Male Infertility

Question 1

What is the most common cause of male infertility?

Answer 1

idiopathic

Question 2

What defines male infertility?

Answer 2

infertility resulting from a failure of the sperm to normally fertilise the egg
theres usualy abnormalities in semen analysis

Question 3

What are common causes of obstructive male infertility?

Answer 3

cystic fibrosis - associated with vas deferens abnormalities
vasectomy
infection

Question 4

What are common causes of non obstructive male infertility?

Answer 4

cryptorchadisim
mumps orchitis
chemo/radiotherapy
testicular tumour
kleinfelters
microdeletions of Y chromosome
robertsonian translocation
globozoospermia

Question 5

What is a normal pre pubertal testicular volume?

Answer 5

1-3mls

Question 6

What is a normal adult testicular volume?

Answer 6

12-25mls

Question 7

What is a usually infertile testicular volume?

Answer 7

below 5mls

Question 8

What conditions must sperm samples be transported in?

Answer 8

transported warm
must be abstinent for 3 days
must be assessed less than 1 hour after production

Question 9

What are the characteristics of obstructive infertility?

Answer 9

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

Question 10

What are the characteristics of non obstructive infertility?

Answer 10

low testicular volume and reduced secondary sexual characteristics
present vas deferens
high LH, FSH and potentially low testosterone

Question 11

What are treatment options for infertility?

Answer 11

vasectomy reversal - more sucessful if recent
intracytoplasmic sperm injection
surgical sperm aspiration
donor sperm insemination

Question 12

What general advice should be given to males with fertility issues?

Answer 12

2-3x a week intercourse
avoid lubricants toxic to sperm - KY jelly
<4 units of alcohol per day
BMI <30
avoid tight fitting underwear and prolonged exposure to hot baths/saunas

Question 13

What is intracytoplasmic sperm injection?

Answer 13

sperm is prepared from semen then injected into stripped egg
35% sucess rate

Question 14

What is surgical sperm aspiration?

Answer 14

for those with azoospermia
sperm is aspirated surgically then inserted into the oocyte
95% sucess in obstructed azoospermia
50% sucess in non obstructed azoospermia

Question 15

What is donor insemination?

Answer 15

donor matched for recipients characteristics and screened for genetic conditions + STIs
sample is inserted into the uterus at the time of ovulation
pregnancy rate = 15% per cycle

Question 16

What is androgen insensitivity syndrome?

Answer 16

x linked recessive disorder
testes develop but do not descend
congenital insensitivity to androgens - so no induction of Wolffian duct or inhibition of Mullarian duct
born phenotypically with external genitalia of a female but absence of a uterus and a short vagina

Question 17

How does androgen insensitivity syndrome present?

Answer 17

at puberty with primary amenorrhoea and lack of pubic hair