Male Infertility Flashcards
In general, semen parameters peak after ___ days of abstinence and then decline
In general, semen parameters peak after 1 or 2 days of abstinence and then decline
However, for increasing the probability of conception and pregnancy, intercourse every day around the time of ___ is likely the best strategy
However, for increasing the probability of conception and pregnancy, intercourse every day around the time of ovulation is likely the best strategy
On average, female fecundity declines precipitously after age __
35
Diseases that interfere with normal coordinated ejaculatory function, as does spinal cord injury
Diabetes mellitus and multiple sclerosis interfere with normal coordinated ejaculatory function, as does spinal cord injury
this procedure may result in obstruction of the vas deferens
Herniorrhaphy may result in obstruction of the vas deferens
mechanisms that affect ratio of estrogen to androgen through a variety of mechanisms
- molecular similarity to estrogen 2. increased estrogen synthesis 3. increased aromatase activity, dissociation of steroids from sex hormone–binding globulin (SHBG) 4. decreased testosterone synthesis, competitive and noncompetitive binding to steroid receptors 5. decreased synthesis of adrenal steroids 5 and induction of hyperprolactinemia
medications that affect ratio of estrogen to androgen
antiandrogens bicalutamide, flutamide, and nilutamide e spironolactone; the antiretroviral protease inhibitors such as indinavir; the nucleoside reverse transcriptase inhibitors such as stavudine; corticosteroids, especially in adolescence; and exogenous estrogen
exogenous testosterone acts to decrease intratesticular testosterone synthesis and reduce spermatogenesis primarily through?
Primarily through conversion to estradiol by aromatase and consequent inhibition of luteinizing hormone (LH) secretion by the pituitary
cannabis decreases plasma testosterone in a __-dependent and duration __-dependent manner
cannabis decreases plasma testosterone in a dose-dependent and durationdependent manner
___ intake also appears to increase aromatization of testosterone to estradiol
Heavy chronic alcohol intake also appears to increase aromatization of testosterone to estradiol
___ increased seminal oxidative stress parameters and decreased metrics of sperm DNA quality
cigarette smoking increased seminal oxidative stress parameters and decreased metrics of sperm DNA quality
The negative effects of cigarette smoking on sperm bulk parameters and DNA quality appear to be especially acute in the presence of a ___, suggesting the possibility of additive toxicity
The negative effects of cigarette smoking on sperm bulk parameters and DNA quality appear to be especially acute in the presence of a clinical varicocele, suggesting the possibility of additive toxicity
Consistent with these laboratory findings, epidemiologic data associated ___ to smaller testes, lower sperm counts, and alterations in sex hormones in the adult male offspring
Consistent with these laboratory findings, epidemiologic data associated maternal cigarette smoking to smaller testes, lower sperm counts, and alterations in sex hormones in the adult male offspring
The most common mechanism of action for antipsychotic drugs is ____, which causes loss of libido as a side effect in the majority of patients
antagonism of dopamine,
Opioid analgesics suppress ___ primarily through hypothalamic-mediated mechanisms and consequently reduce testosterone synthesis
Opioid analgesics suppress LH release primarily through hypothalamic-mediated mechanisms and consequently reduce testosterone synthesis (Subirán et al., 2011). Experimental evidence in animals demonstrates
Evidence suggests that discontinuation of opioid analgesics may be associated with rapid return of androgen, perhaps as early as ___
Evidence suggests that discontinuation of opioid analgesics may be associated with rapid return of androgen, perhaps as early as within 1 month
TICS mnemonic
Toxins, Infections and inflammation, Congenital, sexual history
With the widespread prescribing of opioid analgesics and the epidemic of opioid abuse, their use as a cause of ____ should be suspected in all such hypoandrogenic men.
hypogonadotropic hypogonadism
agents that impair spermatogenesis
Other chemotherapeutic agents commonly used in conjunction with cyclophosphamide to treat non-Hodgkin lymphoma, including doxorubicin, vincristine, and prednisone
Evidence suggests that sperm DNA damage can be detected at least up to___ after chemotherapy, arguing that ___ of sperm before treatment with cytotoxic chemotherapeutic agents is preferable to awaiting the return of sperm after chemotherapy
2 years cyropreservation
Hypertension effects on fertility CCB ACE inhibitors
calcium channel blockers impair fertilization by inhibiting expression of mannose-ligand binding receptors and preventing sperm from attaching to the zona pellucida Angiotensin-converting enzyme inhibitors appear to improve sperm motility through a presumptive effect on seminal plasma kinins
bacille Calmette-Guérin into the bladder for superficial transitional cell carcinoma resulted
significant decrease in sperm concentration and motility
Scrotal temperature in humans is maintained to be (TEMP) below core body temperature by mechanisms including a countercurrent heat exchange between a central set of (ARTERIES) directing blood toward the testis and a (type of veins and location) draining blood back toward the vena cava
2°C to 4°C linear arteries plexus of veins surrounding the arteries
Testes directly exposed to ionizing radiation suffer __ and __
germ cell loss and Leydig cell dysfunction
In a survey of childhood cancer survivors, chances of having future offspring were lessened by radiation doses to the testes of ___ GY and above
7.5 gy
effect of EMV on sperm
The authors identified a significant decrease in motility and an increase in DNA fragmentation of the exposed aliquot
Typical epididymal organisms include
Neisseria gonorrhoeae, Chlamydia trachomatis, and E. coli
Infectious urethral organisms in the context of impaired male reproduction include
N. gonorrhoeae, C. trachomatis, Mycoplasma species, and Trichomonas vaginalis
Mycobacterium tuberculosis may affect any reproductive organ and cause___ of the __ and ___
scarring of the vas deferens and epidydymis
As an example of direct effects, investigators observed that incubating sperm with increasing concentrations of __ was associated with degradation of sperm DNA in a time-dependent manner (Satta et al., 2005).
Human papillomavirus was associated with impairment of bulk seminal parameters
As an example of direct effects, investigators observed that incubating sperm with increasing concentrations of C. trachomatis serovar E elementary bodies was associated with degradation of sperm DNA in a time-dependent manner
Human papillomavirus was associated with impairment of bulk seminal parameters,
One putative mechanism by which nonbacterial prostatitis may lead to male infertility is through:
seminal leukocytosis or pyospermia and the release of ROSs resulting in sperm damage
