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3 REPRO > male infertility > Flashcards

male infertility Flashcards

1
Q

which factor causes development of the male internal genital tract

A

mullerian inhibiting factor

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2
Q

what are the two primitive genital tracts

A

wolffian (male)

mullerian (female)

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3
Q

what is androgen insensitivity syndrome also known as

A

testicular feminisation

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4
Q

what karyotype does androgen insensitivity syndrome have

A

46XY

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5
Q

what happens in androgen insensitivity syndrome

A

androgen induction of wollfian does not occur, mullerian inhibition does occur; born phenotypically external genitalia female, absence of uterus and ovaries, whit short vagina

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6
Q

how does androgen insensitivity syndrome present

A

at puberty with primary amenorrhoea and lack of pubic hair

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7
Q

why is it important for the testes to descend

A

lower temperature outside the body is needed for spermatogenesis

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8
Q

which muscle can raise/lower testes according to temperature

A

dartos muscle

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9
Q

what is cryptorchidism

A

undescended testes

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10
Q

implications of cryptorchidism

A

reduces sperm count

higher chance of seminoma

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11
Q

how is cryptorchisdism managed

A

orchidopexy

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12
Q

roles of Sertoli cells

A 
form a blood-testes barrier
provide nutrients 
phagocytosis 
secrete seminiferous tubule fluid
secrete androgen binding globulin
secrete inhibit and activin hormones
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13
Q

FSH acts of which testicular cells

A

Sertoli cells

enhance spermatogenesis

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14
Q

LH acts of which testicular cells

A

Leydig cells

regulate testosterone secretion

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15
Q

where is testosterone produced

A

leydig cells

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16
Q

effects of testosterone before brith

A

masculinises reproductive tract and promotes descent of testes

17
Q

effects of testosterone during puberty

A

promotes puberty and male characteristics (growth and maturation male reproductive system)

18
Q

testosterone effects in adults

A 
controls spermatogenesis 
secondary sexual characteristics (male body shape, deep voice, thickens skin)
libido
penile erection 
aggressive behaviour
19
Q

when is the fertilised egg ready for implantation

A

when a blastocyst is formed

20
Q

functions of epididymis and vas deferens

A

exit route from testes to urethra
concentrate and store sperm
site for sperm maturation

21
Q

functions of seminal vesicles

A 
produce semen into ejaculatory duct 
supply fructose 
secrete prostaglandins (stimulate motility)
secretes fibrinogen (clot precursor)
22
Q

functions of prostate gland

A

produces alkaline fluid (neutralises vaginal acidity)

produce clotting enzymes to clot semen within female

23
Q

function of bulbourethral glands

A

secrete mucus to act as lubricant

24
Q

what is male infertility

A

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

25
Q

aetiology of male infertility

A 
idiopathic (most common)
obstructive 
- cystic fibrosis
- vasectomy 
- infection 
non-obstructive 
- congenital 
- infection 
- iatrogenic
- pathological 
- genetic 
- specific semen abnormality 
- systemic disorder 
- endocrine
26
Q

endocrine causes of infertility

A 
PITUITARY 
acromegaly, Cushing's disease, hyperprolactinaemia
HYPOTHALAMIC 
idiopathic, tumours, kallman's syndrome, anorexia 
THYROID 
hyper- or hypothyroidism 
DIABETES 
CAH
ANDROGEN INSENSITIVITY 
STEROID ABUSE
27
Q

general examination of male infertility

A

secondary sexual characteristics

presence of gyanecomastia

28
Q

genital examination of male infertility

A

testicular volume
presence of vas deferens and epididymis
penis (urethral orifice)
presence of any varicocele/other scrotal swelling

29
Q

semen analysis

A 
volume 
density - numbers of sperm
motility - what proportion are moving 
progression - how well they move 
morphology
30
Q

factors affecting results of semen analysis

A 
completeness of sample 
period of abstinence 
condition during transport 
time between production and assessment (deteriorates if after 1 hour)
natural variations between samples 
health of man 3 months before production
31
Q

further assessment of male infertility

A 
repeat semen analysis 6 weeks later 
endocrine profile 
chromosome analysis 
testicular biopsy 
scrotal scan
32
Q

clinical features of obstructive infertility

A

normal testicular volume
normal secondary sexual characteristics
vas deferens may be absent
normal LH, FSH, testosterone

33
Q

clinical features of non-obstructive infertility

A

low testicular volume
reduced secondary sexual characteristics
vas deferens present
high LH/FSH +/- low testosterone

34
Q

stages of ICSI

A

sperm prepared from semen (or tissue from surgical sperm aspiration)
each egg is stripped
sperm immobilised
single sperm injected

35
Q

success rate at obtaining sperm during surgical sperm aspiration

A

95% in obstructed azoospermia

50% in non-obstructive

36
Q

indications for donor sperm insemination

A

azoospermia or very low count
failed ICSI treatment
genetic conditions
infective conditions

3 REPRO (40 decks)

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