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Flashcards in infertility Deck (23):
1

what are 2 embyrological duct systems and what do they end up as

1. wolfian - epidyd, vas, seminal vesicles, ejac. duct
2. mullerian - uterur, fallopian tubes, upper vag

2

what is sig. of this

wolfian system missing in 80% of CF

3

what is most important hormone to measure

FSH

4

what is FSH loop

FSH>sertoli cells>inhibin-ve>hypo>GNrh

5

what is LH loop

LH>leydig cells>T-ve to>hypo> GNRH

6

how long does sperm take to mature and sig. of this

70 days to be made
14 days to mature and travel
3 months before can assess Tx

7

where does sperm mature

epididymis
- gain motility
- stabilize condense chromatin

8

how long is epidid

6 meters

9

where is semen from (3)

10% testes
60-70% seminal vesicles
20% prostate

10

3 factors important about duration of infert. on Hx

1. primary vs. secondary
2. previous Tx
3. female factor

11

5 other things to ask on Hx

1. childhood and dev.
- cryptorchidism
- pubertal dev.
2. med. Hx
3. surg. Hx
4. infections
- STI, prostatitis, mumps
5. env. toxins
- smoking, drugs, steroids, pestiticdes

12

3 important types of meds, and the phase they affect

1. hormonal (pre-testicular)
- andogens, anti androgens
2. gonadotoxic (testicular)
- Chemo
- ABs
3. spermatoctoxic (post- testicular)
- Ca channel blockers

13

4 parts of Phx

1. general appearance
2. CNS
3. breasts - gynecomastia
4. abdo scars or masses

14

5 things to look at on genital exam

1. penile anat
2. teste size and consistency
3. presence of vas
4. epidyddimal congestion
5. varicocoel

15

what is normal testes size

2x4 cm
15-22 CC

16

3 grades of varicocele

1. with valsalva
2.
3. out all the time

17

what will FSH, LH, and T look like in pre-test. azoospermia

FSH- low
LH - low
T - low-normal

18

what will FSH, LH, and T look like in test. azoospermia

FSH- high
LH - high/norm
T - norm

19

what will FSH, LH, and T look like in post-test. azoospermia

FSH- norm
LH - norm
T - norm

20

4 genetic issues to screen for

1. XXY - klinfelters
2. roberson translocation
3. XX male - no hope
4. Y chromo deletion

21

what is seen in klinefleters

- gynecomastia
- eunuchoid
- delay puberty
- sterile

22

what is Tx for klinefleter's

- testicular sperm extraction
- find a few sperm in lobes of 50%
- IVF them fuckers in

23

what is TESE success rate

micro - 49%
regular 33%

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