Reducing the risks associated with in vitro fertilization—Pretest (optional)

The editors of Sexuality, Reproduction & Menopause would like insight into your current knowledge of IVF risks. Your answers to these questions are anonymous and are not linked to your name or CME posttest score.

1) Which choice does not identify a patient who is a priori at risk?

Young ageObesityAppearance of polycystic type ovariesHypothalamic amenorrheaLow BMI

2) Which one of the following risk factors for OHSS can be identified during the progression of a stimulation cycle?

Peak estradiol levels <2000 pg/mlA plateau of serum estradiol levelsThe presence of numerous small and intermediate folliclesLuteal phase support with progesteroneWithholding hCG administration

3) All of the following are perinatal risks of multiple pregnancies except:

PreeclampsiaNeonatal death by three years of ageHigher incidence of congenital anomaliesPlacenta previaPlacental abruption

4) Most reported series suggest a loss rate following selective reduction from triplets to twins of between:

1% and 3%4% and 6%8% and 10%12% and 15%10% and 20%

5) ART has what percent incidence of monozygotic twinning?

3.2%5.6%2.9%4.3%1.0%

6) All of the following statements about ovarian and endometrial cancer risks are true, except:

Endometrial cancer is increased in patients with chronic anovulation and unexposed estrogenClomiphene usage for the highest doses and the longest durations seem to be associated with the highest risk of endometrial cancerThere has not been an association of endometriosis with ovarian cancerIt has been hypothesized that clomiphene may increase the risk of endometrial cancer by a tamoxifen-like effectClomiphene usage for one year or longer has been associated with an increased ovarian cancer risk

7) What is the main concern for patients with Turner’s syndrome becoming pregnant?

Uterine rupture from pregnancy in an infantile uterusDevelopment of autoimmune diseaseIncreased risk for dissection and rupture of the ascending aortaIncreased risk of spontaneous abortionSevere lymphedema of pregnancy because of abnormal lymphatics

8) The great majority of more than 30 multicolor FISH studies done on infertile men has shown which one of the following?

OligozoospermiaAsthenozoospermiaMotility problemsAn increased frequency of disomy for the autosomes and the sex chromosomesNo sperm in the ejaculate

9) All of the following are requirements for imprinting except:

There must be a predetermined selection for transcription from one specific chromosome of the homologous pairImprinting has to be reversible on passage through the opposite parental germline and allow a chance to switch that imprintThere has to be differential expression of the new parental imprint in the offspringThe imprint has to be stable transmission through mitosis in somatic cellsIt must originate from a trisomy

10) The overall malformation rate for ART appears to be increased with a relative risk of which of the following?

1.1 to 1.21.3 to 1.42.3 to 2.43.2 to 3.44.0 to 5.0