Male Infertility Flashcards
3 reasons for male infertility
- low sperm count
- sperm transport
- environmental factors
what is leading cause of male infertility?
- low sperm count (oligospermia)
- absence of sperm (azoospermia)
low sperm count + hypothal ant.pit.
lower normal function
- not enough GnRH
- not enough FSH, LH
treatment for lower than normal hypothal fxn
GnRH stimulatory agonists
- Gn
- anti-E (E may have negative feedback on Gn)
- Pl antagonists (needed at optimal level. too much or too little is bad. can suppress Gn, like E.
what may occur if testes don’t respond to Gn
- structural abnormalities : correct surgically
- Permanent damage (chemo/radiation) : no production of viable sperm
testes issue causing low sperm count
varicocele : varicose veins in scrotum (countercurrent heat-xchange is broken = too hot, sperm is hote not forming properly)
cyptorchidism: one or both remain undescended. compromise fertility. can still produce sperm if 1 descends
missing portion of Y chromosome: lack of testes = lack of sperm
orchitis: testicular inflammation. temporary or permanent infertility, infection. can be resolved - sperm count can come back to normal. *but some infection can lead to permanent infertility
autoantibodies to sperm: immune system attacks sperm.
– treat with cortisol = immunosuppressant effects
immunophysiology of male reproduction
immune system has close connection with reproductive system
- tight control of inflammation of repro system.
differentiated sperm appears at sexual maturation, long after establishment of immune system.
development of sperm + immune system
immature immune system
- spermatogonia arrested + quiescent
- immune system develops
- develops tolerance to self-antigens
- at puberty, sperm matures, may present antigens that werent present earlier. immune system can recognize sperm as non-self.
blood-testis barrier + immunophysiology
– similar regulatory networks in repro + immune. explain?
- tightly controlled elements.
- blood testis barrier is imperfect. have Leydig cells require macrophage to control inflammation, Antigen-presenting complex. t-cell, mast cell, CK released to release Leydig cells.
- local immunoregulatory and immunosuppressive mechanisms = protection for endogenous antigens of spermatogenesis
- immune cells in repro system are modified: restrict proinflammation, provide immunologically constrained enviro (antigen-specific)
systemic illness effects repro function
bc so closely linked.
- serum androgen level decrease, decrease sperm output
- dampens libido
issues in sperm transport?
- improper development/ function of secondary accessory ducts (vericocele occludes testicular vein to impair ejaculation., or scar tissue - fix w surgery)
- malfunction/inactivity of secondary accessory gland (underdeveloped - give A; prostate infection - sterility: need proper fxn for sperm + zinc
- erectile dysfunction (inability to ejaculate)
environmental factors on fertility
temporary or permanent
- smoking
- pollution
- chronic drug use
- age
- heat
how smoking affects sperm transport?
decreases sperm motility
- increased number of structurally abnormal sperm
- lower T levels
endocrine disruptor - BPA
suppress GnRH, testicular function
- synthetic forms of hormone. disrupt endocrine function
chronic drug use on fertility
alcohol suppress GnRH
marijuana - unsure but probs not gr8
anabolic steroids (-)
