Male Reproductive Physiology - Montemayor Flashcards
35yo M unable to conceive after 3 years
sparse facial hair
decreased axillary and pubic hair growth
testes small and firm
low testicular volume
high LH and FSH
low Testosterone
low sperm
karyotype XXY
klinefelters
klinefelters
XXY
seminiferous tubule dysgenesis
most common form male hypogonadism**
intrauterine development of testes
SRY - on Y chromosome
transcription factor - TDF
AMH
antimullerian hormone
-for mullerian duct regression
from sertoli cells
sertoli cells
produce AMH
cause regression of female sex tract
seminal vesicles, ejaculatory duct, vas deferens development
testosterone
testosterone production
leydig cells
before LH effect
hCG promotes fetal leydig to form testosterone**
hCG
can be used to stimulate spermatogenesis
similar to LH effects
penis, scrotum, prostate development
DHT
-dihydrotestosterone
binds greater affinity to testosterone angrogen receptor
testosterone > DHT conversion
5 alpha reductase 2
can be deficient - ambiguous external genitalia
retention of wolffian ducts
testosterone
gynecomastia
elevated estradiol
-increased E:T ratio
androgen to estrogen conversion
CYP-19 aromatase
hormone initiate puberty
pulsatile GnRH**
primary hypogonadism
elevated gonadotropin
androgen decreased levels
androgen actions
variety of androgenic and anabolic effects
internal genitalia
testosterone
external genitalia
DHT
circulating testosterone
majority is bound
SHBG - 45-60%
serum albumin 40%
protein testosterone concentration in testes
androgen binding protein - ABP
high T in testes
100x circulating
of promotion of adequate spermatogenesis
promote LH and FSH secretion
GnRH pulsatile
target of LH in testes
leydig cells
target of FSH in testes
sertoli cells
continuous GnRH
will inhibit gonadotropin secretion
for prostate cancer
sertoli functions
produce aromatase blood testis barrier hormone receptors produce ABP produce AMH produce inhibin B - neg feedback on FSH
T, DHT, and E
negative feedback on LH
3 hormones for spermatogenesis
testosterone - high testicular concentration (ABP bound)
FSH and LH
also estradiol and GH
tx for patient with klinefelter
androgen replacement therapy
exogenous T - virilzation of secondary male sexual traits
fertility - testes fibrotic - no work in this klinefelters
exogenous testosterone for fertility
no - just has negative feedback on entire axis
need ABP - to keep high concentration in testes but low circulating
eunuchoidism
absense of secondary sex characteristics
gonadal failure before puberty
13yo M b/l testicles absence
testes in inguinal canal
failure to descend causes defect of?
maturation of spermatogonia
25yo M not able to conceive
decreased facial and axillary hair
decreased penile length
hypogonadism
due to?
DHT
DHT
external genitalia and secondary sex characteristics
continuous long lasting of what to delay puberty
GnRH agonist
FSH Abs for male contraception
men expected to have?
decreased serum inhibin B
remove FSH on sertoli cell function**
22yo M seminiferous tubule dysgenesis
sertoli cells do what
maintain blood testis barrier
leydig cell vs. sertoli cell function
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