2- Infertility Flashcards
What is the most common sex chromosome anomaly in males and what is the cause?
- Klinefelter’s syndrome caused by XXY karyotype
If a patient is suffering from hypogonadism secondary to a prolactinoma what is the treatment?
- dopamine agonist = cabergoline
What ART is the most common and effective technique for patients with male factor infertility?
- intracytoplasmic injections of spermatozoa
What is the cause of obstructive azoospermia and how is it evaluated?
- ejaculatory duct is obstructed
- requires transrectal ultrasound
If semen analysis reveals a low volume but normal concentration what are the 2 possible causes?
- incomplete collection
- retrograde ejaculation
Men with sperm concentrations of <5million/ml is seen in what condition?
- Y chromosome microdeletions
What is the likely diagnosis for the following results:
Testosterone: low
FSH: normal/low
LH: normal/low
- secondary hypogonadism
If semen analysis returns normal most likely what is the diagnosis?
- idiopathic male infertility
If a semen analysis shows a concentration of less <10 million/ml that could clue you into what condition?
- Klinefelter’s syndrome
how is infertility defined?
when a couple is unable to achieve conception despite 1 year of frequent, unprotected intercourse.
What is the treatment for primary hypogonadism?
- there is no effective medical therapy
On physical exam you notice atypical genitalia, micropenis, and loss of secondary sex characteristics. What diagnoses are you concerned for?
- Androgen deficiency
What testing should be done in men with severe oligozoospermia or azoospermia?
- endocrine and genetic testing
What is the likely diagnosis for the following results:
Testosterone: low
FSH: high
LH: normal
- primary hypogonadism
What is the protocol surrounding semen sample collection?
- collect after 2-7 days of abstinence
- should be collected in the office
- need 2 samples 1 week apart
If you see immature germ cells under microscopy what are you concerned for?
- disorder of spermatogenesis
Fertility may be optimized by vaginal intercourse at how many times/week?
> 2 times/week
What is the likely diagnosis for the following results:
Testosterone: high
FSH: normal
LH: high
- partial androgen resistance
What is the treatment for idiopathic male infertility?
- continue attempts at natural conception or ART
What is the most common category of male infertility?
a. endocrine and systemic disorders
b. primary testicular defects in spermatogenesis
c. sperm transport disorders
d. idiopathic male infertility
b. primary testicular defects in spermatogenesis
If a patient has obstructive azoospermia you should consider testing for this type of mutation.
- cystic fibrosis transmembrane conductance regulatory mutations
If semen analysis reveals azoospermia or oligozoospermia what is the possible cause??
- genital tract obstruction
What is the treatment for dysspermatogenesis?
- conception with ART
If semen analysis reveals a low volume and low concentration what is the possible cause?
- testosterone deficiency
How is secondary hypogonadism treated?
- gonadotropin replacement therapy for 6 months-2 years
What additional test can be done for retrograde ejaculation?
- post-ejaculate urine
What is the likely diagnosis for the following results:
Testosterone: low
FSH: high
LH: high
- primary hypogonadism
What is the KEY laboratory assessment for male infertility.
semen analysis
