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Reproduction and Sexual Health > Male Infertility and Spermatogenesis > Flashcards

Male Infertility and Spermatogenesis Flashcards

1
Q

how does the internal reproductive tract of a male develop

A

wolffian ducts develop the reproductive tract

mullerian ducts degenerate

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2
Q

how does internal reproductive tract of females form

A

wolffian ducts degenerate, mullerian ducts form the reproductive tract

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3
Q

what does lack of mullerian inhibiting factor in females cause

A

mullerian ducts to develop into femal reproductive tract

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4
Q

what does testosterone in males cause

A

transforms wolffian ducts into male reproductive tract and testosterone converted to dihydrotestosterone which causes undifferentiated external genitalia to develop-penis scrotum

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5
Q

describe androgen insensitivity syndrome

A

male karyotype
x linked recessive disorder
testes develop but do not descend
external female genitalia

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6
Q

why in androgen insensitivity syndrome do you get external female and internal male

A

androgen induction of wolffian duct does not occur but mullerian inhibition does occu-born with phenotypically external genitalia female

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7
Q

what do testes secrete in males which causes development of internal and external sex organs

A

testes secrete testosterone and mullerian inhibiting factor

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8
Q

in ovaries what is secreted

A

no Y chromosome so no SRY(sex determining region), undifferentiated gonads develop into ovaries, no testosterone or Mullerian inhibiting factor

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9
Q

what is cryptorchidism

A

undescended testes

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10
Q

what are the clinical implications of cryptorchidism

A

increasingly common

reduces sperm count but if unilateral usually fertile

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11
Q

if cryptorchidism what can reduce chance of germ cell cancer

A

orchidopexy if below age 14 to minimise risk testicular germ cell cancer
if undescended as adult, consider orchidectomy

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12
Q

what is the function of the testis

A

spermatogenesis and production of testosterone

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13
Q

what is contained in the acrosome

A

enzymes for penetrating the ovum

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14
Q

what is the role of the sertoli cells

A 
forms a blood-testes barrier
provides nutrients for the developing cells 
phagocytosis 
secrete seminiferous tubule fluid 
secrete androgen binding globulin 
secrete inhibin and activin hormones
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15
Q

where are leydig cells in the testis

A

in the intersitium

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16
Q

what does LH stimulate

A

testosterone secretion

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17
Q

what does testosterone do via negative feedback

A

decrease release of GnRH and LH

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18
Q

what does FSH stimulate

A

FSH and testosterone stimulate spermatogenesis

19
Q

what decreases secretion of FSH

A

inhibin

20
Q

where is GnRH released from

A

hypothalamus

21
Q

what does GnRH stimulate

A

the anterior pituitary to produce LH and FSH

22
Q

production of testosterone and spermatogenesis is cyclical or non-cyclical

A

non cyclical (cyclical in females)

23
Q

when testosterone is produced where is it secreted

A

into blood and seminiferous tubules for sperm production

24
Q

what is the effect of testosterone before birth

A

masculinises reproductive tract and promotes descent of testes

25
Q

where are inhibin and activin secreted from

A

sertoli cell

26
Q

what does inhibin do

A

feedback of FSH to decrease release

27
Q

what does activin do

A

stimulate FSH release

28
Q

what are the steps of capacitation

A 
cehmoattraction 
docking(specific recognition
acrosomal exocytosis 
hyperactivity 
penetration of egg coat and membrane fusion 
zonal reaction
29
Q

what is capacitation

A

series biochemical and electrical events before fertilisation (hyperactivited motility, ability to bind to zona pellucida and AR)

30
Q

what is the function of the epididymis and vas deferens

A

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

31
Q

what is the function of seminal vesicles

A

produce semen into ejaculatory duct, supply fructose, secrete prostaglandins (stimulates motility), secrete fibrinogen (clot precursor)

32
Q

what is the function of the prostate gland

A

produce alkaline fluid (neutralises vaginal acidity), produces clotting enzymes to clot semen within female

33
Q

what is the most common cause for male infertility

A

idiopathic

34
Q

name some obstructive causes for male infertility

A

cystic fibrosis, vasectomy, infection

35
Q

name some non-obstructive causes of male infertility

A 
cryptorchidism 
infection: mumps orchitis 
iatrogenic-chemo/radiotherapy 
pathological eg tumour 
genetic
36
Q

describe some endocrine causes of male infertility

A 
pituitary tumours-acromegaly, cushings disease, hyperprolactinaemia
hypothalamic causes 
thyroid disorders 
diabetes 
CAH
androgen insensitivity 
steroid abuse
37
Q

what is the normal testicular volume

A

12-25 mls

38
Q

what is looked at in semen analysis

A

volume, density, motility, progression, morphology

39
Q

what are some of the xtrinisc factors which may affect 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
40
Q

if semen analysis found to be abnormal what would you do

A

repeat semen analysis 6 weeks later
endocrine profile (LH, FSH, testosterone, PRL, TSH)
chromosome analysis (including Y chromosome microdeletions), cf screening
depending on results-testicular biopsy, scrotal scan

41
Q

what are the clinical features of an obstructive cause

A

normal testiucalr volume, normal secondary sexual characteristics
vas deferens may be absent
endocrine features-normal LH, FSH and testosterone

42
Q

what are the clinical features of non-obstructive

A

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

43
Q

what is the indication for surgical sperm aspiration

A

azoospermia

44
Q

what is the success rate at obtaining sperm from obstructed vs non-obstructed azoospermia

A

95% obstructed and 50% non-obstructive

Reproduction and Sexual Health (24 decks)

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