ACOG Infertility UPDATED ACTUAL
Questions and CORRECT Answers
Define infertility and subsequent infertility evaluation (timing) - CORRECT ANSWER -
Women older than 35 years should receive an expedited evaluation and undergo treatment after 6
months of failed attempts to become pregnant or earlier, if clinically indicated.
In women older than 40 years, more immediate evaluation and treatment are warranted.
If a woman has a condition known to cause infertility, the obstetrician-gynecologist should offer
immediate evaluation.
For infertility assessment: a targeted physical examination of the female partner should be
performed with a focus on vital signs and include: - CORRECT ANSWER - a thyroid,
breast, and pelvic examination.
For the female partner, tests will focus on - CORRECT ANSWER - ovarian reserve,
ovulatory function, and structural abnormalities
Infertility affects what percent of couples: - CORRECT ANSWER - 15%
Indications for immediate infertility evaluation include the following: - CORRECT
ANSWER - - oligomenorrhea or amenorrhea
- known or suspected uterine, tubal, or peritoneal disease
- stage III or stage IV endometriosis
- known or suspected male infertility
Basic infertility evaluation components - CORRECT ANSWER - Female:
History, Physical, Prepregnancy evaluation
, Additional evaluation for etiology of infertility:
- diminished ovarian reserve (AMH
or basal FSH and estradiol
or Transvaginal US with astral follicle count)
- Ovulatory dysfunction (ovulatory function test (serum progesterone measurement)
- Tubal factor (HSG, Hysterosalpingo-constrast sonography)
- Uterine factor ( Transvaginal US, sonohysterography, hysteroscopy, HSG)
Male:
history and semen analysis
Key historical factors to elicit from the patient undergoing infertility evaluation include the
following - CORRECT ANSWER - -duration of infertility and results of any previous
evaluation and treatment
-menstrual history (including age at menarche, cycle interval, length, and characteristics;
presence of molimina [mild premenstrual symptoms and changes]; and onset and severity of
dysmenorrhea), signs of ovulation including positive ovulation tests, cervical mucus changes, or
biphasic basal body temperatures
-pregnancy history (gravidity, parity, time to preg- nancy, fertility treatments, pregnancy
outcome, delivery route, and associated complications)
-previous methods of contraception
- coital frequency and timing
- sexual dysfunction
- past surgery (procedures, indications, and out- comes) focused on abdominal and pelvic
procedures
Questions and CORRECT Answers
Define infertility and subsequent infertility evaluation (timing) - CORRECT ANSWER -
Women older than 35 years should receive an expedited evaluation and undergo treatment after 6
months of failed attempts to become pregnant or earlier, if clinically indicated.
In women older than 40 years, more immediate evaluation and treatment are warranted.
If a woman has a condition known to cause infertility, the obstetrician-gynecologist should offer
immediate evaluation.
For infertility assessment: a targeted physical examination of the female partner should be
performed with a focus on vital signs and include: - CORRECT ANSWER - a thyroid,
breast, and pelvic examination.
For the female partner, tests will focus on - CORRECT ANSWER - ovarian reserve,
ovulatory function, and structural abnormalities
Infertility affects what percent of couples: - CORRECT ANSWER - 15%
Indications for immediate infertility evaluation include the following: - CORRECT
ANSWER - - oligomenorrhea or amenorrhea
- known or suspected uterine, tubal, or peritoneal disease
- stage III or stage IV endometriosis
- known or suspected male infertility
Basic infertility evaluation components - CORRECT ANSWER - Female:
History, Physical, Prepregnancy evaluation
, Additional evaluation for etiology of infertility:
- diminished ovarian reserve (AMH
or basal FSH and estradiol
or Transvaginal US with astral follicle count)
- Ovulatory dysfunction (ovulatory function test (serum progesterone measurement)
- Tubal factor (HSG, Hysterosalpingo-constrast sonography)
- Uterine factor ( Transvaginal US, sonohysterography, hysteroscopy, HSG)
Male:
history and semen analysis
Key historical factors to elicit from the patient undergoing infertility evaluation include the
following - CORRECT ANSWER - -duration of infertility and results of any previous
evaluation and treatment
-menstrual history (including age at menarche, cycle interval, length, and characteristics;
presence of molimina [mild premenstrual symptoms and changes]; and onset and severity of
dysmenorrhea), signs of ovulation including positive ovulation tests, cervical mucus changes, or
biphasic basal body temperatures
-pregnancy history (gravidity, parity, time to preg- nancy, fertility treatments, pregnancy
outcome, delivery route, and associated complications)
-previous methods of contraception
- coital frequency and timing
- sexual dysfunction
- past surgery (procedures, indications, and out- comes) focused on abdominal and pelvic
procedures
