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Reproduction > Male Infertility > Flashcards

Male Infertility Flashcards

1
Q

What does the Wolffian ducts develop into?

A

male reproductive tract

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2
Q

What do the mullerian ducts devlop into?

A

female repro tract

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3
Q

What do the fetal testes secrete?

A

testosterone and mullerian inhibiting factors

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4
Q

What occurs during androgen insensitivity syndrome?

A

androgen induction of Wolffian duct does not occur, Mullerian inhibition does occur: born phenotypically external genitalia femal, ansence uterus and ovaries with short vagin

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5
Q

What does testosterone do?

A

undifferentiated extenral genitalia develop along male lines; transforms wolffian ducts into male reprod tract

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6
Q

What does the mullerian-inhibiting factor cause?

A

degeneration of mullerian ducts

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7
Q

How do patients with androgen insensitivity syndrome usually present?

A

at puberty with primary amenorrhoea and lack of pubic hair

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8
Q

Why do testes need to descend?

A

lower temp outside body to facilitate spermatogenesis

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9
Q

What muscle contracts to lower or raise the testes?

A

dartos muscle

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10
Q

What is undescended testes called?

A

cryptorchidism

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11
Q

When should orchidopexy be performed with cryptorchidism?

A

below age 14

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12
Q

What is the risk with undescened testes?

A

testicular germ celll cancer x6 as adult

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13
Q

What cells produce testosterone?

A

leydig cells

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14
Q

What cell produces sperm?

A

sertoli cells

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15
Q

What is found within the acrosome of the sperm?

A

enxymes for penetrating the ovum

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16
Q

What are the functions of sertoli cells?

A

blood-testes barrier; provide nutriets; phagocytosis; secrete seminiferous ubule fluid ;secrete androgen binding globulin and secretes inhibin and activin

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17
Q

What si the function of a blood-testes barrier?

A

protects sperm from antibody attack; provides a suitable fluid composition allowing later stage sof speram development

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18
Q

what is the function of seminiferous tubule fluid?

A

carry cells to epididymis

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19
Q

What is the function of androgen binding globulin?

A

binds testosterone so conc. remains high in the lumen, essential for sperm production

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20
Q

What is the function of inhibin adn activin?

A

regulates FSH secretion and controls spermatogenesis

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21
Q

What hormone stimulates spermatogenesis?

A

FSH

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22
Q

What hormone stimulates production of testosterone?

A

LH

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23
Q

What is the function of GnRH?

A

stimulates anterior pituitary to produce LH and FSH

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24
Q

What are the effects of testosterone in the adult?

A

contorols spermatogeneiss; secondary sexual characterisitsc; libido; penile erection; aggressive behaviour?

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25
Q

What type of molecule is inhibin nad activin?

A

peptides

26
Q

What is capacitation?

A

the function changes that lead to hyperactive motility and which later allow the spermatozoa to undergo acrosome reaction

27
Q

How are sperm attracted to the oocyte?

A

chemoattraction

28
Q

What is the function of the seminal vesicles?

A

produce semen into ejaculatory duct, supply fructose, secrete PGs and secrete fibrinogen

29
Q

What is the function of PGs in sperm?

A

stimulate motility

30
Q

What is the funcion of the prostate gland?

A

produces alkaline fluid and clotting enzymes to clot semen within the female

31
Q

What is the function of the bulbourethral glands?

A

secrete mucus to act as lubricant

32
Q

What nervous system controls erection?

A

parasympathetics

33
Q

What nervous system controls ejaculation?

A

sympathetics

34
Q

What is emission?

A

contraction of accessory sex glands and vas deferens so semen expelled to urethra

35
Q

What is male infertility?

A

infertility resulting from failure of the sperm to normall fertilise the egg

36
Q

What is male infertility usually caused by?

A

abnormalities in semen analysis

37
Q

Why is male infertility incresing?

A

environmental oestrognes?

38
Q

What are the obstructive causes of male infertility?

A

CF; vasectomy; infection

39
Q

What infection is implicated in non-obstructive male infertility?

A

mumps orchitis

40
Q

Why do thyroid disorders cause male infertility?

A

decrease sexual function and decrease testosterone

41
Q

What are hypothalamic causes of male infertility?

A

idiopathetic, tumours, Kallman’s syndrome, anorexia

42
Q

How is diabetes implicated in male infertility?

A

decrease sexual function and decrease testosterone

43
Q

What DMARD is associated with male infertility?

A

sulfasalazine

44
Q

What is normal pre-pubertal testicular volume?

A

1-3mls

45
Q

What is normal testicular volume in adults?

A

12-25mls

46
Q

Under what testicular volume is someone unlikely to be fertile?

A

below 5mls

47
Q

What extrinsic factors can cause abnormalities in semen analysis?

A

completeness of sample; period of abstinence; condition during transport; time between production and assessment; natural variations between samples; health of man 3 months before production

48
Q

What are the clinical features of obstructive male infertility?

A

normal testicular volume; normal secondary sexual characteristics; vas deferens may be absent; normal hormones

49
Q

What are the features of non-obstructive male infertility?

A

low testicular volume; reduces secondary sexual characteristics; vas deferens present; high LH and FSH; low testosterone

50
Q

How many times per week should patients with male infertility have sex?

A

2-3 times per week

51
Q

What is the indication for intra-uterine insemination

A

mildly reduced sperm count

52
Q

What is the procedure for intrauterine insemination?

A

semen sample prepared to produce conc. sperm sample; inseminated into uterine cavity around ovulation

53
Q

What is the pregnancy rate iwth intra-uterine insemination?

A

15% per treatment cycle

54
Q

What is the indication for intracytoplasmic sperm injection?

A

very low sperm count

55
Q

What is the proedure for ICSI?

A

sperm injected into strippeed oocyte obtained during IVF

56
Q

What is the pregnancy rate with ICSI?

A

30% per treatment cycle

57
Q

What is the indication for surgical sperm aspiration?

A

azoospermia

58
Q

What is the proceure with surgical sperm aspiration?

A

sperm aspirated surgically, sperm then injected into oocyte(ICSI)

59
Q

What is the success rate at obtaining sperm with surgical aspiration?

A

95%- obstructive

50% non-obstructive

60
Q

What are the indications with donor sperm insemination?

A

azoospermia or very low sperm count; genetic conditions; infection conditions

61
Q

What is the pregnancy rate with donor sperm insemination?

A

15%

Reproduction (52 decks)

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