8: Male infertility

Question 1

What area of the embryo has the potential to develop into male or female gonads?

Answer 1

Bipotential gonad ridge

Question 2

Which named ducts develop into the genital tract in

a) males
b) females?

Answer 2

a) Wolffian duct

b) Mullerian duct

Question 3

Which hormone is produced by the testes and encourages development of the male genital tract?

Answer 3

Testosterone

Question 4

Which genital tract develops in the absence of testosterone?

Answer 4

Female genital tract

Question 5

The presence of a Y chromosome causes the development of the ___ genital tract.

Answer 5

male

Question 6

The absence of a Y chromosome causes the development of the ___ genital tract.

Answer 6

female genital tract

XX OR XO

Question 7

A congenital insensitivity to androgens i.e testosterone causes what presentation?

Answer 7

Male with external female genitalia but no uterus or ovaries

Often brought up as female until puberty

Question 8

There is a fold of ___ around the scrotum.

What disease can develop from this?

Answer 8

peritoneum

hydrocele

Question 9

Where do the testes develop?

Answer 9

Abdominal cavity

Question 10

Which muscles contract to lift the scrotum in cold temperatures?

Answer 10

Dartos / cremasteric muscle

Question 11

What is another name for undescended testes?

Answer 11

Cryptorchidism

Question 12

Having undescended testes increases a patient’s chances of developing which disease?

Answer 12

Sperm cell cancer

Question 13

Within the testes, which cells

a) produce testosterone
b) support sperm cells?

Answer 13

a) Leydig cells

b) Sertoli cells

Question 14

Describe the production of FSH and LH by the anterior pituitary in

a) females

b) males?

Answer 14

a) Cyclical

b) Constant

Question 15

Which hormone is released in a pulsatile manner by the hypothalamus?

Answer 15

GnRH

Question 16

Which hormone triggers spermatogenesis in men?

Answer 16

FSH

Question 17

Which hormone triggers testosterone secretion by Leydig cells?

Answer 17

LH

Question 18

Which hormone is released by Leydig cells and stimulates spermatogenesis?

Answer 18

Testosterone

Question 19

Which enzymes do sperm cells use to digest the zona pellucida of an egg?

Answer 19

Acrosomes

Question 20

Which reaction stops multiple fertilisations of an egg cell?

Answer 20

Zonal reaction

Question 21

Which nervous system controls erection?

Answer 21

Parasympathetic

PS - point & shoot

Question 22

What is the most common cause of infertility?

Answer 22

Male infertility

for a variety of reasons

Question 23

What is thought to be causing a decrease in male fertility (sperm counts)?

Answer 23

Environmental factors

e.g oestrogen

Question 24

Male infertility can be ___ or ___.

Answer 24

obstructive

non-obstructive

Question 25

What are some **obstructive causes** of **male infertility**?

Answer 25

**Cystic fibrosis** **Vasectomy**

Question 26

What are some **non-obstructive causes** of **male infertility?**

Answer 26

**Undescended testes** **Mumps infection** **Genetic syndromes e.g Klinefelter's** **Chemo/radiotherapy** **Endocrine disease** (virtually all of them)

Question 27

What is a **chromosomal disorder** which causes male infertility?

Answer 27

**Klinefelter syndrome** | (47 XXY)

Question 28

What is the most common **endocrine** cause of male infertility?

Answer 28

**Hyperprolactinaemia**

Question 29

What **chronic** endocrine disease commonly causes erectile dysfunction?

Answer 29

**Diabetes**

Question 30

Male bodybuilders who use which type of drug are at risk of male infertility?

Answer 30

**Steroids**

Question 31

How long do sperm cells take to mature?

Answer 31

**3 months**

Question 32

If a semen sample is dodgy, when would you repeat it?

Answer 32

**6 weeks later**

Question 33

What are levels of **LH, FSH** and **testosterone** like in **obstructive male infertility?**

Answer 33

**All normal**

Question 34

Describe **FSH, LH and testosterone** levels in **non-obstructive male infertility.**

Answer 34

**FSH and LH up** **Testosterone normal or down**

Question 35

What is an intentional cause of obstructive male infertility? Can it be reversed?

Answer 35

**Vasectomy** **Yes**

Question 36

What assisted reproduction techniques can be used for male infertility?

Answer 36

**DI** **ICSI**

Question 37

What is the success rate of ICSI?

Answer 37

**35%**

Question 38

What is **azoospermia**?

Answer 38

**Condition in which a man's semen contains no sperm**

Question 39

How is **sperm** **obtained for ICSI** in men with **azoospermia?**

Answer 39

**Surgical sperm aspiration**