Lecture 15- Andropause & infertility in men

Question 1

As men age they have less testosterone. What are the symptoms of having less testosterone?

Answer 1

• Increased fat
• decreased energy and muscle strength
• depression
• Sleep problems
• decreased libido (sexual desire)

Question 2

What happens if there is a problem with Leydig cells? (stop working)

Answer 2

Testosterone decreases→ FSH and LH increase→ GNRH decreases

Question 3

As men get older they have less LH receptors which causes less testosterone. How would we treat that?

Answer 3

• Directly inject cells with forskolin=cAMP goes up→ testosterone production goes up.
• Or you could inject cells with A LOT of LH, for a small increase of testosterone. Injecting cells with forskolin is the better option

Question 4

What happens to sperm as men age?

And how do you treat the problems?

Answer 4

• Sperm motility(becomes slower)
• Sperm quantity
• Volume of ejaculate
• More abnormal sperm.

1. Slow release of testosterone (To help replace the testosterone levels that are lost with old age)
2. Calcium intake (fights against osteoporosis aka brittle bones)
3. weight-bearing exercise (fights against osteoporosis aka brittle bones)

Question 5

Infertility in men: Looking for low sperm count.

Sperm quality/quantity compromised by:

Answer 5

• age
• injury
• Immunological
• Smoking
• Steroid use
• Retrograde ejaculation (Semen going into the bladder)
• Testosterone deficiency

Question 6

Can cancer treatment impact a males’ fertility? If yes, why?

Answer 6

Yes, cancer treatment can impact a males fertility. Cancer treatment is stopping the division of rapidly dividing cells→ called oncofertility. Spermatogonium(the thing that eventually becomes sperm) rapidly divides.

Question 7

How do steroids lead to infertility?

Answer 7

It messes with the negative feedback loop. Lowers GNRH→ Lower FSH and LH→ Lower Testosterone→ infertility

Low FSH and LH can result in smaller size of testicles because Sertoli and Leydig cells reduce in size.

Question 8

What is Kallman syndrome?

Answer 8

GNRH-secreting cells never migrate where they are supposed to be→ GNRH does not get produced→ Low FSH and LH→ Low testosterone

Question 9

Infertility in men: Stress

When a man is constantly stressed, he is not in the parasympathetic state. High blood pressure also does not allow for parasympathetic state.

Why does stress and high blood pressure lead to infertility?

Answer 9

because in order to get an erection you need to be in a parasympathetic state where your blood vessels vasodilate. Need vasodilation to open up blood vessels for an erection.

Question 10

When should couples participate in coitus to have a kid?

Answer 10

Before the LH surge has the highest chance of a woman getting pregnant.

Question 11

Infertility in men: What is cryptorchidism and how does it lead to infertility?

Answer 11

It is the condition that one or both of the testes don’t descend from the body cavity. Since one or both of testicles are in the body cavity you produce low amounts of sperm.