Male infertility

Question 1

pre testicular causes?

Answer 1

endocrine:
- hypogonadotropic 
- hypogonadism 
- hypothyroidism 
- hyperprolactinaemia 
- diabetes 
coital disorders:
- erectile dysfunction 
- ejaculatory failure

Question 2

testicular causes

Answer 2

genetic:
- Klinefelter syndrome 
- Y chromosome deletion 
- immotile cilia 
syndrome 

congenital:
- cyptorchidism
- infective
- antispermatogenic agents - heat, irradiation, drugs, chemotherapy

vascular:

• torsion
• varicocele

immunological

Question 3

post testicular causes

Answer 3

obstructive:
epdidymal
- congenital
- infective

vasal:
genetic - cystic fibrosis 
acquired 
- vastoectomy 
- ejaculatory duct, obstruction 
- accessory gland infection 

immunological:
- idiopathic
- post vasectomy

Question 4

what investigations are done in males?

Answer 4

• Semen analysis

* Testicular ultrasound

Question 5

what test do you do if you find abnormal semen analysis?

Answer 5

LH and FSH,
testosterone,
prolactin,
thyroid function

Question 6

what tests should be done if there is severely abnormal semen analysis/azoospermic (semen contains no sperm)?

Answer 6

endocrone profile - LH and FSH, testosterone, prolactin, thyroid function
chromosome analysis
screen for CF
testicular biopsy

Question 7

what should be done of there is an abnormality on genital examination

Answer 7

scrotal ultrasound