NURSING 7281
Advanced Reproductive
Dynamics
Q & A w/ Rationales
2024
,1. A 35-year-old woman with a history of endometriosis
and infertility is undergoing in vitro fertilization (IVF)
treatment. She receives daily injections of gonadotropins to
stimulate ovarian follicle development. On day 10 of her
cycle, she undergoes transvaginal ultrasound to assess the
number and size of the follicles. The ultrasound reveals that
she has 12 follicles, ranging from 15 to 20 mm in diameter.
What is the most appropriate next step in her treatment?
A) Continue gonadotropin injections until the follicles
reach 25 mm in diameter.
B) Administer human chorionic gonadotropin (hCG)
injection to trigger ovulation and schedule oocyte retrieval.
C) Reduce the dose of gonadotropins to prevent ovarian
hyperstimulation syndrome (OHSS).
D) Cancel the cycle and start a new one with a lower dose
of gonadotropins.
Answer: B) Administer human chorionic gonadotropin
(hCG) injection to trigger ovulation and schedule oocyte
retrieval.
Rationale: The optimal size of the follicles for IVF is
between 18 and 22 mm in diameter. When the majority of
the follicles reach this size, hCG injection is given to
induce final maturation and ovulation of the oocytes.
Oocyte retrieval is performed 34 to 36 hours after hCG
injection. Continuing gonadotropin injections or reducing
the dose may compromise the quality and quantity of the
oocytes. Cancelling the cycle is not necessary unless there
are signs of OHSS or other complications.
, 2. A 28-year-old man with a history of cryptorchidism and
oligospermia is undergoing intracytoplasmic sperm
injection (ICSI) treatment with his partner, who has normal
fertility. He provides a semen sample on the day of his
partner's oocyte retrieval. The semen analysis shows that he
has a sperm concentration of 8 million/mL, a motility of
40%, and a morphology of 20%. What is the most likely
outcome of his ICSI treatment?
A) He will have a high fertilization rate and a good chance
of achieving pregnancy.
B) He will have a low fertilization rate and a poor chance
of achieving pregnancy.
C) He will have a normal fertilization rate but a low
implantation rate and a poor chance of achieving
pregnancy.
D) He will have no fertilization and will need to use donor
sperm or testicular sperm extraction (TESE).
Answer: A) He will have a high fertilization rate and a
good chance of achieving pregnancy.
Rationale: ICSI is a technique that involves injecting a
single sperm directly into an oocyte, bypassing the need for
sperm to penetrate the zona pellucida. ICSI can overcome
most causes of male factor infertility, such as low sperm
count, poor motility, or abnormal morphology. The
fertilization rate with ICSI is similar to that with
conventional IVF, around 70%. The implantation rate and
pregnancy rate depend on other factors, such as the quality
of the oocytes and embryos, the age of the female partner,
and the presence of uterine or tubal abnormalities.
Advanced Reproductive
Dynamics
Q & A w/ Rationales
2024
,1. A 35-year-old woman with a history of endometriosis
and infertility is undergoing in vitro fertilization (IVF)
treatment. She receives daily injections of gonadotropins to
stimulate ovarian follicle development. On day 10 of her
cycle, she undergoes transvaginal ultrasound to assess the
number and size of the follicles. The ultrasound reveals that
she has 12 follicles, ranging from 15 to 20 mm in diameter.
What is the most appropriate next step in her treatment?
A) Continue gonadotropin injections until the follicles
reach 25 mm in diameter.
B) Administer human chorionic gonadotropin (hCG)
injection to trigger ovulation and schedule oocyte retrieval.
C) Reduce the dose of gonadotropins to prevent ovarian
hyperstimulation syndrome (OHSS).
D) Cancel the cycle and start a new one with a lower dose
of gonadotropins.
Answer: B) Administer human chorionic gonadotropin
(hCG) injection to trigger ovulation and schedule oocyte
retrieval.
Rationale: The optimal size of the follicles for IVF is
between 18 and 22 mm in diameter. When the majority of
the follicles reach this size, hCG injection is given to
induce final maturation and ovulation of the oocytes.
Oocyte retrieval is performed 34 to 36 hours after hCG
injection. Continuing gonadotropin injections or reducing
the dose may compromise the quality and quantity of the
oocytes. Cancelling the cycle is not necessary unless there
are signs of OHSS or other complications.
, 2. A 28-year-old man with a history of cryptorchidism and
oligospermia is undergoing intracytoplasmic sperm
injection (ICSI) treatment with his partner, who has normal
fertility. He provides a semen sample on the day of his
partner's oocyte retrieval. The semen analysis shows that he
has a sperm concentration of 8 million/mL, a motility of
40%, and a morphology of 20%. What is the most likely
outcome of his ICSI treatment?
A) He will have a high fertilization rate and a good chance
of achieving pregnancy.
B) He will have a low fertilization rate and a poor chance
of achieving pregnancy.
C) He will have a normal fertilization rate but a low
implantation rate and a poor chance of achieving
pregnancy.
D) He will have no fertilization and will need to use donor
sperm or testicular sperm extraction (TESE).
Answer: A) He will have a high fertilization rate and a
good chance of achieving pregnancy.
Rationale: ICSI is a technique that involves injecting a
single sperm directly into an oocyte, bypassing the need for
sperm to penetrate the zona pellucida. ICSI can overcome
most causes of male factor infertility, such as low sperm
count, poor motility, or abnormal morphology. The
fertilization rate with ICSI is similar to that with
conventional IVF, around 70%. The implantation rate and
pregnancy rate depend on other factors, such as the quality
of the oocytes and embryos, the age of the female partner,
and the presence of uterine or tubal abnormalities.
