Male Infertility

Question 1

What is the definition of male infertility?

Answer 1

Failure to conceive after 12 months of adequate cohabitation.

Question 2

What percentage of barren marriages are due to male infertility?

Answer 2

0.4

Question 3

What percentage of infertility cases are due to both male and female factors?

Answer 3

0.2

Question 4

What is the most common surgically correctable cause of male infertility?

Answer 4

Varicocele.

Question 5

What percentage of the normal population has varicocele?

Answer 5

0.15

Question 6

What percentage of primary infertility cases are due to varicocele?

Answer 6

0.35

Question 7

What percentage of secondary infertility cases are due to varicocele?

Answer 7

0.81

Question 8

Name two common testicular disorders causing male infertility.

Answer 8

Epididymo-orchitis, testicular torsion.

Question 9

What is Sertoli cell-only syndrome?

Answer 9

A condition where only Sertoli cells are present, leading to azoospermia.

Question 10

Which endocrine disorders can cause male infertility?

Answer 10

Hypopituitarism, hypogonadotrophic hypogonadism, hyperprolactinemia, thyroid disorders.

Question 11

What genetic syndromes are associated with male infertility?

Answer 11

Klinefelter’s syndrome, Kartagener’s syndrome, Noonan’s syndrome, Kallman’s syndrome.

Question 12

Which systemic illnesses can lead to male infertility?

Answer 12

Sickle cell disease, chronic liver disease, leukemia, lymphomas, amyloidosis.

Question 13

How can chemotherapy affect male fertility?

Answer 13

It can cause germ cell damage leading to azoospermia.

Question 14

What congenital abnormalities of the penis can cause infertility?

Answer 14

Hypospadias and epispadias.

Question 15

How can occupational factors contribute to male infertility?

Answer 15

Long-distance driving, exposure to radiation, welding, hazardous chemicals.

Question 16

What social habits negatively impact male fertility?

Answer 16

Smoking, alcohol, hot baths.

Question 17

Why is timing of intercourse important in infertility evaluation?

Answer 17

To ensure intercourse aligns with ovulation (Day 11-14).

Question 18

Which previous infections are relevant in male infertility history?

Answer 18

Mumps parotitis, orchitis.

Question 19

What are key components of the general examination for male infertility?

Answer 19

Gynecomastia, hair distribution, webbed neck, external genitalia examination.

Question 20

What is the significance of situs inversus in male infertility?

Answer 20

It is associated with Kartagener syndrome and impaired sperm motility.

Question 21

What is the purpose of seminal fluid analysis (SFA)?

Answer 21

To assess sperm count, motility, and morphology.

Question 22

What is the normal sperm count in SFA?

Answer 22

> 15 million/mL.

Question 23

What are the two types of azoospermia?

Answer 23

Obstructive and non-obstructive.

Question 24

How long should a patient abstain before semen collection?

Answer 24

3 days.

Question 25

What is the required time for semen liquefaction?

Answer 25

Within 30 minutes.

Question 26

Which hormones are evaluated in male infertility workup?

Answer 26

FSH, LH, testosterone, prolactin, estrogen.

Question 27

What test is used to diagnose congenital adrenal hyperplasia in infertility cases?

Answer 27

17-hydroxyprogesterone measurement.

Question 28

Which imaging modality is used for varicocele assessment?

Answer 28

Doppler ultrasound of the scrotum.

Question 29

What imaging is done for suspected pituitary pathology?

Answer 29

MRI.

Question 30

What test assesses vas deferens patency?

Answer 30

Vasography.

Question 31

What is the purpose of a testicular biopsy in male infertility?

Answer 31

To differentiate between obstructive and non-obstructive azoospermia.

Question 32

Which solutions should be used for testicular biopsy fixation?

Answer 32

Bouin’s solution or Zenker’s solution.

Question 33

Which solution should NOT be used for testicular biopsy fixation?

Answer 33

Formalin.

Question 34

What is the role of post-coital testing in infertility evaluation?

Answer 34

To assess sperm-cervical mucus interaction.

Question 35

What lifestyle modifications can improve male fertility?

Answer 35

Avoid smoking, alcohol, and recreational drugs.

Question 36

What is the role of sperm banking in male infertility management?

Answer 36

It preserves sperm for future use, especially in testicular cancer cases.

Question 37

What is immunological infertility?

Answer 37

Infertility due to sperm antibodies.

Question 38

What is the first-line treatment for immunological infertility?

Answer 38

Steroid administration.

Question 39

What surgical procedures can treat obstructive infertility?

Answer 39

Vaso-vasostomy, epididimo-vasostomy, microsurgical vas-to-seminiferous tubule anastomosis.

Question 40

What is ART?

Answer 40

Assisted Reproductive Techniques.

Question 41

What are the main ART options?

Answer 41

IVF, ICSI, sperm retrieval techniques.

Question 42

What are ethical and religious considerations in IVF?

Answer 42

Concerns regarding embryo manipulation, selective reduction, and donor sperm use.

Question 43

What is the most effective treatment for azoospermia due to obstruction?

Answer 43

Microsurgical reconstruction (vaso-vasostomy, epididimo-vasostomy).

Question 44

What is the main hormonal treatment for hypogonadotropic hypogonadism?

Answer 44

hCG and FSH therapy.

Question 45

What is the relationship between obesity and male infertility?

Answer 45

Obesity causes hormonal imbalances and reduced testosterone production.

Question 46

How does hyperprolactinemia cause male infertility?

Answer 46

It suppresses gonadotropin release, leading to low testosterone levels.

Question 47

What are the key semen parameters evaluated in SFA?

Answer 47

Sperm count, motility, morphology, volume, liquefaction time, viscosity.

Question 48

What role does testosterone replacement therapy play in infertility?

Answer 48

It is generally NOT used, as it can suppress spermatogenesis.

Question 49

What is the impact of cryptorchidism on fertility?

Answer 49

Increased risk of infertility due to testicular damage from undescended testes.