Male Infertility Flashcards
What is the definition of male infertility?
Failure to conceive after 12 months of adequate cohabitation.
What percentage of barren marriages are due to male infertility?
0.4
What percentage of infertility cases are due to both male and female factors?
0.2
What is the most common surgically correctable cause of male infertility?
Varicocele.
What percentage of the normal population has varicocele?
0.15
What percentage of primary infertility cases are due to varicocele?
0.35
What percentage of secondary infertility cases are due to varicocele?
0.81
Name two common testicular disorders causing male infertility.
Epididymo-orchitis, testicular torsion.
What is Sertoli cell-only syndrome?
A condition where only Sertoli cells are present, leading to azoospermia.
Which endocrine disorders can cause male infertility?
Hypopituitarism, hypogonadotrophic hypogonadism, hyperprolactinemia, thyroid disorders.
What genetic syndromes are associated with male infertility?
Klinefelter’s syndrome, Kartagener’s syndrome, Noonan’s syndrome, Kallman’s syndrome.
Which systemic illnesses can lead to male infertility?
Sickle cell disease, chronic liver disease, leukemia, lymphomas, amyloidosis.
How can chemotherapy affect male fertility?
It can cause germ cell damage leading to azoospermia.
What congenital abnormalities of the penis can cause infertility?
Hypospadias and epispadias.
How can occupational factors contribute to male infertility?
Long-distance driving, exposure to radiation, welding, hazardous chemicals.
What social habits negatively impact male fertility?
Smoking, alcohol, hot baths.
Why is timing of intercourse important in infertility evaluation?
To ensure intercourse aligns with ovulation (Day 11-14).
Which previous infections are relevant in male infertility history?
Mumps parotitis, orchitis.
What are key components of the general examination for male infertility?
Gynecomastia, hair distribution, webbed neck, external genitalia examination.
What is the significance of situs inversus in male infertility?
It is associated with Kartagener syndrome and impaired sperm motility.
What is the purpose of seminal fluid analysis (SFA)?
To assess sperm count, motility, and morphology.
What is the normal sperm count in SFA?
> 15 million/mL.
What are the two types of azoospermia?
Obstructive and non-obstructive.
How long should a patient abstain before semen collection?
3 days.
What is the required time for semen liquefaction?
Within 30 minutes.
Which hormones are evaluated in male infertility workup?
FSH, LH, testosterone, prolactin, estrogen.
What test is used to diagnose congenital adrenal hyperplasia in infertility cases?
17-hydroxyprogesterone measurement.
Which imaging modality is used for varicocele assessment?
Doppler ultrasound of the scrotum.
What imaging is done for suspected pituitary pathology?
MRI.
What test assesses vas deferens patency?
Vasography.
What is the purpose of a testicular biopsy in male infertility?
To differentiate between obstructive and non-obstructive azoospermia.
Which solutions should be used for testicular biopsy fixation?
Bouin’s solution or Zenker’s solution.
Which solution should NOT be used for testicular biopsy fixation?
Formalin.
What is the role of post-coital testing in infertility evaluation?
To assess sperm-cervical mucus interaction.
What lifestyle modifications can improve male fertility?
Avoid smoking, alcohol, and recreational drugs.
What is the role of sperm banking in male infertility management?
It preserves sperm for future use, especially in testicular cancer cases.
What is immunological infertility?
Infertility due to sperm antibodies.
What is the first-line treatment for immunological infertility?
Steroid administration.
What surgical procedures can treat obstructive infertility?
Vaso-vasostomy, epididimo-vasostomy, microsurgical vas-to-seminiferous tubule anastomosis.
What is ART?
Assisted Reproductive Techniques.
What are the main ART options?
IVF, ICSI, sperm retrieval techniques.
What are ethical and religious considerations in IVF?
Concerns regarding embryo manipulation, selective reduction, and donor sperm use.
What is the most effective treatment for azoospermia due to obstruction?
Microsurgical reconstruction (vaso-vasostomy, epididimo-vasostomy).
What is the main hormonal treatment for hypogonadotropic hypogonadism?
hCG and FSH therapy.
What is the relationship between obesity and male infertility?
Obesity causes hormonal imbalances and reduced testosterone production.
How does hyperprolactinemia cause male infertility?
It suppresses gonadotropin release, leading to low testosterone levels.
What are the key semen parameters evaluated in SFA?
Sperm count, motility, morphology, volume, liquefaction time, viscosity.
What role does testosterone replacement therapy play in infertility?
It is generally NOT used, as it can suppress spermatogenesis.
What is the impact of cryptorchidism on fertility?
Increased risk of infertility due to testicular damage from undescended testes.
