infertility Flashcards
how does low sperm count affect infertility
-concentration
-motility
-morphology
what is sperm quality/quantity compromised by
age, injury, immunological, smoking, steroid use, retrograde ejaculation, testosterone deficiency
how do you preserve fertility during oncofertility
-since cancer treatments target cell division, spermatogonium will be affected
-decreased sperm count
-you can store sperm
how might steroids lead to fertility problems
-decrease in androgens –> decrease GnRH –> decrease LH/FSH
-leydig and sertoli cells decrease in size
if you stop androgen steroids, less negative feedback, increase in LH/FSH
what is cryptorchidism
-one or both testes do not descend from body cavity
-sperm production is temperature dependent
-DHT brings testicles down to scrotum
a 16 year old male presents in a clinic. he has: low LH/FSH, low T, almost no sperm. what is the cause
low GnRH
what are the effects of Kallman syndrome
-GnRH secreting cells of hypothalamus never migrate to where they’re supposed to (hypothalamus void of GnRH producing cells)
-GnRH doesn’t get produced so LH/FSH arent produced much
-low T, low sperm count
-form of hypogonadotropic hypogonadism (low LH/FSH)
what is treatment for Kallman syndrome
-stop smoking, taking steroids
-retrograde ejaculation: cessation of medications that cause it or assisted reproductive technology (ART)
-hormone replacement therapy
when should a couple engage in coitus to try and get pregnant
a few days before LH surge
which branch of the ANS is required for an erection
parasympathetic
how do erections form
-NO comes from epithelial cells
-epithelial cells stimulated via parasympathetic nervous system
what does increased FSH levels indicate
-depleted follicular pool
-E2 surge required for ovulation
how does block of fertilization: tubual problems cause infertility
-a result of infection (STDs)
-chlamydia most common cause of infertility
what are the causes for anovulatory: PCOS
-elevated LH levels (stimulates inner theca cells to make androgens
-elevated androgens
-2/3: anovulation/amenorrhea: hyperandrogenism; polycystic ovaries
-obesity can be a factor
-increase in adipose tissue, increases estrone, which decreases FSH, and increases ratio of FSH:LH, and decreases estrogen
how do implantation problems contribute to infertility
-implantation rate depends on embryo quality and endometrial thickness
-issues with endometrial lining occur when the basal endometrium is compromised in its response to estrogen
-implantation rates decline with female age: chromosomal abnormalities, vascular changes to vessels that supply uterus
how do repetitive pregnancy loss contribute to infertility
-uterine polyps or fibroids can develop
-can stimulate uterine contractions leading to pregnancy loss
how does clomiphene treatment anovulatory conditions
-estrogen receptor antagonist
-E2 inhibits ARC nucleus, if inhibition gone when inhibiting estrogen, increase in FSH, more bigger follicles, increase in E2 surge, stimulates AVPV nucleus, increase LH surge, ovulation occurs
why is timing of clomiphene important
-clomiphene inhibits E2 receptors everywhere
-need during follicular phase
-wants to increase FSH
-during days 2-3 of menstrual cycle for 5 days to prevent negative feedback to ARC nucleus
how do FSH injections help fertility
-stimulate more and larger follicles
-leads to more E2 and P4
-increase in LH surge, ovulating more than 1 oocyte, possibility of twins
