Guide to Infertility and Reproductive Technologies Study Guide

Managing Symptoms and Health in ART

Assisted reproductive technology (ART) involves considerations for cancer screenings, risks of multiple births, and managing chromosomal or genetic abnormalities.

• Assisted reproductive technology (ART)
• In vitro fertilization (IVF)
• Cancer screening
• Multiple births
• Chromosomal abnormalities
• Genetic effects
• Fertility specialist

• Understanding Assisted Reproductive Technology (ART)

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Understanding Infertility and Reproductive Technologies

This text discusses the definition, causes, and psychological impact of infertility, alongside diagnostic tests, treatments, reproductive technologies, and ethical considerations.

• infertility definition
• hormonal imbalances
• structural issues
• lifestyle factors
• psychological impact
• stress
• anxiety
• depression
• hormone levels
• ovulation monitoring
• semen analysis
• ovulation induction
• intrauterine insemination (IUI)
• in vitro fertilization (IVF)
• assisted reproductive technology (ART)
• reproductive technologies and ethics
• donor eggs and sperm
• fertility preservation
• egg freezing
• embryo freezing

• Understanding Infertility and Reproductive Technologies

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Pregnancy Decision-Making and Supportive Care

This chapter discusses symptoms, complications, and monitoring for patients after an abortion.

• abortion complications
• retained products of conception
• infection symptoms
• uterine perforation
• hemorrhage
• ultrasound diagnosis
• antibiotic treatment

Pregnancy Decision-Making and Support Care

This chapter discusses the complexities of pregnancy decision-making, clinical implications for clinicians, and definitions and epidemiology regarding unintended pregnancy.

• Pregnancy decision-making
• Unintended pregnancy
• Mistimed pregnancy
• Unwanted pregnancy
• Clinical implications
• Shared Management
• Preconception Guidance
• Epidemiology

Pregnancy Decision-Making and Supportive Care

• Postabortion warning signs
• Self-care instructions
• Pain management
• Pelvic rest
• Medication abortion
• Misoprostol
• Progesterone antagonist
• Prostaglandin analogue

Factors Affecting Infertility

This text discusses various behavioral risk factors and environmental factors that can affect fertility, including caffeine, weight, body mass index, alcohol, smoking, drug use, toxins, and stress.

• Caffeine consumption
• Weight and Body Mass Index (BMI)
• Alcohol consumption
• Smoking
• Drug use
• Environmental toxins
• Stress
• Hormonal system
• Ovulation
• Sperm quality

• Factors Affecting Infertility

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Pregnancy Decision-Making and Supportive Care

Clinicians provide accurate and unbiased information regarding medication abortion, surgical abortion, and continuing the pregnancy, including risks, benefits, and post-abortion care.

• medication abortion
• surgical abortion
• early abortion counseling
• self-managed abortion
• post-abortion care
• abortion complications
• pain management

Pregnancy Decision-Making and Supportive Care

This text discusses pregnancy decision-making processes, supportive assessments, and resources for reproductive health, legal issues, and adoption options.

• Pregnancy decision-making
• Supportive counseling
• Patient autonomy
• Socioeconomic status
• Barriers to accessing care
• Reproductive health services
• Adoption options
• Legal and policy issues
• Abortion laws
• Medicaid and insurance coverage

Managing Symptoms and Infertility Risk Factors

This text provides a detailed breakdown of the World Health Organization classification for ovulation disorders and categorizes causes of infertility in females and males.

• World Health Organization classification for ovulation disorders
• WHO Class I hyperprolactinemia and hypothyroidism
• WHO Class II functional hypothalamic amenorrhea and hypothalamic dysfunction
• WHO Class III primary ovarian insufficiency and premature ovarian failure
• WHO Class IV obesity and metabolic factors
• Causes of female infertility
• Causes of male infertility
• Advanced maternal age and genetic abnormalities
• Identifiable risk factors for infertility

• Understanding Infertility: Causes, Risk Factors, and WHO Classifications

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Comparison of Procedural and Medication Abortion

A comparison of procedural and medication abortion regarding timing, procedure, provider involvement, control, management, and efficacy.

• Procedural abortion
• Medication abortion
• Self-managed abortion
• Abortion efficacy
• Abortion access barriers
• Legal and policy landscape
• Information seeking

• Procedural vs. Medication Abortion: Methods, Efficacy, and Access

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Preconception Counseling and Unintended Pregnancy

Preconception care is a part of preventive health care for women of reproductive age involving health planning and identifying reproductive, parental, and fetal risks.

• Preconception care
• Unintended pregnancy
• Unplanned pregnancy
• Unwanted pregnancy
• Mistimed pregnancy
• Birth defects
• Preterm birth
• Low birth weight
• Maternal death
• Nutritional deficiencies
• Folic acid intake
• Intimate partner violence
• Preventive health care

Mifepristone and Misoprostol Medical Abortion Protocols

This text discusses the use of mifepristone and misoprostol for medical abortion, including administration protocols, side effects, and clinical considerations.

• Misoprostol
• medical abortion
• prostaglandin analogue
• uterine contractions
• FDA-approved regimen
• side effects
• clinical considerations
• gestational age
• legal and regulatory context

Abortion Resources in the Post-Roe Era

Resources for people and providers on abortion in the post-Roe era including legal/policy providers, information on self-managed abortion pills, postabortion support, financial resources, and resources for clinicians.

• legal/policy providers
• self-managed abortion pills
• postabortion support
• financial resources for abortions
• resources for clinicians
• medical management
• abortion access
• legal issues

Abortion Access and Maternal Health Considerations

The text discusses the legal, social, and medical landscape of abortion access in the United States, including the impact of legal restrictions on maternal mortality and morbidity.

• abortion access
• legal restrictions
• maternal mortality
• maternal morbidity
• socioeconomic factors
• reproductive healthcare access
• healthcare providers
• abortion bans
• marginalized communities

Hormonal Regulation in Assisted Reproductive Technologies

The text discusses GnRH and hCG hormones and their roles in stimulating the pituitary gland and ovaries during assisted reproductive technologies.

• Gonadotropin-Releasing Hormone (GnRH)
• Hypothalamus
• Pituitary gland
• Gonadotropins
• Follicle-stimulating hormone (FSH)
• Luteinizing hormone (LH)
• Receptor downregulation
• Assisted reproductive technologies (ART)
• Placenta
• Ovulation trigger
• Luteal phase support

Infertility Treatments and Assisted Reproductive Technology

The text discusses aromatase inhibitors, intrauterine insemination, and assisted reproductive technology used for the treatment of infertility.

• aromatase inhibitors
• androgens
• estrogens
• FSH
• LH
• follicular development
• letrozole
• anastrozole
• endometrium
• Intrauterine Insemination (IUI)
• ovulation
• gonadotropins
• Assisted Reproductive Technology (ART)
• in vitro fertilization (IVF)
• intracytoplasmic sperm injection (ICSI)

Health Promotion and Contraception Overview

This text discusses female tubal sterilizations, male sterilization through vasectomy, and modern contraception options.

• female tubal sterilizations
• male sterilization
• vasectomy
• modern contraception
• ectopic pregnancy
• surgical complications

Preconception Counseling and Infectious Disease Risks

Infectious diseases and maternal health conditions like diabetes, hypothyroidism, and phenylketonuria can act as teratogens or impact fetal neurological development.

• TORCH infections
• Toxoplasmosis etiology and transmission
• Varicella malformations
• Diabetes management and birth defects
• Hypothyroidism and levothyroxine adjustment
• Heart disease and hypertension in pregnancy
• Maternal Phenylketonuria and phenylalanine levels
• HIV/AIDS prophylaxis
• Infectious diseases as teratogens

Intimate Partner Violence Screening Exemplars

Exemplar questions and instructions for screening intimate partner violence to assess health and well-being.

• Intimate partner violence screening
• Direct inquiry
• Post-inquiry instructions
• Safety assessment

Preconception Physical Examination and Fertility Preservation

A preconception physical examination includes assessment of maternal health and laboratory testing for STIs, while reproductive identity and fertility preservation considerations address diverse patient needs.

• Hepatitis C risk factors
• Preconception physical examination
• Maternal health assessment
• Reproductive identity
• Fertility preservation
• Gender identity and reproductive technologies
• Tuberculosis screening
• Toxoplasmosis and CMV infection

Preconception Counseling and Contraceptive Use

Contraception is an important component of preconception health to facilitate a planned pregnancy and prevent unintended pregnancy in reproductive-age women.

• Preconception counseling
• Contraception
• Planned pregnancy
• Unintended pregnancy
• Chronic conditions
• Clinical guidelines for Contraceptive Use (USMEC)
• Emergency contraception
• Teratogenic medication
• Long-acting reversible contraception (LARC)
• Prenatal vitamins
• Folic acid

Overview of Barrier Contraception Methods

Barrier contraception includes male and female condoms, the diaphragm, and the contraceptive sponge to prevent pregnancy and STIs.

• Barrier methods
• Male condom
• Female condom
• Diaphragm
• Contraceptive sponge
• Spermicide
• STI protection
• Pregnancy prevention efficacy

Disparities in Unintended Pregnancy

Unintended pregnancy rates vary by demographic indicators, including race/ethnicity, social, and population factors, and are driven by access to reproductive health services, socioeconomic status, and systemic racism.

• demographic indicators
• race/ethnicity
• socioeconomic status
• systemic racism
• reproductive health services
• social determinants of health
• unintended pregnancy rates
• clinical implications

Physical Assessment and Management of Infertility

This text discusses the physical assessment and management of infertile couples, including diagnostic approaches such as semen analysis and evaluation of medical conditions.

• Physical assessment
• Polycystic ovary syndrome (PCOS)
• Endometriosis
• Uterine abnormalities
• Hyperprolactinemia
• Thyroid dysfunction
• Male factor infertility
• Oligospermia
• Azoospermia
• Abnormal sperm morphology
• Erectile dysfunction
• Undescended testes
• Varicoceles
• Semen analysis
• Laboratory analysis
• Epididymitis
• Testicular volume

Contraceptive Sponge and Injectable Contraception

This text discusses the contraceptive sponge and depot medroxyprogesterone acetate (DMPA) formulations including intramuscular and subcutaneous administration.

• Contraceptive sponge
• Depot medroxyprogesterone acetate (DMPA)
• DMPA-IM
• DMPA-SC
• Progestin-only contraceptives
• Suppression of ovulation
• Cervical mucus thickening
• Bone density loss
• Subcutaneous injection
• Intramuscular injection

Fertility Self-Management and Shared Management

This text discusses fertility self-management including adverse effects of hormonal models, intrauterine device removal, and sterilization methods.

• Hormonal models
• Menstrual changes
• Intrauterine devices
• Progestin-only IUDs
• Copper IUDs
• Intrauterine device removal
• Sterilization
• Tubal ligation
• Transcervical sterilization
• Surgical sterilization
• Laparoscopic procedure

Copper IUD and Levonorgestrel IUS

Comparison of copper intrauterine device and Levonorgestrel intrauterine system types, side effects, and insertion procedures.

• Copper intrauterine device
• Levonorgestrel intrauterine system
• Copper IUD side effects
• Levonorgestrel (LNG) release
• IUD insertion procedure
• Bimanual examination
• Postpartum IUD placement
• IUD expulsion rate

Nexplanon Use and Clinical Management

Information regarding Nexplanon implant advantages, disadvantages, insertion and removal procedures, adverse effects, and eligibility criteria.

• Nexplanon advantages and disadvantages
• Implant insertion procedure
• Implant removal procedure
• Adverse effects and side effects
• Monitoring and care card
• Eligibility criteria and contraindications

Embryo Development and Organogenesis Vulnerability

A diagrammatic overview of embryo development and organogenesis illustrating the vulnerability of different physiological systems to teratogens during specific embryonic periods.

• Neural tube/Central nervous system
• Heart/Cardiovascular system
• Digestive/Respiratory/Urinary systems
• Musculoskeletal/Integumentary systems
• Neural tube defects (NTDs)
• Cardiac malformations
• Septal defects (SA, ASD, and VSD)
• Embryonic period sensitivity
• Major congenital anomalies
• Teratogen susceptibility

Preconception Counseling and Intimate Partner Violence

This chapter covers preconception counseling including family history and genetic testing, as well as the prevalence and screening of intimate partner violence.

• Preconception counseling
• Family history
• Genetic testing
• Genetic counseling
• Intimate partner violence
• Reproductive coercion
• Physical abuse
• Psychological abuse
• Emotional abuse
• IPV prevalence
• IPV screening
• Risk reduction and management

Maternal Obesity and Preconception Health Risks

Maternal obesity and diabetes increase risks for neural tube defects, gestational diabetes, gestational hypertension, and pregnancy complications.

• Preconception obesity
• Neural Tube Defects (NTDs)
• Gestational diabetes
• Gestational hypertension
• Preterm birth
• Maternal obesity risks
• Folic acid deficiency
• HIV screening in pregnancy
• Mother-to-child transmission
• Body Mass Index (BMI)

Lead and Mercury Exposure in Pregnancy

Lead and mercury exposure during pregnancy can harm the kidneys, nervous system, brain, and developing fetuses.

• Etiology of lead and mercury
• Environmental mercury contamination
• Fetal development risks
• Blood mercury levels
• Lead levels in pregnant women
• Assessment and management of heavy metals
• Seafood intake recommendations
• Lead exposure from old plumbing and pottery
• Counseling on supplemental calcium, iron, protein, and vitamins

Management of Chronic Conditions in Pregnancy

Medical interventions and risk reduction strategies for managing HIV, hypertensive disorders, phenylketonuria, and other chronic medical conditions during pregnancy.

• HIV vertical transmission prevention
• Hypertensive disorders of pregnancy
• Preeclampsia classification
• Phenylketonuria (PKU) management
• Teratogenic effects of phenylalanine
• Chronic medical conditions in pregnancy
• Maternal-fetal medicine specialist consultation
• Pregnancy planning and risk reduction

Emergency Contraception and Progesterone-only Pills

This text discusses various methods of emergency contraception including combined oral contraceptives, levonorgestrel, ulipristal acetate, and intrauterine devices, alongside the usage of progesterone-only pills.

• Emergency contraception
• Combined oral contraceptive (COC)
• Progesterone-only pill (POP)
• Levonorgestrel
• Ulipristal acetate (UPA)
• Intrauterine device (IUD)
• Copper IUD
• Unprotected intercourse
• Side effects
• Contraceptive effectiveness

Preconception Counseling and Contraceptive Trends

This text discusses contraceptive usage trends, socioeconomic factors affecting pregnancy rates, and contraceptive barriers and facilitators for sexual minority women and gender-identifying persons.

• Contraceptive usage trends
• Socioeconomic factors in pregnancy rates
• Unintended pregnancy risks
• Preconception healthcare
• Sexual minority health
• Intimate partner violence (IPV)
• Contraceptive barriers for queer women
• Contraceptive facilitators for queer women

Preconception Counseling Health Conditions and Risks

Health conditions, related risks, and treatment goals during pregnancy including gestational diabetes mellitus, chronic hypertension, hypothyroidism, bariatric surgery, and mood disorders.

• Gestational diabetes mellitus
• Chronic hypertension
• Congenital anomalies
• Preeclampsia
• Intrauterine growth restriction
• Hemoglobin A1c
• Hypothyroidism
• Spontaneous abortion
• Placental abnormalities
• Preterm birth
• Fetal death
• TSH
• Bariatric surgery
• Small for gestational age
• Mood disorders
• Postpartum psychiatric illness

Pregnancy Risks and Health Conditions

This text discusses diabetes mellitus and HIV in the context of pregnancy, including etiology, prevalence, and vertical transmission risks.

• Diabetes mellitus
• HIV
• Vertical transmission
• Congenital anomalies
• Cardiac malformations
• CD4 cells
• Perinatal transmission
• Prenatal care

Questioning Strategies in Preconception Counseling

Therapy uses framing statements, indirect questioning, direct questioning, and information/education to address smoking, alcohol, and recreational drug use.

• Framing Statement
• Indirect Questioning
• Direct Questioning
• Information/Education
• Preconception Counseling
• Substance use screening

Repetitive Data Findings in 2021

New data have been found to show that in 2021.

Clinic Visit Resource List Reference

A reference to Table 36.1 for a list of resources making for use during a clinic visit or upon request.

Studies on Unintended Pregnancy

Some studies suggest that unintended pregnancy can lead to various outcomes.

• unintended pregnancy

Reproductive Technologies and Genetic Diagnosis

This text discusses intracytoplasmic sperm injection and preimplantation genetic diagnosis used to assess embryos for genetic abnormalities and attain fertilization.

• intracytoplasmic sperm injection
• preimplantation genetic diagnosis
• obstructive azoospermia
• male factor infertility
• prenatal diagnosis
• fertilization rates

Defining Experienced Pregnancy

A woman is considered to have experienced a pregnancy if she has ever achieved pregnancy after regular unprotected intercourse.

• experienced pregnancy
• unprotected intercourse

Informing Patients of Pregnancy Test Results

The patient must be informed if the test is positive or that pregnancy has been tested and results confirmed.

• positive test results
• pregnancy testing
• confirmed results
• patient information

Postabortion Care and Self-Care Instructions

This text discusses postabortion self-care, management of complications, and the importance of follow-up, counseling, and culturally sensitive care.

• postabortion self-care
• medical abortion follow-up
• pain management
• infection prevention
• emotional support
• counseling
• management of complications
• incomplete abortion
• heavy bleeding
• culturally sensitive care

Genetic Disorders and Carrier Testing Recommendations

Descriptions and carrier testing recommendations for genetic disorders including Leukodystrophies, CFTR Mutations, Hereditary Sensory and Autonomic Neuropathies, Spinal Muscular Atrophy, and Tay-Sachs Disease.

• Leukodystrophies
• CFTR Mutations
• Cystic Fibrosis
• Hereditary Sensory and Autonomic Neuropathies
• HSAN1 gene
• Spinal Muscular Atrophy
• Tay-Sachs Disease
• Autosomal recessive inheritance
• Carrier testing

Laboratory Testing in Morning Urine

Additional laboratory tests are tested in the first morning urine if levels are greater than 15 mg/mL.

• laboratory tests
• mg/mL levels

Laboratory Testing for Urine Levels

Additional laboratory tests are tested in the first morning urine if levels are greater than 15 mg/mL.

• laboratory tests
• mg/mL levels

Alcohol Exposure and Fetal Development

Prenatal exposure to alcohol acts as a neurotoxin that can cause birth defects, developmental disabilities, and fetal alcohol syndrome.

• Alcohol dependency
• Fetal alcohol syndrome
• Fetal alcohol spectrum disorders
• Neurocognitive deficits
• Prenatal alcohol exposure
• Reproductive toxicity
• Alcohol cessation strategies
• Risk reduction and management

Alcohol Reproductive Toxicity

Alcohol is a reproductive toxin that can affect the reproductive system and cause damage to the developing fetus.

• reproductive toxicity
• reproductive system
• developing fetus

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Managing Combined Oral Contraceptives

Information regarding the risks, side effects, and management of combined oral contraceptives (COCs) for patients.

• combined oral contraceptives (COCs)
• thromboembolic events
• deep vein thrombosis (DVT)
• pulmonary embolism
• breakthrough bleeding (BTB)
• nausea
• mild headache
• missed pills

DMPA and Return to Fertility

Some studies show that return to fertility may be delayed for some users of DMPA.

• DMPA
• return to fertility

Clinician Rod Manipulation Procedure

The clinician will then push down on the rod.

Workplace Hazard Management and Risk Reduction

Strategies for risk reduction and management include using Material Safety Data Sheets to identify workplace hazards and prevent exposure to toxicants during pregnancy.

• Material Safety Data Sheet (MSDS)
• Workplace hazards
• Risk reduction and management
• Pregnancy prevention
• Reproductive toxins
• Accidental exposure reporting

Teratogens and Smoking Risks in Pregnancy

Smoking and teratogens can cause fetotoxicity, affecting fetal oxygenation and increasing risks such as low birth weight, miscarriage, and congenital anomalies.

• fetotoxicity
• fetal oxygenation
• placental blood flow
• nicotine
• low birth weight
• miscarriage
• gestational diabetes
• placental abruption
• congenital anomalies
• teratogens
• genotype susceptibility
• timing of exposure
• specific mechanism
• manifestation
• agent
• dose

Legal and Ethical Abortion Care Considerations

The text discusses legal, ethical, and professional considerations regarding pregnancy and abortion care in the United States following the Dobbs decision.

• legal considerations
• ethical considerations
• professional responsibility
• abortion care
• Dobbs decision
• reproductive healthcare access disparities
• clinical implications

STI Management and Pregnancy Risks

Early STI screening and treatment prevent adverse outcomes to pregnancy, infertility, and chronic pelvic pain.

• Herpes etiology
• Neonatal herpes transmission
• HSV assessment and management
• STI screening
• Ectopic pregnancy
• Infertility
• Chronic pelvic pain

Impacts and Assessment of Unintended Pregnancy

Unintended pregnancy is associated with maternal and infant mortality, increased stress, and varying rates driven by systemic inequities and social determinants of health.

• maternal and infant mortality
• stress and anxiety
• assessment of unintended pregnancy
• systemic inequities
• access to healthcare
• social determinants of health

Ongoing Pregnancy Complications

Ongoing pregnancy is a rare complication of an abortion occurring when the procedure is unsuccessful and the pregnancy continues.

• ongoing pregnancy
• abortion complication
• pregnancy test
• ultrasound
• diagnosis

• Understanding Ongoing Pregnancy as an Abortion Complication

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Reproductive and Developmental Toxicity of Toxicants

This section discusses how environmental exposures to toxicants can impact fertility, fetal development, and adverse pregnancy outcomes.

• Reproductive toxicity
• Developmental toxicity
• Fertility
• Fetal development
• Neurotoxins
• Endocrine disruptors
• Reproductive toxicants
• Spontaneous abortions
• Preterm birth
• Organogenesis
• Placental transfer
• Maternal metabolism
• Fetal metabolism

Retained Issue Infection and Pregnancy

The text is organized into sections regarding retained issue, infection, and ongoing pregnancy.

• RETAINED ISSUE
• INFECTION
• ONGOING PREGNANCY

Assessment of Risk and Chemical Exposure

Assessment of risk regarding potential toxicants, sexually transmitted infections, and common chemicals in the home.

• Assessment of Risk
• Potential toxicants
• Sexually transmitted infections
• High-risk pregnancy
• Common chemicals in the home