Male Infertility Flashcards
Inability to conceive via unprotected natural intercourse within 12 months
Infertility
Major causes of Male Infertility
Varicocele (35%)
Idiopathic (25%)
GU Infection (10%)
Genetic (10%)
Dilation of the Pampiniform Plexus; usually asymptomatic, but can cause atrophy, asymmetry or pain; seen in Infertile men due to hyperthermia and hypoxia
Varicocele
How can Varicocele cause Infertility
Hyperthermia
Hypoxia
Varicocele is more common on the (left/right) testes and why?
Left (longer vein towards the left renal vein)
MOST common GENETIC cause of Male Infertility; men with 47 XXY karyotype; primary hypogonadism, small testes, tall stature and gynecomastia
Klinefelter Syndrome
Karyotype for Klinefelter Syndrome
47 XXY
Signs/Symptoms of Klinefelter Syndrome (47 XXY)
Small testes
Infertility
Tall stature
Gynecomastia
Genetic causes of Male Infertility
Klinefelter Syndrome (most common) Congenital Bilateral Absence of Vas Deferens (Cystic Fibrosis carrier) Azoospermia (no sperm due to Y chromosome micro-deletion)
Examples of Endocrine causes of Male Infertility
Exogenous testosteone
Prolactinoma (suppressed GnRH)
Examples of Gonadotoxins
Pesticides
Solvents
Drugs (alcohol, steroids, cocaine, marijuana)
TESTOSTERONE
Examples of physical obstructions of the Male Reproductive system
Spermatocele (epididymis) Vasectomy Inguinal Hernia/repair Prostatic cyst Urethral stricture
Example of permanent sterilization; 99.9% effective; simple surgery through posterior scrotum; segmental excision and cauterization of ends
Vasectomy
Twisting of testical on vasculature; most common in teenagers; SEVERE pain and swelling; surgical EMERGENCY
Testicular Torsion
A SOLID testicular mass is ____________ until proven otherwise
Cancer
Lab Work-Up for suspected Male Infertility
- 1st test after H &P: Semen analysis (abstinence for 2-5 days)
Hormone profile (FSH & Testosterone minimum) Genetic testing
Normal values for Semen Analysis
Volume: 2-5 mL
Conc: >15 million/mL
Never give _____ since it can cause testis atrophy, cessation of spermatogenesis and infertility.
exogenous testosterone
Tx for infertility due to varicocele
varicocele repair
- improvements in semen quality in most cases.
Is vasectomy reversal?
yes!
Microsurgical vasectomy reversal can be done.
An assisted reproductive technology that requires injection of a SINGLE sperm/egg; enabled men to be biologic fathers in cases of severe testicular damage/obstruction since very few sperms are needed.
ICSI (intracytoplasmic sperm injection)
(T/F) Male factor infertility is present in half of infertile couples
True!
