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Flashcards in Male Infertility Deck (44)
1

Where is the sex determining region

Y chromosome

2

What causes the development of the male reproductive tract and genitalia

Testosterone (and mullerian inhibiting factor)

3

What primitive duct becomes the male reproductive tract

wolffian

4

What primitive duct becomes the female reproductive tract

Mullerian

5

What does the mullerian duct become

the fallopian tubes

6

what does the wolffian duct become

the ductus deferens

7

What is androgen insensitivity syndrome

Congenital insensitivity to androgens

8

What happens in congenital androgen insensitivity syndrome

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

9

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

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

10

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

dartos muscle

11

What is cryptochidism

undescended testes

12

What is the treatment of cryptochidism

orchidoplexy before age 14 or orchidectomy in adults

13

What is the risks of undescended testes left until adulthood

6 x increased risk of testicular cancer

14

where does spermatogenesis occur

seminiferous tubules

15

Where does testosterone production occur

leydig cells

16

what is contained in the acrosome of a sperm

enzymes to help penetrate the ovum

17

What is the role of sertoli cells

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

18

What is the function of androgen binding globulin

binds testosterone so that concentration remains hgh

19

What do inhibin do

decreases FSH secretion to control spermatogenesis

20

What stimulates spermatogenesis

fsh and testosteron

21

what stimulates testosterone secretion

LH

22

what is the effect of testosterone on GnRH and LH

decreases the release of both

23

What is GnrH

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

24

What are LH and FSH

glycoproteins

25

What does FSH act on

sertoli cells to enhance spermatogenesis

26

What does LH act on

Leydig cells - to produce testosterone

27

What are the effects of testosterone

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

28

What is capacitiation

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

29

where does the sperm initially bind to the oocyte

zona pellucida

30

What is the function of the epididymis

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

31

What is the function of the seminal vesicles

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

32

What does the prostate do

alkaline fluid is produces and clotting enzymes

33

What does the bulbourethral glands do

secrete mucus to act as lubricant

34

What can cause male infertility

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

35

What are obstructive causes

Congenital absence of vas deferens due to cystic fibrosis
infection
vasectomy

36

What are non obstructive causes

kleinfelters
chemotherapy
radiotherapy
undescended testes
idiopathic

37

endocrine causes

acromegaly
cushings
hyperprolactinaemia anorexia
hyper/hypo thyroid

38

What would be defined as small testes

less than 15mls

39

When is IUI indicated to treat male infertility

low sperm count

40

When is surgical aspiration of sperm indicated

azoospermia

sperm in aspirated and then ICSI can be performed

41

What is the success rate in surgical sperm aspiration

95 percent obstructive
50 percent non obstructive

42

define azoospermia

when there is little or no sperm present in the semen

43

oligoasthenospermia

low sperm count + low motility

44

teratoasthenospermia

low motility and abnormal forms