Infertility Assessment and male causes

Question 1

what are some of the drugs that can cause male infertility

Answer 1

excess alcohol, marijuana, tobacco, testosterone supplement, cocaine

Question 2

what groups can the causes of male infertility be grouped into

Answer 2

non-obstructive and obstructive

Question 3

give some examples of non-obstructive causes of male infertility

Answer 3

genetic, chemo/radiotherapy, undescended testes, idiopathic

Question 4

what are some of clinical features of non-obstructive male infertility

Answer 4

low testicular volume, reduced secondary sexual characteristics, vas deferens present

Question 5

what are the endocrine features of non-obstructive male infertility

Answer 5

High FSH and LH, low testosterone

Question 6

what are some the causes of obstructive male infertility

Answer 6

congenital(eg cystic fibrosis), infection, vasectomy

Question 7

what are some of the clinical features seen in male infertility

Answer 7

normal testicular volume, normal secondary sexual characteristics, vas deferens may be absent

Question 8

what endocrine features are seen in obstructive male infertility

Answer 8

normal FSH, LH and testosterone

Question 9

what is assessed in the clinical examination of a female for infertility

Answer 9

BMI, general exam, body hair distribution, galactorrhoea, pelvic exam, uterine/ovarian abnormalities/tenderness/mobility

Question 10

what is assessed in the clinical examination of a male for infertility

Answer 10

BMI, general exam, genital exam, assessing size/position of testes, penile abnormalities, presence vas deferens, presence varicoceles

Question 11

what are the general investigations done for female infertility

Answer 11

endocervical swab(chlamydia), cervical smear, blood(rubella), midluteal progesterone level, test to tubal patency

Question 12

what tests can be done for test of tubal patency for female ifnertility

Answer 12

hysterosalpingiogram or laparoscopy

Question 13

what other assessments can be done for female infertility, if needed

Answer 13

hysteroscopy, pelvic ultrasound, endocrine profile and chromosomes

Question 14

when would a hysterosalpingiogram be done for female infertility

Answer 14

if nil known risk factors tubal/pelvic pathology, or laparoscopy contrandicated

Question 15

when would laparoscopy be done for female infertility

Answer 15

possible tubal/pelvic pathology, known previous pathology, previously abnormal HSG

Question 16

when would a hysteroscopy or pelvic ultrasound be needed for female infertility

Answer 16

hysterectomy = suspected endometrial pathology

pelvic ultrasound = abnormality on pelvic exam, or indicated by other tests

Question 17

what investigations are typically used for male infertility

Answer 17

history, examination(general, genital), semen analysis(twice 6 weeks apart)

Question 18

what other assessments are done if semen analysis abnormal

Answer 18

LH and FSH, testosterone, prolactin, thyroid function

Question 19

what other assessments are done if semen analysis is severely abnormal

Answer 19

endocrine profile,(as in abnormal semen), chromosome analysis, screen for CF, testicular biopsy

Question 20

when would a scrotal ultrasound be used

Answer 20

if there is an abnormality on genital examination