infertility

Question 1

how does low sperm count affect infertility

Answer 1

-concentration
-motility
-morphology

Question 2

what is sperm quality/quantity compromised by

Answer 2

age, injury, immunological, smoking, steroid use, retrograde ejaculation, testosterone deficiency

Question 3

how do you preserve fertility during oncofertility

Answer 3

-since cancer treatments target cell division, spermatogonium will be affected
-decreased sperm count
-you can store sperm

Question 4

how might steroids lead to fertility problems

Answer 4

-decrease in androgens –> decrease GnRH –> decrease LH/FSH
-leydig and sertoli cells decrease in size

if you stop androgen steroids, less negative feedback, increase in LH/FSH

Question 5

what is cryptorchidism

Answer 5

-one or both testes do not descend from body cavity
-sperm production is temperature dependent
-DHT brings testicles down to scrotum

Question 6

a 16 year old male presents in a clinic. he has: low LH/FSH, low T, almost no sperm. what is the cause

Answer 6

low GnRH

Question 7

what are the effects of Kallman syndrome

Answer 7

-GnRH secreting cells of hypothalamus never migrate to where they’re supposed to (hypothalamus void of GnRH producing cells)
-GnRH doesn’t get produced so LH/FSH arent produced much
-low T, low sperm count
-form of hypogonadotropic hypogonadism (low LH/FSH)

Question 8

what is treatment for Kallman syndrome

Answer 8

-stop smoking, taking steroids
-retrograde ejaculation: cessation of medications that cause it or assisted reproductive technology (ART)
-hormone replacement therapy

Question 9

when should a couple engage in coitus to try and get pregnant

Answer 9

a few days before LH surge

Question 10

which branch of the ANS is required for an erection

Answer 10

parasympathetic

Question 11

how do erections form

Answer 11

-NO comes from epithelial cells
-epithelial cells stimulated via parasympathetic nervous system

Question 12

what does increased FSH levels indicate

Answer 12

-depleted follicular pool
-E2 surge required for ovulation

Question 13

how does block of fertilization: tubual problems cause infertility

Answer 13

-a result of infection (STDs)
-chlamydia most common cause of infertility

Question 13

what are the causes for anovulatory: PCOS

Answer 13

-elevated LH levels (stimulates inner theca cells to make androgens
-elevated androgens
-2/3: anovulation/amenorrhea: hyperandrogenism; polycystic ovaries
-obesity can be a factor
-increase in adipose tissue, increases estrone, which decreases FSH, and increases ratio of FSH:LH, and decreases estrogen

Question 14

how do implantation problems contribute to infertility

Answer 14

-implantation rate depends on embryo quality and endometrial thickness
-issues with endometrial lining occur when the basal endometrium is compromised in its response to estrogen
-implantation rates decline with female age: chromosomal abnormalities, vascular changes to vessels that supply uterus

Question 15

how do repetitive pregnancy loss contribute to infertility

Answer 15

-uterine polyps or fibroids can develop
-can stimulate uterine contractions leading to pregnancy loss

Question 16

how does clomiphene treatment anovulatory conditions

Answer 16

-estrogen receptor antagonist
-E2 inhibits ARC nucleus, if inhibition gone when inhibiting estrogen, increase in FSH, more bigger follicles, increase in E2 surge, stimulates AVPV nucleus, increase LH surge, ovulation occurs

Question 17

why is timing of clomiphene important

Answer 17

-clomiphene inhibits E2 receptors everywhere
-need during follicular phase
-wants to increase FSH
-during days 2-3 of menstrual cycle for 5 days to prevent negative feedback to ARC nucleus

Question 18

how do FSH injections help fertility

Answer 18

-stimulate more and larger follicles
-leads to more E2 and P4
-increase in LH surge, ovulating more than 1 oocyte, possibility of twins