Male Infertility

Question 1

Where is the sex determining region

Answer 1

Y chromosome

Question 2

What causes the development of the male reproductive tract and genitalia

Answer 2

Testosterone (and mullerian inhibiting factor)

Question 3

What primitive duct becomes the male reproductive tract

Answer 3

wolffian

Question 4

What primitive duct becomes the female reproductive tract

Answer 4

Mullerian

Question 5

What does the mullerian duct become

Answer 5

the fallopian tubes

Question 6

what does the wolffian duct become

Answer 6

the ductus deferens

Question 7

What is androgen insensitivity syndrome

Answer 7

Congenital insensitivity to androgens

Question 8

What happens in congenital androgen insensitivity syndrome

Answer 8

Male karyotype however due to being insensitive to testosterone they do not develop male genitalia and their testes remain undescended.

Question 9

What are the features of the reproductive system in someone with AIS

Answer 9

testes develop but do not descend
female external genitalia
short vagina
absence of ovaries or uterus

Question 10

what muscle in the scrotal sac lowers/raises the testes according to external temp

Answer 10

dartos muscle

Question 11

What is cryptochidism

Answer 11

undescended testes

Question 12

What is the treatment of cryptochidism

Answer 12

orchidoplexy before age 14 or orchidectomy in adults

Question 13

What is the risks of undescended testes left until adulthood

Answer 13

6 x increased risk of testicular cancer

Question 14

where does spermatogenesis occur

Answer 14

seminiferous tubules

Question 15

Where does testosterone production occur

Answer 15

leydig cells

Question 16

what is contained in the acrosome of a sperm

Answer 16

enzymes to help penetrate the ovum

Question 17

What is the role of sertoli cells

Answer 17

Form a blood testes barrier
Provides nutrients
Phagocytosis
Secrete seminiferous tubule fluid
Secrete androgen binding globulin
Secrete inhibin and activin

Question 18

What is the function of androgen binding globulin

Answer 18

binds testosterone so that concentration remains hgh

Question 19

What do inhibin do

Answer 19

decreases FSH secretion to control spermatogenesis

Question 20

What stimulates spermatogenesis

Answer 20

fsh and testosteron

Question 21

what stimulates testosterone secretion

Answer 21

LH

Question 22

what is the effect of testosterone on GnRH and LH

Answer 22

decreases the release of both

Question 23

What is GnrH

Answer 23

decapeptide
releases in bursts every 2-3 hours from hypothalamus
Stimunlates anterior pituitary to produce LH and FSH
Negative feedback control from testosterone

Question 24

What are LH and FSH

Answer 24

glycoproteins

Question 25

What does FSH act on

Answer 25

sertoli cells to enhance spermatogenesis

Question 26

What does LH act on

Answer 26

Leydig cells - to produce testosterone

Question 27

What are the effects of testosterone

Answer 27

Before birth - masculinise repro tract and testicular descent Puberty - male characteristics Adult - controls spermatogenesis, secondary sexual characteristics, libido

Question 28

What is capacitiation

Answer 28

A series of biochemical and electrical events that occur before fertilisation in the sperm.

Question 29

where does the sperm initially bind to the oocyte

Answer 29

zona pellucida

Question 30

What is the function of the epididymis

Answer 30

exit route from testes to urethra, concentrate and stores sperm, site of sperm maturtion

Question 31

What is the function of the seminal vesicles

Answer 31

Produce semen in ejaculatory duct, suppe fructose, secrete prostaglandins (stimulates motility), secrete fibrinogen

Question 32

What does the prostate do

Answer 32

alkaline fluid is produces and clotting enzymes

Question 33

What does the bulbourethral glands do

Answer 33

secrete mucus to act as lubricant

Question 34

What can cause male infertility

Answer 34

``` Low sperm count or quality - usually idiopathic Obstruction Non obstruction Endocrine cause Erectile cause ```

Question 35

What are obstructive causes

Answer 35

Congenital absence of vas deferens due to cystic fibrosis infection vasectomy

Question 36

What are non obstructive causes

Answer 36

``` kleinfelters chemotherapy radiotherapy undescended testes idiopathic ```

Question 37

endocrine causes

Answer 37

acromegaly cushings hyperprolactinaemia anorexia hyper/hypo thyroid

Question 38

What would be defined as small testes

Answer 38

less than 15mls

Question 39

When is IUI indicated to treat male infertility

Answer 39

low sperm count

Question 40

When is surgical aspiration of sperm indicated

Answer 40

azoospermia sperm in aspirated and then ICSI can be performed

Question 41

What is the success rate in surgical sperm aspiration

Answer 41

95 percent obstructive | 50 percent non obstructive

Question 42

define azoospermia

Answer 42

when there is little or no sperm present in the semen

Question 43

oligoasthenospermia

Answer 43

low sperm count + low motility

Question 44

teratoasthenospermia

Answer 44

low motility and abnormal forms