Fertility and Sterility® continuing medical education questions

FERTILITY AND STERILITY ® CONTINUING MEDICAL EDUCATION QUESTIONS To obtain the 15 Category I CME credits, the entire examination of lessons from Volume 85 of Fertility and Sterility® must be taken. The answer sheet will be available in the June 2006 issue and will be graded. A 70% passing score must be achieved and documentation will be mailed with the corrected examination to the participant. April 2006 Mahdavi et al. 85:819 –26 (Lesson 12) Objective: To critically examine the possible association between ovulation-inducing drugs and ovarian cancer 1. Which of the following observations on the occurrence of ovarian cancer supports the hypothesis that repeated ovulation causes ovarian cancer? a) higher cancer rates in domesticated hens b) higher cancer rates in animals that birth litters c) higher cancer rates in grand multiparas d) lower cancer rates in hormone contraceptive users e) lower cancer rates in barrier contraceptive users 2. Which of the following factors confounds studies of fertility drug use and ovarian cancer? a) different mean ages at which fertility drugs are given and ovarian cancer occurs b) different ethnicities of fertility drug users and ovarian cancer victims c) different socioeconomic demographics of fertility drug users and ovarian cancer victims d) low occurrence rate of ovarian cancer in all women e) high occurrence rate of ovarian cancer in subfertile women 3. Which of the following statements regarding fertility drugs and borderline ovarian tumors is not correct? a) There is a stronger association between fertility drugs and invasive tumors b) the association is consistent among different studies c) estrogen receptor expression is a common feature of ovarian border tumors d) medical surveillance is increased for subfertile women receiving treatment compared with infertile women e) subfertile women are younger in age than infertile women 4. In a Finnish study, the incidence of one type of ovarian tumor has declined as the use of fertility drugs has increased. What is this tumor? a) borderline tumors b) epithelial cell tumors c) granulosa cell tumors d) stromal cell tumors e) germ cell tumors

White et al. 85:853–7 (Lesson 13) Objective: To present an integrated model of helpseeking and show its application to race/ethnic disparities in infertility care 1. What was the single most important predictor of helpseeking in a pilot study for infertility problems? a) having a regular doctor for primary/preventive care b) recognizing that one has infertility c) having peers who have sought infertility treatment d) having failed self-initiated treatments e) having failed self-initiated life-style changes 2. White et al. suggest that race-based and class-based ideas about who deserves to be a mother shape who gets treatment. What evidence do they offer to support this statement? a) one in five providers refuses treatment to unmarried women b) insured African Americans are one-half as likely as white beneficiaries to seek free vaccination c) 72%–95% of United Kingdom residents who have national health insurance coverage seek infertility care d) 33% of Hispanics are uninsured e) childless African Americans are more likely to seek spiritual solutions Duleba et al. 85:996 –1001 (Lesson 14) Objective: To test the hypothesis that statins improve hyperandrogenemia in women with polycystic ovary syndrome (PCOS) 1. Which of the following is a metabolic action of the statin group of medications? a) stimulate 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase b) decrease expression of low density lipoprotein (LDL) cholesterol receptor in the liver c) increase high density lipoprotein cholesterol in serum

Fertility and Sterility姞 Vol. 85, No. 4, April 2006 Copyright ©2006 American Society for Reproductive Medicine, Published by Elsevier Inc.

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d) act as an antioxidant e) stimulate ovarian theca-interstitial cell proliferation in culture 2. In patients with PCOS who were randomized to simvastatin treatment, which of the following changes was not statistically significant at treatment week 12?

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a) decreased testosterone level b) decreased luteinizing hormone/follicle-stimulating hormone ratio c) decreased insulin area-under-the-curve d) decreased level of LDL cholesterol e) decreased triglyceride level

Vol. 85, No. 4, April 2006