B8-010 CBCL Male Infertility Flashcards
contains enzymes that allow sperm to enter egg
acrosome
sperm maturation and storage occurs in the
epididymis
sperm transport and ejaculation occurs in the
vas deferens
adds secretions like proteins, sugars, and salts to the semen
seminal vesicle
last stages of sperm maturation occurring in the female genital tract
capacitation
if the semen analysis shows low volume, test for
obstructions
retrograde ejaculation
if the semen analysis shows no sperm, the next best test is
testicular biopsy
if the semen analysis shows abnormal morphology/function, the next best test is
hormonal tests
check for varicocele
if the semen analysis is normal, the next best test is
advanced sperm tests (viability, penetration assay)
low ejaculate volume
hypospermia
increased amorphous sperm
teratospermia
asthenozoospermia
low sperm motility
<15 M sperm/ejaculate
oligospermia
can measure total and different patterns of sperm motility in multiple spermatozoa simultaneously
CASA
(computer sperm analysis)
if the total testosterone is low on initial testing…
repeat total and free T
exogenous […] is a powerful male contraceptive
testosterone
(converted to estradiol via aromatase, estradiol inhibits GnRH)
[…] leads to poor development of the vas deferens and obstructive infertility
cystic fibrosis
images prostate, seminal vesicles, and vas deferens to rule out obstructive infertility
transrectal US
imaging modality for varicocele, epididymal abnormalities, undescended testis
scrotal US
presence indicates autoimmune infertility
anti-sperm antibodies
when absent, indicates seminal vesicle issues or duct obstruction
seminal fructose
dyes used to determine live/dead sperm
used when sperm mobility is less than 5%
sperm viability testing
TUNEL assay for DNA fragmentation
sperm DNA testing
hemizona assay
measures binding to isolated zona pellucida and then compared to normal
sperm-zona binding study
measures sperm penetration in hamster oocytes freed of zona pellucida
sperm penetration testing
XXY
klinefelter’s syndrome
genetic cause of infertility due to blockage/absence of vas deferens
cystic fibrosis
genetic cause of infertility due to hypogonadotropic hypogonadism
Kallman syndrome
genetic cause of infertility due to dysfunctional cilia/flagellum
kartagener’s syndrome
infections commonly causing infertility [3]
orquitus
epididymitis
STIs
one of the most common causes of male infertility
varicocele
dilation and tortuosity of the internal spermatic veins (pampiniform plexus) that drains the testis
varicocele
most common symptom of varicocele is
infertility
[what grade varicocele]
subclinical, non-palpable
only visualized on doppler
grade 0
[what grade varicocele]
palpable only during valsalva maneuver
grade 1
[what grade varicocele]
easily palpable in standing position, but not visible
grade 2
[what grade varicocele]
easily palpable and visbile
grade 3
semen analysis of a patient with varicocele will show:
normal volume
oligospermia
teratospermia
asthenoospermia
FSH, LH, and testosterone levels of a patient with varicocele will show:
all normal
no issue with HPG axis
provides immediate symptom relief of varicocele
percutaneous drainage
most definitive treatment for varicocele
varicocelectomy
(ligation of spermatic veins with preservation of lymphatics)
when are semen parameters expected to return to normal following varicocelectomy?
3 months
(time for spermatogenesis and spermiogenesis)
most common complication of varicocelectomy
hydrocele due to lack of drainage
treatment for obstructive causes of male infertility
surgery
treatment for male infertility due to absence of ductal system
sperm retrieval from testis or epididymis –> IVF, ICSI
treatment for male infertility due to low sperm quality but good numbers, female cervix factor
IUI
infertility is defined as the inability to conceive after […] of unprotected intercourse
one year
lack of semen
aspermia
oligospermia and asthenoospermia would be consistent with what cause of infertility?
varicocele
azoospermia and low fructose would be consistent with what cause of infertility?
obstruction of male genital tract
most probably cause of infertility due to varicocele
issues with spermatogenesis due to increase in temperature, pressure, and hypoxia of testes
lymphatics are [ligated/preserved] in varicocelectomy
preserved
spermatic veins are [ligated/preserved] in varicocelectomy
ligated
65% of the cases of male infertility are […]
idiopathic
