Spermatogenesis And Male Infertility Flashcards

1
Q

What chromosome contains the sex determining region?

A

The Y chromosome

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2
Q

Development of testis occurs from what?

A

Bipotential gland

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3
Q

What does the foetal testes secrete?

A

Testosterone and mullerian inhibiting factors

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4
Q

What are the two primitive genital tracts?

A

Wolffian

Mullerian

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5
Q

What causes development of female genital tract?

A

Müllerian ducts -> repro tract

Wolffian ducts degenerate

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6
Q

What causes male repro tract to develop?

A

Wolffian ducts -> repro tract

Müllerian ducts degenerate

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7
Q

What is androgen insensitivity syndrome?

A

Testicular feminisation

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8
Q

Genetics of androgen insensitivity syndrome?

A

X linked recessive

46 XY

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9
Q

What happens in androgen insensitivity syndrome?

A

Androgen induction of wolffian duct doesn’t occur but mullerian inhibition does occur.
Testis develop but don’t descend.
Born phenotypically with female external genitalia - absence of ovaries and uterus

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10
Q

When does androgen insensitivity syndrome tend to present?

A

At puberty with primary amenorrhea and lack of public hair

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11
Q

How do the testes adapt to external temperature?

A

Nervous reflexes trigger dartos muscle contraction in scrotal sac to lower/ raise testes according to external temp

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12
Q

What is cryptorchidism?

A

Undescended testes

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13
Q

Management of cryptorchidism?

A

Orchidopexy before age of 14 to reduce risk of testicular germ cell cancer .
If an adult, consider orchidectomy

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14
Q

Function of the testis?

A

Spermatogenesis (seminiferous tubules)

Production of testosterone (leydig cells)

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15
Q

What do Sertoli cells do?

A
Form blood- testis barrier 
Provide nutrients for developing cells
Phagocytosis 
Secrete seminiferous tubule fluid 
Secrete androgen binding globulin 
Secrete inhibit and activin hormones
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16
Q

Where is GnRH secreted from?

A

Hypothalamus, every 2-3 hours

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17
Q

What does GnRH do?

A

Stimulates anterior pituitary to produce LH and FSH

18
Q

Where are LH and FSH secreted from?

A

Anterior pituitary

19
Q

What does LH do?

A

Acts on Leydig cells, regulating testosterone secretion

20
Q

What does FSH do?

A

Acts on Sertoli cells to enhance spermatogensis

21
Q

Where is testosterone produced ?

A

In leydig cells

22
Q

What is testosterone derived from?

A

Cholesterol

23
Q

Where is inhibin and activin produced?

A

Sertoli cells

24
Q

After ejaculation, what do spermatozoa do?

A

Chemo attraction to oocyte and bind to zone pellucida of oocyte
Acrosome reaction
Hyper activated motility
Penetration and fusion with oocyte membrane
Zonal reaction

25
Q

Function of epididymis and vas deferens?

A

Exit route from testis to urethra
Concentrate and store sperm
Site for sperm maturation

26
Q

Function of seminal vesicles?

A

Produce semen into ejaculatory duct

Secrete fibrinogen

27
Q

Function of prostate gland?

A

Produces alkaline fluid - neutralises vaginal acidity

Produces clotting enzymes to clot semen within female

28
Q

Function of bulbourethral gland?

A

Secretes mucous to act as a lubricant

29
Q

Route of sperm?

A
Testes
Epididymis 
Vas deferens
Ejaculatory duct 
Urethra
30
Q

Most common cause of male infertility?

A

Idiopathic

31
Q

Obstructive causes of Male infertility?

A

CF
Vasectomy
Infection

32
Q

Congenital causes of male infertility?

A

Cryptorchidism

33
Q

Infective non obstructive cause of male infertility?

A

Mumps orchitis

34
Q

Genetic non obstructive cause of male infertility?

A

Chromosomal- kleinfelters, micro deletions of Y chromosome, robertsonian translocation

35
Q

Endocrine causes of non obstructive infertility?

A

Pituitary- Acromegaly, customs, hyperprotlactinaemia
Hypothalamic- Kallmans, anorexia, tumours
Thyroid- hyper/hypothyroidism
Diabetes
CAH
Androgen insensitivity
Steroid abuse

36
Q

What is the normal testicular volume of an adult?

A

12-25ml

37
Q

How do you measure testicular volume?

A

Orchidometer

38
Q

What is involved in an endocrine profile for infertility?

A
LH
FSH
testosterone 
Prolactin
TSH
39
Q

Findings if obstructive cause of infertility?

A

Normal testicular volume
Normal secondary sexual characteristics
Vas deferens may be absent
Normal LH, FSH, testosterone

40
Q

Findings if non-obstructive cause of infertility?

A

Low testicular volume
Reduce secondary sexual characteristics
Vas deferens present
High LH, FSH and low testosterone