Reproductive: Male Infertility Flashcards
What are the major categories of male infertility?
- Obstructive (e.g. congenital absence of vas deferens)
- Non-obstructive (e.g. varicocele, cryptorchidism)
What are the common causes of obstructive male infertility?
- Congenital absence of the vas deferens (seen in cystic fibrosis)
- Ejaculatory duct obstruction
- Prostatic cysts
What are the common causes of non-obstructive male infertility
- Varicocele
- Cryptorchidism
- Anabolic steroid use
- Erectile dysfunction
What is the most common correctable cause of male infertility?
Varicocele
Isolated right-sided varicocele
Concerning for a pathologic process compressing the right gonadal vein (get CT a/p)
Note: Isolated left-sided varicocele is common, but the right shouldn’t have a varicocele without getting one in the left first.
What is the most common location of an undescended testis?
Inguinal canal
Cryptorchidism is most commonly seen in…
Premature infants (20%)
Complications of cryptorchidism
- Malignant degeneration (can be either the undescended testis or the contralateral testis)
- Infertility
- Torsion
- Bowel incarceration (due to associated indirect inguinal hernia)
Are undescended testes at a higher risk for orchitis?
No, same risk as descended testes
Male infertility with high serum prolactin levels…
Pituitary adenoma
Male infertility and impaired sense of smell…
Think Kallman syndrome (delayed/absent puberty due to hypogonadism)
Male infertility in a pt who is tall and has gynecomastia
Think Klinefelter syndrome (XXY syndrome)
Male infertility in a pt with renal agenesis and an ipsilateral seminal vesicle cyst…
Think Zinner syndrome (malformation of the mesonephric duct during embryogenesis, leading to renal agenesis, seminal vesicle cyst, and ejaculatory duct obstruction)
Ejaculatory duct obstruction is seen with which syndrome?
Zinner syndrome (embryological mesonephric duct malformation)
