540 Obstetrics and Gynecology Board Review •••
❍ How does chemotherapy affect gonadal function of the in males and females?
In postpubertal males, approximately 90% will have azoospermia, while women with the same treatment have
50% to 75% chance of ovarian failure. In prepubertal boys, 83% had azoospermia, while 13% of prepubertal girls
had ovarian failure.
FEMALE INFERTILITY
❍ What are the primary diagnoses in the infertile woman and what percentage of infertile women have each
diagnosis?
Ovulatory dysfunction (40%).
Tubal and pelvic pathology (40%).
Unexplained (10%).
Unusual problems, that is, anatomic abnormalities, thyroid disease (10%).
❍ How many oocytes are present in each stage of reproductive development?
16 to 20 weeks’ gestation: 6 to 7 million oogonia.
Birth: 1 to 2 million oocytes.
Onset of puberty: 300,000 to 500,000 oocytes.
Age 37 to 38: 25,000 oocytes.
Menopause: 1000 oocytes.
❍ What is the average age of menopause in the United States?
51 years old.
❍ How many years prior to menopause does follicular loss occur?
10 to 15 years.
Ovulation
❍ What are the causes of adult-onset anovulation?
Hypothalamic dysfunction (38%).
Pituitary disease (17%).
Ovarian dysfunction (45%).
❍ Hypothalamic dysfunction may result in anovulation. Name three causes.
Stress, weight and body composition, and strenuous exercise.
❍ The most common pituitary disorder that causes anovulation is?
Prolactinoma (empty sella, Sheehan, and Cushing syndromes).
❍ Name the two most common causes of hyperprolactinemia.
Prolactin-secreting pituitary gland tumors and psychiatric medications.