77. Infertility. Male infertility. Etiology and diagnosis. Treatment and prophylactic.

Question 1

male infertility are split into groups what are they ?

Answer 1

group 1 - factors affecting spematogensiis

group 2 - reason affecting normal sperm discharge

group 3 - idiopathic infertility

Question 2

what are some of the group 1 affecting spermatogenesis factors ?

Answer 2

Cryptorchidism
 Testicular trauma or torsion
Viral orchitis
Hypogonadotropic hypogonadism
Testicular neoplasia

genetic syndrome such as klinefelter and androgen insensitivity

Question 3

what are some of the group 2 factors ?

Answer 3

Infections (epididymitis, prostatitis)
Inborn lack of vas deferens
Operative treatment of inguinal hernia or hydrocele Hypospadias, 
varicocele
Vasectomy

Question 4

what are the reasons for group 3 ?

Answer 4

immunological reasons

and genetic reasons
micro deletion in the y chromosome mostly located in the long arm of the chromosome

Question 5

diagnosis of male infertility is split into what ?

Answer 5

anamnesis
physical examination
spermogram
test for antisperm antibodies

Question 6

what are the key questions asked in anamnesis ?

Answer 6

freq of sexual intercourse

continuity of infertility

extragenita diseases

presence of any disease such as - diabetes and cystic fibrosis

surgeries - hernioplasty

STI

exposure to gonadotropins

Question 7

what should be looked out for in physical examination ?

Answer 7

penis - hypospadias , epispadia

testicles - consistency and size

varicocele -enlargement of the veins within the loose bag of skin that holds your testicles similar to varicose veins

secondary sexual characteristics - such as mammary glands and hair sparsisty

rectal examination - for abnormalities in the prostate gland

Question 8

what are we looking for in a spermogram

Answer 8

colour – milky white
 liquefaction time up to 60 min. 
 viscosity - low
 smell
 pH – 7.2 – 7,8

 concentration of spermatozoa
– over 15 million / ml

total number of spermatozoa in the entire ejaculate
– over 40 million

 sperm mobility

 Morphology

 Leukocytes
– below 1 million / ml agglutinates

Question 9

when is there testing for antiserum antibodies

Answer 9

when there are agglutinates in the spermogram and unexplained infertility

Question 10

what immunogliobin are antiserum antibodies and how are they tested ?

Answer 10

IgG and IgA

elisa

Question 11

ASTHENOZOOSPERMIA?

Answer 11

below 50% progressively mobile

/or below 25% fast progressively mobile

Question 12

TERATOZOOSPERMIA

Answer 12

spermatozoa with normal morphology below 30%

Question 13

OLIGOZOOSPERMIA

Answer 13

less than 20 million spermatozoa /ml

Question 14

OTA Sd ?

Answer 14

OLIGOZOOSPERMIA
TERATOZOOSPERMIA
ASTHENOZOOSPERMIA

Question 15

ASPERMIA

Answer 15

no spermatogenesis cells in the ejaculate

Question 16

AZOOSPERMIA

Answer 16

no sperm in the ejaculate after centrifugation

Question 17

ASPERMATISM

Answer 17

lack of ejaculation.

Question 18

GLOBOZOOSPERMIA

Answer 18

spermatozoa lack acrozome

Question 19

ADDITIONAL EXAMINATIONS AND TES?

Answer 19

Testosterone, prolactin, FSH and LH are tested.

Question 20

prophylaxis for male infertility ?

Answer 20

Don’t smoke.
Limit or abstain from alcohol.
Steer clear of illicit drugs.
Keep the weight off.

Question 21

when a spermogram is done what is recommended to the male ?

Answer 21

masturbation after 3 – 5 days of sexual abstinence