Male factor infertility Flashcards
(16 cards)
What does semen analysis examine?
The quantity and quality of semen and sperm to assess for male factor infertility
What are the instructions that need to be given when asking for a sample?
Abstain from ejaculation for at least 3 days and at most 7 days. Avoid hot baths, sauna and tight underwear in the lead up to providing a sample. Attempt to catch the full sample. Deliver the sample to the lab within an hour of ejaculation. Keep the sample warm before delivery.
What factors affect semen analysis?
Hot baths & tight underwear, smoking & alcohol, raised BMI and caffeine.
When is a repeat sample indicated?
After 3 months in borderline results or earlier in very abnormal results.
What is polyspermia?
High number of sperm in the semen sample.
What is normospermia?
Normal characteristics of sperm in the sample.
What is oligospermia?
Reduced number of sperm in the semen sample which can be classified as mild, moderate or severe.
What is cryptozoospermia?
Very few sperm in the semen sample.
What is azoospermia?
The absence of sperm in the semen.
What can lead to low testosterone and therefore low FH and FSH?
Pathology of pituitary gland or hypothalamus, suppression due to stress, chronic conditions or hyperprolactinaemia, Kallman syndrome.
What can lead to testicular damage?
Mumps, undescended testes, trauma, radio or chemotherapy, cancer.
What genetic disorders can result in defective/absent sperm production?
Klinefelter syndrome, Y chromosome deletions, Sertoli cell only syndrome, anorchia (absent testes).
What testicular damage can occur to affect fertility?
Damage to the testicle or vas deferens from trauma, surgery or cancer, ejaculatory duct obstruction, retrograde ejaculation, scarring from epididymitis (e.g., chlamydia), absence of vas deferens.
What investigations are done after an abnormal semen analysis?
History & exam, repeat sample, USS of testes.
What further investigations can be done?
Hormonal analysis with LH, FSH and testosterone, genetic testing, further imaging such as MRI, vasography (injecting contrast into vas deferens and performing an X-ray to check for obstruction), testicular biopsy.
What is the management for male factor infertility?
Surgical sperm retrieval, surgical correction of obstruction, intra-uterine insemination (separate high quality sperm, then inject them into uterus), ICSI (inject sperm directly into egg cytoplasm), donor insemination (use donor sperm).
