthy BMI, track cycle

Infertility disparities (conceptual)

Most infertility occurs in ___ and ___ due to inadequate care → poor women

Age and infertility (conceptual)

Most infertility affects women in their ___ → 20s

Delayed childbirth trend (conceptual)

Age-related infertility rising due to ___ → later first births

Advanced maternal age (conceptual)

Successful births in 40s increasing due to ___ → improved healthcare

Age-related infertility (definition)

Fertility decline that accumulates over ___ → time

Gender difference (conceptual)

Age-related infertility appears earlier in ___ → women

Genetic risks (conceptual)

Older sperm and eggs linked to ___ and ___ → developmental disabilities

Pregnancy risks with age (conceptual)

Increased risk of ___ and ___ → preterm birth

Infertility treatment strategy (conceptual)

Treatment depends on ___ → underlying cause

Wellness approaches (definition)

Lifestyle and health improvements to enhance fertility

Ovulation induction (definition)

Technique to ___ a menstrual cycle → initiate

Progesterone withdrawal (definition)

Method used in ovulation induction

Ovarian stimulation (definition)

Drugs used to increase ___ production → egg

Ovarian stimulation drugs (list)

Clomid, Femara, Letrozole, Tamoxifen

Intrauterine insemination (IUI) (definition)

Procedure placing sperm closer to ___ → egg

IUI use cases (conceptual)

Used for low sperm quality/quantity or ___ → donor sperm

IUI cost (data)

Cost per cycle → $3,000–$5,000 + meds

IUI success rate (data)

Success rate → 10–15%

IVF (definition)

Fertilization of egg ___ the body → outside

IVF indication (conceptual)

Used when sperm and egg cannot ___ naturally → meet

IVF cost (data)

Cost per cycle → $12,000–$20,000 + meds

IVF success rate (data)

Average success rate → ~30%

IVF specialist (definition)

Performed by reproductive endocrinologist

IVF advanced options (list)

ICSI, egg donation, embryo donation, gestational carriers, 3-person IVF

Alternative family building (definition)

Non-biological parenting routes

Hidden infertility effect (financial)

Infertility causes significant ___ burden → financial

Psychological effects (list)

Anxiety, depression, low self-worth

Social effects (list)

Strain on relationships and family stability

Productivity effects (definition)

Reduced work output

Spiritual effects (definition)

Loss of hope or meaning

Informed consent (definition)

Ensuring patients understand ___ and ___ of treatments → risks

Clomid (definition)

Hormonal drug used to stimulate ovulation

Clomid risks (conceptual)

Associated with ___ side effects and uncertain long-term impacts → negative

Braxton Hicks contractions (definition)

Early ___ contractions → false/practice

Effacement (definition)

___ and shortening of cervix → thinning

First stage labor (definition)

Most ___ stage of labor → painful

Transition (definition)

Intense phase between first and second stage

Second stage labor (definition)

Stage of pushing, less painful, lasts ___ → 10 min to 3–4 hrs

US childbirth ranking (conceptual)

US ranks ___ among industrialized countries → worst

Physician preference (conceptual)

Preference for hospital births and ___ → C-sections

Healthcare system (conceptual)

US system is ___-driven → for-profit

Spending vs outcomes (conceptual)

US spends ___ but has ___ results → more

Hospital birth safety (conceptual)

Safer for infant mortality but ___ difference → small

Midwives (conceptual)

Certified nurse-midwives are ___ in many states → restricted/outlawed

Midwife limitation (definition)

Must work under doctor supervision in hospitals

Hospital birth focus (conceptual)

System prioritizes ___ over maternal health → baby’s life

Malpractice system (conceptual)

Families often must ___ to afford care → sue

Healthcare burden (conceptual)

Without lawsuits, families may ___ → go bankrupt

Infection timing (conceptual)

Hospital time limits linked to preventing infection from ___ → ruptured amniotic sac

Mortality misconception (conceptual)

High US mortality blamed on ___ and ___ → age

True causes (conceptual)

Differences due to inequality, lack of care, and ___ → poverty

Texas births (data)

Nearly ___ of births covered by Medicaid → half

Childbirth sequelae (definition)

Possible long-term effects of normal childbirth

Urinary incontinence (definition)

Loss of bladder control

Postpartum conditions (list)

Diabetes, high blood pressure

Calcium loss (definition)

Weakening of bones and teeth

Pelvic floor relaxation (definition)

Weakening leading to gynecological issues

Episiotomy complications (list)

Loss of sexual sensation, inelasticity, pain during intercourse

Chronic condition exacerbation (definition)

Worsening of heart, kidney, or lung disease

Cesarean complications (list)

Loss of abdominal tone, muscle rupt