Male Infertility

Question 1

In general, semen parameters peak after ___ days of abstinence and then decline

Answer 1

In general, semen parameters peak after 1 or 2 days of abstinence and then decline

Question 2

However, for increasing the probability of conception and pregnancy, intercourse every day around the time of ___ is likely the best strategy

Answer 2

However, for increasing the probability of conception and pregnancy, intercourse every day around the time of ovulation is likely the best strategy

Question 3

On average, female fecundity declines precipitously after age __

Answer 3

35

Question 4

Diseases that interfere with normal coordinated ejaculatory function, as does spinal cord injury

Answer 4

Diabetes mellitus and multiple sclerosis interfere with normal coordinated ejaculatory function, as does spinal cord injury

Question 5

this procedure may result in obstruction of the vas deferens

Answer 5

Herniorrhaphy may result in obstruction of the vas deferens

Question 6

mechanisms that affect ratio of estrogen to androgen through a variety of mechanisms

Answer 6

1. molecular similarity to estrogen 2. increased estrogen synthesis 3. increased aromatase activity, dissociation of steroids from sex hormone–binding globulin (SHBG) 4. decreased testosterone synthesis, competitive and noncompetitive binding to steroid receptors 5. decreased synthesis of adrenal steroids 5 and induction of hyperprolactinemia

Question 7

medications that affect ratio of estrogen to androgen

Answer 7

antiandrogens bicalutamide, flutamide, and nilutamide e spironolactone; the antiretroviral protease inhibitors such as indinavir; the nucleoside reverse transcriptase inhibitors such as stavudine; corticosteroids, especially in adolescence; and exogenous estrogen

Question 8

exogenous testosterone acts to decrease intratesticular testosterone synthesis and reduce spermatogenesis primarily through?

Answer 8

Primarily through conversion to estradiol by aromatase and consequent inhibition of luteinizing hormone (LH) secretion by the pituitary

Question 9

cannabis decreases plasma testosterone in a __-dependent and duration __-dependent manner

Answer 9

cannabis decreases plasma testosterone in a dose-dependent and durationdependent manner

Question 10

___ intake also appears to increase aromatization of testosterone to estradiol

Answer 10

Heavy chronic alcohol intake also appears to increase aromatization of testosterone to estradiol

Question 11

___ increased seminal oxidative stress parameters and decreased metrics of sperm DNA quality

Answer 11

cigarette smoking increased seminal oxidative stress parameters and decreased metrics of sperm DNA quality

Question 12

The negative effects of cigarette smoking on sperm bulk parameters and DNA quality appear to be especially acute in the presence of a ___, suggesting the possibility of additive toxicity

Answer 12

The negative effects of cigarette smoking on sperm bulk parameters and DNA quality appear to be especially acute in the presence of a clinical varicocele, suggesting the possibility of additive toxicity

Question 13

Consistent with these laboratory findings, epidemiologic data associated ___ to smaller testes, lower sperm counts, and alterations in sex hormones in the adult male offspring

Answer 13

Consistent with these laboratory findings, epidemiologic data associated maternal cigarette smoking to smaller testes, lower sperm counts, and alterations in sex hormones in the adult male offspring

Question 14

The most common mechanism of action for antipsychotic drugs is ____, which causes loss of libido as a side effect in the majority of patients

Answer 14

antagonism of dopamine,

Question 15

Opioid analgesics suppress ___ primarily through hypothalamic-mediated mechanisms and consequently reduce testosterone synthesis

Answer 15

Opioid analgesics suppress LH release primarily through hypothalamic-mediated mechanisms and consequently reduce testosterone synthesis (Subirán et al., 2011). Experimental evidence in animals demonstrates

Question 16

Evidence suggests that discontinuation of opioid analgesics may be associated with rapid return of androgen, perhaps as early as ___

Answer 16

Evidence suggests that discontinuation of opioid analgesics may be associated with rapid return of androgen, perhaps as early as within 1 month

Question 17

TICS mnemonic

Answer 17

Toxins, Infections and inflammation, Congenital, sexual history

Question 18

With the widespread prescribing of opioid analgesics and the epidemic of opioid abuse, their use as a cause of ____ should be suspected in all such hypoandrogenic men.

Answer 18

hypogonadotropic hypogonadism

Question 19

agents that impair spermatogenesis

Answer 19

Other chemotherapeutic agents commonly used in conjunction with cyclophosphamide to treat non-Hodgkin lymphoma, including doxorubicin, vincristine, and prednisone

Question 20

Evidence suggests that sperm DNA damage can be detected at least up to___ after chemotherapy, arguing that ___ of sperm before treatment with cytotoxic chemotherapeutic agents is preferable to awaiting the return of sperm after chemotherapy

Answer 20

2 years cyropreservation

Question 21

Hypertension effects on fertility CCB ACE inhibitors

Answer 21

calcium channel blockers impair fertilization by inhibiting expression of mannose-ligand binding receptors and preventing sperm from attaching to the zona pellucida Angiotensin-converting enzyme inhibitors appear to improve sperm motility through a presumptive effect on seminal plasma kinins

Question 22

bacille Calmette-Guérin into the bladder for superficial transitional cell carcinoma resulted

Answer 22

significant decrease in sperm concentration and motility

Question 23

Scrotal temperature in humans is maintained to be (TEMP) below core body temperature by mechanisms including a countercurrent heat exchange between a central set of (ARTERIES) directing blood toward the testis and a (type of veins and location) draining blood back toward the vena cava

Answer 23

2°C to 4°C linear arteries plexus of veins surrounding the arteries

Question 24

Testes directly exposed to ionizing radiation suffer __ and __

Answer 24

germ cell loss and Leydig cell dysfunction

Question 25

In a survey of childhood cancer survivors, chances of having future offspring were lessened by radiation doses to the testes of ___ GY and above

Answer 25

7.5 gy

Question 26

effect of EMV on sperm

Answer 26

The authors identified a significant decrease in motility and an increase in DNA fragmentation of the exposed aliquot

Question 27

Typical epididymal organisms include

Answer 27

Neisseria gonorrhoeae, Chlamydia trachomatis, and E. coli

Question 28

Infectious urethral organisms in the context of impaired male reproduction include

Answer 28

N. gonorrhoeae, C. trachomatis, Mycoplasma species, and Trichomonas vaginalis

Question 29

Mycobacterium tuberculosis may affect any reproductive organ and cause___ of the __ and ___

Answer 29

scarring of the vas deferens and epidydymis

Question 30

As an example of direct effects, investigators observed that incubating sperm with increasing concentrations of __ was associated with degradation of sperm DNA in a time-dependent manner (Satta et al., 2005).

Human papillomavirus was associated with impairment of bulk seminal parameters

Answer 30

As an example of direct effects, investigators observed that incubating sperm with increasing concentrations of C. trachomatis serovar E elementary bodies was associated with degradation of sperm DNA in a time-dependent manner

Human papillomavirus was associated with impairment of bulk seminal parameters,

Question 31

One putative mechanism by which nonbacterial prostatitis may lead to male infertility is through:

Answer 31

seminal leukocytosis or pyospermia and the release of ROSs resulting in sperm damage