Infertility - Men Flashcards

1
Q

What are the major causes of infertility in men?

A
Epididymitis due to STDs
CF
CBAVD
Testicular Maldescent
Varicocele
Hypospadias
Tumours
Azoospermia
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2
Q

How does CF cause infertility?

A

Leads to mutations in the Vas Deferens

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3
Q

What is CBAVD?

A

Congenital Bilateral Absence of Vas Deferens

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4
Q

What is varicocele?

A

Dilatation of pampiniform venous plexus

Surgically repairing it doesn’t actually help pregnancy rate so we often don’t (For fertility anyway)

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5
Q

What are the types of Azoospermia?

A

Testicular:

  • Normogonadotrophic
  • Hypogonadism

Post-testicular (Obstructive)

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6
Q

Give an example of hypogonadism causing Azoospermia?

A

Klinefelter syndrome

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7
Q

What could cause obstructive azoospermia?

A
  • Iatrogenic
  • Congenital e.g. CF
  • Infection
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8
Q

What would we want to ask a man about fertility?

A
  • Change in body hair
  • Testicular Descent
  • PMH relating testicles, chemo or radiotherapy.
  • Occupational history
  • Sexual history
  • Drugs & Environmental
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9
Q

What do we look for on exam for man’s fertility?

A

BMI
Fait/Hair distribution (hair loss due to hypoandrogenism)
Abdo & inguinal Exam
Genital Exam

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10
Q

What sources of infertility could we spot on a genital exam?

A
  • Undescended or too small testes
  • Epididymitis
  • Lack of Vas Deferens
  • Varicocele
  • Hypospadias
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11
Q

What investigations can we do for male infertility?

A
History & exam
FSH, LH, Testosterone & PRL
Karyotyping
CF screen
Computerised Semen Analysis
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12
Q

Give some rough reference values for sperm concentration?

A

Lower reference value is 15million/ml
<15 is oligospermia
<5 is severe
0 (or close) is termed Azoospermia

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13
Q

How do we manage a male whos infertile?

A

If they are in fact producing sperm we can do Surgical Sperm Retrieval for IVF by either:

  • Micro-epididymal Sperm Aspiration
  • Testicular Sperm Extraction
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