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3 Reproduction and Sexual Health > Male Infertility > Flashcards

Male Infertility Flashcards

1
Q

what, at gonadal level, indicates that you will become female?

A

absence of a Y chromosome

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2
Q

name the 2 primitive genital tracts?

A

wolffian duct

mullerian duct

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3
Q

what 2 chemicals cause the development of the male internal genital tract?

A

testosterone

mullerian inhibiting factor

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4
Q

what do the wolffian ducts form?

A

male genital tract

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5
Q

what do the mullerian ducts form?

A

female genital tract

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6
Q

when is the earliest time on a scan that you can tell if its a male or female?

A

16 weeks

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7
Q

patient presents with amenorrhoea and lack of pubic hair in puberty…

A

suspect androgen insensitivity syndrome

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8
Q

what is androgen insensitivity syndrome?

A

congenital insensitivity to androgens

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9
Q

what is the karyotype in androgen insensitivity syndrome?

A

46XY

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10
Q

inheritance of androgen insensitivity syndrome?

A

x linked recessive

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11
Q

what happens to the testes in androgen insensitivity syndrome?

A

testes develop but dont descend

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12
Q

when do the testes descend into the scrotal sac?

A

before birth

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13
Q

why is it important that testes descend?

A

need a lower temp outside body to facilate spermatogenesis

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14
Q

what muscle facilitates the descent of the testes?

A

dartos

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15
Q

what should be done with testes at birth?

A

checked to see that 2 are present and if they arent they should be found on a scan and child should have surgery before puberty

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16
Q

what is cryptorchidism?

A

undescended testest

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17
Q

male will usually remain fertile in unilateral cryptorchidism T or F

A

T

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18
Q

Tx of cryptorchidism and why?

A

orchidopexy before age 14
orchidectomy
risk of cancer

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19
Q

what structures are responsible for spermatogenesis?

A

seminiferous tubules

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20
Q

what structures are responsible for testosterone production?

A

leydig cells

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21
Q

when are LH and FSH made in men?

A

constantly

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22
Q

what does FSH do in men?

A

tells sertoli cells to make testosterone

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23
Q

sertoli cells secrete….

A

seminiferous tubule fluid
androgen binding globulin
inhibin and activin

24
Q

what do inhibin and activin do?

A

regulate FSH secretion and controls spermatogenesis

25
Q

LH acts on __ cells

A

leydig

26
Q

where is testosterone secreted?

A

blood

seminiferous tubules

27
Q

what does testosterone do before birth?

A

masculinises male RT

promotes descent of testes

28
Q

site for sperm maturation?

A

epididymis

vas deferens

29
Q

what do seminal vesicles secrete?

A

fructose
prostaglandins
fibrinogen

30
Q

how does the prostate gland aid fertilisation?

A

produces an alkaline fluid that clots semen in the female

31
Q

what part of the male RT is responsible for lubrication?

A

bulbourethral gland

32
Q

what drugs can cause retrograde ejaculation?

A

anticholinergics

33
Q

what is hypospadias?

A

urethra is deep down in the scrotum

34
Q

most common cause of male infertility?

A

idiopathic

35
Q

obstructive causes of male infertility?

A

CF
vasectomy
infection

36
Q

non-obstructive male infertility is also known as…

A

testicular failure

37
Q

causes of testicular failure?

A 
cryptorchadism
infection
chemo/radiotherapy
tumour
klinefelter's
semen abnormality
systemic disorder
endocrine
38
Q

endocrine causes of male infertility?

A 
pituitary tumours eg acromegaly, cushings, prolactin
hypothalamic eg kallmans, anorexia
thyroid 
diabetes
CAH
androgen insensitivity
steroid abuse
39
Q

pituitary tumours have what effect on LH, FSH and testosterone?

A

all low

40
Q

thryoid disorders have __ prolactin

A

increased

41
Q

CAH has a ___ effect on testosterone

A

incremental

42
Q

normal male testicular volume range?

A

12-25mls

43
Q

what measures testicular volume?

A

orchidometer

44
Q

what should be tested on genital examination?

A

testicular volume
presence of vas deferens, penis and epididymis
presence of varicoceles and scrotal swellings

45
Q

what is tested on semen analysis?

A 
volume
density
motility
progression
morphology
46
Q

Ix of male infertility?

A 
semen analysis- repeat after 6 weeks
endocrine profile - LH/FSH, testosterone, prolactin, TSH
chromosome analysis
CF screening
testicular biopsy
scrotal scan
47
Q

what is testicular volume like in obstructive male infertility?

A

normal

48
Q

if the vas deferens is absent on examination of a man with male infertility what could have happened?

A

man could have had a vastectomy

49
Q

what are hormone levels like in obstructive infertility?

A

all normal

50
Q

what are LH/FSH and testosterone levels like in non obstructive infertility?

A

high LH/FSH

low testosterone

51
Q

vas deferens is present/absent in non obstructive infertility

A

present

52
Q

Tx of hyperprolactinaemia

A

cabergoline

53
Q

Tx of male infertility

A 
treat cause (eg reverse vasectomy)
ICSI
sperm donor
54
Q

how often should infertility patients have sex per week?

A

2-3 times

55
Q

how much alcohol should be drunk?

A

<4 units

56
Q

indication for surgical sperm aspiration?

A

azoospermia

3 Reproduction and Sexual Health (51 decks)

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