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Nutrition Therapy for Fertility final assessment

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Question 1 of 56

Question 1: A common definition of epigenetics is:

A

The study of the medical conditions that we inherit from our biological parents

B

The study of living organisms and how they procreate

C

The study of how environment can cause changes in gene function that do not involve changes to the DNA sequence

D

The study of medical conditions attributed to In Vitro Fertilization

Question 2 of 56

Question 2: Mrs C is a healthy 31 year old woman. She was diagnosed with Type 1 diabetes when she was 8 years old and Coeliac disease when she was 19 years old. She is now ready to start a family. Prior to conception should she:

A

Commence a folic acid supplement and have loads of sex. She’s got nothing to worry about!

B

Have a personalised consultation with a dietitian prior to commencing trying to conceive

C

Go straight to a Fertility Specialist so that they can choose an egg that won’t pass on these conditions

D

Contact an adoption agency as it’s going to be too difficult to conceive

Question 3 of 56

Question 3: A blastocyst is an embryo that is how many days old?

A

2 days

B

5 days

C

10 days

D

30 days

Question 4 of 56

Question 4: ‘Ovulation Induction’ is:

A

A treatment which involves tracking ovulatory cycles, to better time sexual intercourse

B

A treatment which involves taking a hormone medication (either orally or via injection) which stimulates the pituitary gland to produce FSH, which thereby stimulates the growth of follicles

C

A treatment which involves taking a hormone medication (either orally or via injection) which stimulates the thyroid gland to produce TSH, which thereby stimulates the growth of the gland

D

A treatment which involves warming the egg in vivo to make it more receptive to sperm

Question 5 of 56

Question 5: According to the World Health Organisation ‘infertility’ is defined as:

A

Not being able to get pregnant, despite having frequent, unprotected sex, for at least 3 months

B

Not being able to get pregnant, despite having frequent, unprotected sex, for at least 6 months

C

Not being able to get pregnant, despite having frequent, unprotected sex, for at least 12 months

D

Not being able to get pregnant, and consequently having to consider adoption or childlessness

Question 6 of 56

Question 6: What percentage of infertility is attributed to female complications alone?

A

30%

B

50%

C

70%

D

100%

Question 7 of 56

Question 7: Studies in mice have shown that paternal overnutrition can increase the risk of their offspring developing diabetes.  Which of the following mechanisms is the most likely cause for these effects? 

A

Chromosomal anomalies that occur during cell division in spermatogenesis

B

Epigenetic change to sperm DNA that are inherited by offspring at conception

C

Mutations in paternal genomic DNA that are inherited at conception

D

Reactive oxygen species induced DNA fragmentation

Question 8 of 56

Question 8: Which of the following dietary patterns is more likely to have a negative impact on sperm quality? 

A

A Mediterranean dietary pattern

B

Diets high in fish, meat, low fat dairy and potatoes

C

Diets high in fruits, vegetables and meat

D

Diets high in full fat dairy, processed meat and potatoes

Question 9 of 56

Question 9: Oily fish such as salmon and tuna are fertility superfoods for men because they are rich in:

A

CoQ10, DHA, Selenium and Zinc

B

DHA, Folate, Vitamin E and Zinc

C

DHA, Selenium, Vitamin C and Vitamin E

D

Folate, Selenium, Vitamin C and Zinc

Question 10 of 56

Question 10: The concentration of which fatty acid increases substantially in the sperm membrane during the final stages of spermatogenesis?

A

DHA

B

Linoleic acid

C

Oleic acid

D

Stearic acid

Question 11 of 56

Question 11: All of the following statements regarding selenium are correct EXCEPT: 

A

Fish, organ meats and nuts are excellent sources of selenium

B

Most men are deficient in selenium, so prophylactic supplementation is recommended

C

Selenium is toxic in high doses, so the upper limit of intake is 400 mcg/day

D

Selenium protects sperm from oxidative damage by activating antioxidant enzymes in the epididymis

Question 12 of 56

Question 12: CoQ10 has been hypothesized to reduce peroxide formation in seminal fluid, protecting the sperm membrane from lipid peroxidation and damage. The dose used to date in Randomised Control Trials of COQ10 for male factor fertility has been:

A

50 – 100 mg per day

B

200-300 mg per day

C

300 – 500 mg per day

D

600 – 1000 mg per day

Question 13 of 56

Question 13: How long does it take for a male germ cell to mature into functional sperm?

A

12 days

B

8 weeks

C

74 days

D

3 months

Question 14 of 56

Question 14: Emerging research suggests that which of the following nutrients play a key role in boosting egg health?

A

Omega 3, Calcium, CoQ10

B

Omega 3, Zinc, CoQ10

C

Advanced glycation end-products, Omega 3, Zinc

D

Advanced glycation end-products, Omega 6, Zinc

Question 15 of 56

Questions 15: A woman is born with approximately how oocytes?

A

One thousand oocytes

B

Ten thousand oocytes

C

One million oocytes

D

Ten million oocytes

Question 16 of 56

Question 16: A study by Reubal, L.M. et al. found that overweight and obese women undergoing fertility treatment had poorer egg quality due to having:

A

Fat and inflammation in the fluid surrounding their eggs

B

Eggs with damaged chromosomes

C

An increased rate of miosis

D

Both A) and B)

Question 17 of 56

Question 17: A common blood test that women can undergo to determine if she is pre-menopausal or has a low supply of oocytes is an FSH Test. FSH stands for:

A

Foetal Stimulating Hormone

B

Follicle Stimulating Hormone

C

Follicle Signalling Hormone

D

Folic Suppressing Hormone

Question 18 of 56

Question 18: Studies suggest that women with low AMH levels, often have low levels of which vitamin?

A

Vitamin D

B

Vitamin B12

C

Vitamin E

D

Vitamin C

Question 19 of 56

Question 19: Primary ovarian insufficiency occurs when:

A

FSH levels are higher than testosterone levels

B

Testosterone levels decrease

C

AMH levels increase

D

Estrogen levels decrease

Question 20 of 56

Question 20: Egg freezing:

A

Stops all cell activity, including ageing

B

Stops all cell activity, excluding ageing

C

Only stops cell ageing

D

Only slows cell ageing

Question 21 of 56

Question 21: Which one is NOT one of the phases of the menstrual cycle?

A

Follicular

B

Ovulatory

C

Estrogenic

D

Luteal

Question 22 of 56

Question 22: The hormone sequence that triggers ovulation is:

A

Rising estrogen -> release of Gonadotropin-releasing hormone (GnRH) -> release of Luteinising Hormone (LH) and follicle stimulating hormone (FSH)

B

Rising estrogen -> release of Luteinising Hormone (LH) and follicle stimulating hormone (FSH)

C

Decreasing estrogen -> release of Gonadotropin-releasing hormone (GnRH) -> release of Luteinising Hormone (LH) and follicle stimulating hormone (FSH)

D

Decreasing progesterone -> release of Luteinising Hormone (LH) and follicle stimulating hormone (FSH)

Question 23 of 56

Question 23: In a healthy woman with a typical 28-day cycle, ovulation typically occurs around day:

A

1

B

7

C

14

D

28

Question 24 of 56

Question 24: Which hormones primary function is to prepare the endometrium for the reception and development of the fertilised ovum?

A

Progesterone

B

Estrogen

C

LH

D

FSH

Question 25 of 56

Question 25: Obese women have an increased risk of having ovulatory dysfunction due to:

A

High triglyceride levels cause inflammation of the endometrium

B

Excess estrogen production from adipose tissue

C

Excess adipose tissue increases basal body temperature, meaning that it is not able to further increase to assist with ovulation

D

Adipose tissue surrounding the uterus blocks ovulation from being able to occur

Question 26 of 56

Question 26: RED-S (formally known as 'the female athlete triad') consists of which of the following:

A

Low energy availability, low bone mineral density and anovulation

B

Hypothyroidism, low bone mineral density and anovulation

C

Hypothyroidism, low energy availability and anovulation

D

Hypothyroidism, low energy availability and low bone mineral density

Question 27 of 56

Question 27: A ‘Google’ search will bring up pineapple for being one of the best foods for improving implantation rates. Research shows that:

A

A Systematic Review conducted in 2020 found that women who eat at least 150g (5 ounces) pineapple per day post transfer, are more likely to achieve pregnancy

B

Although no Randomised Controlled Trials have been undertaken, Case Series suggest that eating pineapple core may assist in increasing implantation rates after IVF

C

Although no Randomised Controlled Trials have been undertaken, epidemiological studies suggest that fertility rates are higher in countries which produce pineapples, and consequently it’s feasible that pineapple consumption is higher in these countries

D

There is no research demonstrating that eating pineapples increase implantation rates, however, it is feasible that the bromelain in pineapples may assist in reducing inflammation thinning the blood which may increase implantation rates

Question 28 of 56

Question 28: A common nutritional supplement used to assist with thickening the endometrium is:

A

Vitamin A

B

Vitamin D

C

Vitamin K

D

Vitamin E

Question 29 of 56

Question 29: After an IVF transfer, the couple are required to wait for what period of time to determine whether or not implantation has occurred?

A

24 hours

B

48 hours

C

2 weeks

D

4 weeks

Question 30 of 56

Question 30: A 'chemical pregnancy' is:

A

Becoming pregnant via IVF

B

Becoming pregnant via a series of blood tests to monitor hormone levels

C

Being pregnant prior to 3 weeks gestation

D

Being pregnant prior to 6 weeks gestation

Question 31 of 56

Question 31: Which of the following dietary factors have been associated with recurrent miscarriage?

A

BMI, folate and niacin

B

BMI, thiamine and B12

C

Anxiety scores, folate and niacin

D

Folate, thiamine and B12

Question 32 of 56

Question 32: The following foods have been found to be protective against uterine fibroids:

A

At least two servings per day of fruit and four servings per day of veg, mono and unsaturated fats and red meat

B

At least two servings per day of fruit and four servings per day of veg, mono and unsaturated fats and coffee

C

At least two servings per day of fruit and four servings per day of veg, mono and unsaturated fats and dairy products

D

At least two servings per day of fruit and four servings per day of veg, mono and unsaturated fats and alcohol

Question 33 of 56

Question 33: When it comes to fertility, a vegan diet:

A

Is not recommended unless it’s a personal choice made the client, given the potential for nutrient deficiencies and the lack of available evidence

B

Is a better choice than a vegetarian diet because research suggests that vegans are inadvertently more likely to consume a higher intake of soy isoflavones which lead to increased rates of fertility

C

Is the best dietary style as it significantly reduces saturated fat intakes and consequently reduces inflammation

D

Should always be supplemented with sublingual B12 drops as there are no vegan foods which provide vitamin B12

Question 34 of 56

Question 34: BPA is: 

A

A fertility hormone that plays a key role in ovulation

B

A fertility hormone that plays a key role in implantation

C

A fertility hormone that plays a key role in menstrual cyclicity

D

A synthetic compound that is used in the manufacture of a range of products including re-usable polycarbonate plastic food containers

Question 35 of 56

Question 35: When it comes to trying to conceive, the following statements about caffeine are true EXCEPT:

A

There are no guidelines for the restriction of caffeine intake when trying to conceive, however, it seems prudent that women trying to conceive should follow pregnancy guidelines of restricting caffeine intake to less than 200mg per day.

B

The speed at which caffeine is metabolised by the body varies widely amongst individuals, consequently women experiencing infertility may benefit from avoiding caffeine

C

Caffeine intake of greater than 300mg per day in the lead up to conception is one of the most common causes of miscarriage

D

Emerging research suggests that caffeine might increase estrogen levels

Question 36 of 56

Question 36: The superovulation phase of the IVF cycle often results in fluid retention and bloating.  The best way for women to get rid of the excess fluid and bloating is to:

A

Commence a ketogenic diet

B

Follow a 4-week low FODMAP diet

C

Drink 100ml (3 ounces) beetroot juice each day

D

Wait until the superovulation phase stops and the hormones get excreted into the urine

Question 37 of 56

Question 37: Women trying to conceive should ideally eat fish how often?

A

They should avoid it altogether due to the risk of mercury exposure and take omega 3 supplements instead

B

2-3 times per week so as to optimise omega 3 intake, but minimise methylmercury exposure

C

Every day prior to egg collection as it is one of the best foods to assist with reducing oocyte inflammation

D

Every day prior to transfer as it is one of the best foods to assist with reducing uterine inflammation

Question 38 of 56

Question 38: Studies suggest that excessive maternal pre-pregnancy weight may result in:

A

An increased likelihood of childhood obesity

B

An increased likelihood of childhood stunting

C

An increased likelihood of eating disorders

D

An increased likelihood of malnutrition

Question 39 of 56

Question 39: Dietary factors that may decrease the risk of endometriosis DON’T include:

A

B-group vitamins

B

Dairy products rich in calcium and vitamin D

C

Red meat

D

Fish oils

Question 40 of 56

Question 40: When it comes to fertility, Coeliac Disease:

A

Has no impact

B

Has no impact on pregnancy rates, but has a high risk of being passed on to the next generation unless gluten is reintroduced during pregnancy

C

Is a major cause of recurrent miscarriages if left undiagnosed or untreated

D

Is a major cause of infertility, consequently it is recommended that clients with Coeliac Disease should progress straight to IVF

Question 41 of 56

Question 41: Adenomyosis is a condition where:

A

Endometrial cells grow outside the uterus

B

Endometrial cells grow inside the uterus

C

Endometrial cells grow inside the adenoids

D

Endometrial cells grow outside the adenoids

Question 42 of 56

Question 42: Research suggests that Insulin Resistance impacts fertility by:

A

Triggering a cascade of hormonal changes that impact the production of Progesterone and Luteinising Hormone

B

Triggering a cascade of hormonal changes that impact the production of Growth Hormone and Ghrelin

C

Increasing requirements for niacin

D

Slowing down the absorption of nutrients by the oocyte

Question 43 of 56

Question 43: When seeing a client with PCOS who is trying to conceive, all of the following should be reviewed EXCEPT:

A

Glycemic load

B

Prebiotic intake

C

Ketone production

D

Nutritional supplements

Question 44 of 56

Question 44: To optimise fertility and pregnancy, ideally TSH levels should be:

A

Kept in the middle of the reference range

B

Kept in the higher half of the reference range

C

Kept in the lower half of the reference range

D

Kept slightly above the usual reference range

Question 45 of 56

Question 45: Which of the following is NOT another term for 5MTHF:

A

Activated folate

B

Folinic acid

C

Methylated folate

D

Folate

Question 46 of 56

Question 46: To meet increased iodine needs during pregnancy, guidelines from Australia and America recommend that women planning to conceive take a supplement that contains how much iodine per day? 

A

100mcg per day

B

150mcg per day

C

200mcg per day

D

250mcg per day

Question 47 of 56

Question 47: A client presents with low serum ferritin levels. Which do you do?

A

Take a mental note so that you can reassess later in their pregnancy

B

Talk to your client about iron rich foods

C

Commence them on a preconception multi that includes small amounts of iron as well as a host of other micronutrients thinking that if they have low ferritin levels, they are probably low in a range of other micronutrients as well

D

Commence iron supplements to boost iron levels as quickly as possibly prior to pregnancy and review your clients dietary iron intake

Question 48 of 56

Question 48: Large amounts of supplemental iron (greater than 25 mg/day): 

A

May decrease zinc absorption

B

May increase zinc absorption

C

Reduce risk of gestational diabetes

D

Have no impact

Question 49 of 56

Question 49: Myo-inositol and D-chiro-inositol are involved in the insulin signalling pathways. Current research suggests that when recommending inositol supplements, the ratio of myo-inositol to D-chiro-inositol may be an important consideration. According to current research, the preferred ratio is:

A

2:1

B

4:1

C

20:1

D

40:1

Question 50 of 56

Question 50: The most common dose of CoQ10 currently used for optimising fertility is:

A

600mg ubiquinol daily

B

600mg ubiquinol twice per day

C

1600mg ubiquinol daily

D

1600mg ubiquinol twice per day

Question 51 of 56

In the pre-course questionnaire, we asked you to rate yourself from 1-10 based on how confident you were seeing fertility clients. 

Now that you have completed the program, what would you rate yourself now?  (with 1 being a low level of confidence and 10 being confident to give a great service to anyone who comes in your door).

Question 52 of 56

In the pre-course questionnaire, we asked you to rate yourself from 1-10 based on how close you are to achieving your dream career. 

How close are you to achieving your dream career now? (with 1 feeling like you still have a long way to go, and 10 being already there).

Question 53 of 56

In the pre-course questionnaire, we asked you what your personal goals were for undertaking this program.

Did you achieve the goals that you set?

A

Yes, I’ve achieved them and more!

B

Yes, I achieved the goals that I set

C

I can’t remember what my goals were, but I’ve learnt lots

D

I haven’t achieved my goals yet, I still have a lot more work to do

E

I didn’t get what I hoped to out of the program

Question 54 of 56

What was the main transformation that you’ve had since undertaking this program?

Question 55 of 56

What could we improve for next time?

Question 56 of 56

Would you recommend the Nutrition Therapy for Fertility course to a friend?

Confirm and Submit