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Medical Physiology > Male infertility > Flashcards

Male infertility Flashcards

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USMLE® Step 1 flashcards
1
Q

What do pathophysiological conditions impact?

A

Male fertility.

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2
Q

What is less widely recognised?

A

That male factors contribute to 50% of cases of infertility.

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3
Q

What is recommended?

A

A full medical history of the couple.

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4
Q

What is varicocele?

A

A varicose vein in the scrotum.

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5
Q

For what is the the counter current heat exchange necessary?

A

To help keep the testis cooler than body temperature.

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6
Q

Why does counter current heat exchange that help to keep the testis cooler than body temperature not work efficiently?

A

Because varicocele is essential for that.

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7
Q

What is nutrient and waste exchange equally?

A

Impaired.

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8
Q

Why is the nutrient and waste exchange impaired?

A

So the testis are likely to suffer greater stress.

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9
Q

What does greater stress affect?

A

Spermatogenesis.

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10
Q

In what does hypogonadotropic hypogonadism result?

A

In failed puberty.

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11
Q

Why does hypogonadotropic hypogonadism result in failed puberty?

A

Due to low testosterone.

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12
Q

What do elevated temperature and physical damage impair?

A

Spermatogenesis.

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13
Q

What do bacterial and viral infections cause?

A

Elevated stress .

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14
Q

Why do bacterial and viral infections cause elevated stress?

A

Due to direct damage.

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15
Q

What are some examples of bacterial and viral infections that cause elevated stress?

A

LPS from bacteria.
Reactive oxygen species stress.
Inflammation from the immune response.

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16
Q

What is Kalmann syndrome?

A

A well recognised genetic condition.

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17
Q

About what is there an increasing awareness?

A

About the contribution of genetic defects.

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18
Q

What do genetic defects affect?

A

Spermatogenesis.

Sperm specific proteins.

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19
Q

What can drugs and alcohol lower?

A

Testosterone levels.

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20
Q

What factor do anabolic steroids mimic?

A

Testosterone.

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21
Q

What do anabolic steroids cause?

A

Negative feedback into the hypothalamus and pituitary.

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22
Q

What do anabolic steroids switch off?

A

Natural production of GnRH and gonadotropins.

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23
Q

What does chemotherapy target?

A

Rapidly dividing cells.

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24
Q

What happens to spermatogonia when chemotherapy targets dividing cells?

A

They are damaged.

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25
Q

What can occur as a consequence in male infertility?

A

Observable/measurable defects.

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26
Q

What is Azoospermia?

A

A deficit/loss of sperm production.

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27
Q

How is sperm morphology characterised as an assessment on sperm features?

A

Very subjective.

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28
Q

What is Globozoospermia?

A

The production of sperm with abnormal heads and no acrosome.

29
Q

What can sperm with Globozoospermia not do?

A

Fertilise.

30
Q

What is Asthenozoospermia?

A

Sperm with poor motility.

31
Q

How many cases of male infertility have no obvious cause?

A

Up to 30%.

32
Q

How much should semen volume be for examination of semen range?

A

Above 1.5ml.

With a pH of 7.2.

33
Q

What should be investigated if volume is low?

A

Congenital bilateral absence of the vas deferens.

34
Q

How much should sperm concentration be?

A

At least 15ml.

35
Q

How much of sperm showing progressive forward motility should be?

A

Above 32%.

36
Q

How much should total motility be?

A

Above 40%.

37
Q

What do observed morphological abnormalities impact?

A

Fertility.

38
Q

How many men with complete absence of normal form can achieve pregnancy naturally?

A

Approximately one third.

39
Q

What does embroscope do?

A

Takes image of developing embryos in culture.

Uses an algorithm to predict which ones are developing normally.

40
Q

For how long has computer assisted sperm analysis existed?

A

For a long time.

41
Q

What does the algorithm track?

A

The sperm movement.

42
Q

What does the algorithm give?

A

Various readings on the pattern.

Speed of sperm movement.

43
Q

What are the main parameters in the reading pattern of sperm movement?

A

Straight line velocity.
Average path velocity.
Curvilinear velocity.
Amplitude of lateral head displacement.

44
Q

In what can the parameters of sperm movement reading be useful?

A

In diagnosing asthenozoospermia.

45
Q

To where do the molecular defects contribute?

A

To the hitherto unknown causes of male infertility.

46
Q

What are 2 prominent examples of causes of male infertility?

A

Mutations in the sperm ion channel CatSper.

Loss of PLC-zeta.

47
Q

Where can loss of acrosome function be measured?

A

In the laboratory.

48
Q

What does the western blot show?

A

A complete lack of PLC-zeta in globozoospermia cases.

One failed fertilisation case.

49
Q

What do further studies support?

A

Loss of PLC-zeta as a cause of total failed fertilisation at IVF.

50
Q

What do infertile men have?

A

More sperm with very low or failed acrosome reaction rates.

51
Q

What are the three assisted reproductive technology treatment pathways?

A

IUI.
IVF.
ICSI.

52
Q

With what does the success of all treatment pathways decrease?

A

With age of the woman who is using her own eggs.

53
Q

By what do the key events encounter?

A

By sperm as they travel from the testes to the egg.

54
Q

What is the association between ART procedure and the length of the dashed lines?

A

The more complex the ART procedure the greater the length of the dashed lines.

55
Q

What does IUI mean?

A

Intrauterine insemination.

56
Q

What do the mutations in genes cause?

A

Production of CatSper.

57
Q

What is CatSper?

A

A very complex channel.

58
Q

Of what does CatSper consist?

A

At least 10 subunits.

59
Q

What mutations in genes are found in humans?

A

Mutations in genes for subunits 1 2 and epsilon.

60
Q

With what is a microdeletion in exon 18 of the CatSper auxiliary subunit epsilon gene associated?

A

With loss of CatSper function in sperm.

61
Q

In what does loss of CatSper function in sperm result?

A

In infertility.

62
Q

In what does homozygous 6-base pair in frame deletion in exon 18 of CATSPER EPSILON result?

A

In a loss of Methionine799 and Alanine800 in the putative extracellular domain of CATSPER EPSILON protein.

63
Q

In what does the loss of Methionine799 and Alanine800 in the CATSPER EPSILON protein result?

A

In production of ICatSper-null sperm.

64
Q

What do ICatSper-nullsperm not have?

A

Overt signs of sperm dysfunction.

65
Q

Tow hat does P4 fail?

A

To elicit an increase in calcium concentration in cell populations.

66
Q

How is male infertility diagnosis beyond hormonal and crude semen assessment characterised?

A

Limited.

67
Q

Thanks to what are novel causes slowly being reported?

A

To combined phenotypic and genetic analysis.

68
Q

What is the challenge of male infertility?

A

To find new methods of treating the male that doesn’t involve also treating the female.

Medical Physiology (12 decks)

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