Spermatogenesis and male factor infertility

Question 1

Where does spermatogenesis take place? where is sperm stored?

Answer 1

• takes place in semineferous tubules

- stored/mature in epididymus

Question 2

What is the function of seminal vesicles?

Answer 2

produce semen into ejaculatory duct, supply fructose, secrete prostaglandins, secrete fibrinogen

Question 3

What is the function of prostate gland?

Answer 3

Produces alkaline fluid to neutralise vaginal acidity, produces clotting enzymes to clot semen within female

Question 4

What is the function of the bulbourethral gland?

Answer 4

secrete mucous = lubricant

Question 5

Describe the development descent of the testes? what is this dependant on?

Answer 5

develop in abdo. cavity and drop into scotal sac before birth - androgen dependant

Question 6

How common is male factor infertility?

Answer 6

-50% infertility clinics

Question 7

What is the definition of male factor infertility?

Answer 7

-infertility resulting from failure sperm to normally fertilise egg, usually assoc. with abnormalities on semen analysis

Question 8

What are 6 areas of causes for male factor infertility?

Answer 8

Idiopathic: 50%

Low sperm count/quality: usually idiopathic

Obstruction to vas deferens: congenital absence (C.F), infections, vasectomy

Non-obstructive causes (testicular failure): genetic (kleinfelters), chemo, radiotherapy, cryptochorchidism, idiopathic

Endocrine: acromegaly, cushings disease, hyperprolactinaemia, anorexia, hypo/hyper thyroidism

Erectile difficulties: D.M, spinal cord injury, psychosexual

Question 9

what is the difference on examination/investigations of obstructive/non-obstructive?

Answer 9

Obstructive:

• hormones normal
• normal 2ndry characteristics
• normal testes >15mls

Non-obstructive:

• abnormal hormones (high LH/FSH, low testosterone)
• reduced secondary characteristics
• small testes <15mls

Question 10

What are the treatments for male factor infertility?

Answer 10

• IUI
• ICSII (+ surgical sperm aspiration)
• donor sperm insemination

Question 11

Donor sperm insemination:

• indications
• describe the procedure
• success rate

Answer 11

Indications:

• azoospermia/v. low sperm count
• genetic conditions
• infective conditions

Procedure:

• sperm donor matched for recip. characteristics and screened for genetic conditions and STI’s
• sperm cryopreserved and rescreened
• prepared thawed semen sample inserted IU at time ovulation

Success:
-15% per cycle treatment