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Male Infertility Flashcards

(61 cards)

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1
Q

What does the Wolffian ducts develop into?

A

male reproductive tract

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2
Q

What do the mullerian ducts devlop into?

A

female repro tract

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3
Q

What do the fetal testes secrete?

A

testosterone and mullerian inhibiting factors

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4
Q

What occurs during androgen insensitivity syndrome?

A

androgen induction of Wolffian duct does not occur, Mullerian inhibition does occur: born phenotypically external genitalia femal, ansence uterus and ovaries with short vagin

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5
Q

What does testosterone do?

A

undifferentiated extenral genitalia develop along male lines; transforms wolffian ducts into male reprod tract

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6
Q

What does the mullerian-inhibiting factor cause?

A

degeneration of mullerian ducts

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7
Q

How do patients with androgen insensitivity syndrome usually present?

A

at puberty with primary amenorrhoea and lack of pubic hair

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8
Q

Why do testes need to descend?

A

lower temp outside body to facilitate spermatogenesis

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9
Q

What muscle contracts to lower or raise the testes?

A

dartos muscle

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10
Q

What is undescended testes called?

A

cryptorchidism

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11
Q

When should orchidopexy be performed with cryptorchidism?

A

below age 14

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12
Q

What is the risk with undescened testes?

A

testicular germ celll cancer x6 as adult

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13
Q

What cells produce testosterone?

A

leydig cells

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14
Q

What cell produces sperm?

A

sertoli cells

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15
Q

What is found within the acrosome of the sperm?

A

enxymes for penetrating the ovum

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16
Q

What are the functions of sertoli cells?

A

blood-testes barrier; provide nutriets; phagocytosis; secrete seminiferous ubule fluid ;secrete androgen binding globulin and secretes inhibin and activin

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17
Q

What si the function of a blood-testes barrier?

A

protects sperm from antibody attack; provides a suitable fluid composition allowing later stage sof speram development

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18
Q

what is the function of seminiferous tubule fluid?

A

carry cells to epididymis

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19
Q

What is the function of androgen binding globulin?

A

binds testosterone so conc. remains high in the lumen, essential for sperm production

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20
Q

What is the function of inhibin adn activin?

A

regulates FSH secretion and controls spermatogenesis

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21
Q

What hormone stimulates spermatogenesis?

A

FSH

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22
Q

What hormone stimulates production of testosterone?

A

LH

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23
Q

What is the function of GnRH?

A

stimulates anterior pituitary to produce LH and FSH

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24
Q

What are the effects of testosterone in the adult?

A

contorols spermatogeneiss; secondary sexual characterisitsc; libido; penile erection; aggressive behaviour?

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25
What type of molecule is inhibin nad activin?
peptides
26
What is capacitation?
the function changes that lead to hyperactive motility and which later allow the spermatozoa to undergo acrosome reaction
27
How are sperm attracted to the oocyte?
chemoattraction
28
What is the function of the seminal vesicles?
produce semen into ejaculatory duct, supply fructose, secrete PGs and secrete fibrinogen
29
What is the function of PGs in sperm?
stimulate motility
30
What is the funcion of the prostate gland?
produces alkaline fluid and clotting enzymes to clot semen within the female
31
What is the function of the bulbourethral glands?
secrete mucus to act as lubricant
32
What nervous system controls erection?
parasympathetics
33
What nervous system controls ejaculation?
sympathetics
34
What is emission?
contraction of accessory sex glands and vas deferens so semen expelled to urethra
35
What is male infertility?
infertility resulting from failure of the sperm to normall fertilise the egg
36
What is male infertility usually caused by?
abnormalities in semen analysis
37
Why is male infertility incresing?
environmental oestrognes?
38
What are the obstructive causes of male infertility?
CF; vasectomy; infection
39
What infection is implicated in non-obstructive male infertility?
mumps orchitis
40
Why do thyroid disorders cause male infertility?
decrease sexual function and decrease testosterone
41
What are hypothalamic causes of male infertility?
idiopathetic, tumours, Kallman's syndrome, anorexia
42
How is diabetes implicated in male infertility?
decrease sexual function and decrease testosterone
43
What DMARD is associated with male infertility?
sulfasalazine
44
What is normal pre-pubertal testicular volume?
1-3mls
45
What is normal testicular volume in adults?
12-25mls
46
Under what testicular volume is someone unlikely to be fertile?
below 5mls
47
What extrinsic factors can cause abnormalities in semen analysis?
completeness of sample; period of abstinence; condition during transport; time between production and assessment; natural variations between samples; health of man 3 months before production
48
What are the clinical features of obstructive male infertility?
normal testicular volume; normal secondary sexual characteristics; vas deferens may be absent; normal hormones
49
What are the features of non-obstructive male infertility?
low testicular volume; reduces secondary sexual characteristics; vas deferens present; high LH and FSH; low testosterone
50
How many times per week should patients with male infertility have sex?
2-3 times per week
51
What is the indication for intra-uterine insemination
mildly reduced sperm count
52
What is the procedure for intrauterine insemination?
semen sample prepared to produce conc. sperm sample; inseminated into uterine cavity around ovulation
53
What is the pregnancy rate iwth intra-uterine insemination?
15% per treatment cycle
54
What is the indication for intracytoplasmic sperm injection?
very low sperm count
55
What is the proedure for ICSI?
sperm injected into strippeed oocyte obtained during IVF
56
What is the pregnancy rate with ICSI?
30% per treatment cycle
57
What is the indication for surgical sperm aspiration?
azoospermia
58
What is the proceure with surgical sperm aspiration?
sperm aspirated surgically, sperm then injected into oocyte(ICSI)
59
What is the success rate at obtaining sperm with surgical aspiration?
95%- obstructive | 50% non-obstructive
60
What are the indications with donor sperm insemination?
azoospermia or very low sperm count; genetic conditions; infection conditions
61
What is the pregnancy rate with donor sperm insemination?
15%

Reproduction (52 decks)

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