Testicular and Semen Parameters- WHO 2010

Question 1

The Lower Reference Limits for Semen Volume (ml)

1. 1.2 (1.1-1.6)
2. 1.3 (1.1-1.8)
3. 1.4 ( 1.2-1.7)
4. 1.5 (1.4-1.7)
5. 1.6 (1.4-1.8)

Answer 1

4. (WHO 2010)
   but according to WHO 6th edition 2021
   1.4

Question 2

The lower reference limits for total sperm number (10⁶ per ejaculate)

1. 39 (33-46)
2. 41 (33-48)
3. 43(36-50)
4. 45 (36-50)
5. 47 (36-54)

Answer 2

1.

Question 3

The Lower Reference Limits for Sperm Concentration (per ml)

1. 8 (4-10)
2. 10 (5-15)
3. 13 (10-17)
4. 15 (12-16)
5. 20 (15-25)

Answer 3

4.
but according to WHO 6th edition 2021
16 million/ml

Question 4

The Lower Reference Limits for Total Motility (PR + NP, %)

1. 20 (18-22)
2. 30 (28-32)
3. 40 (38-42)
4. 50 (48-52)
5. 60 (58-62)

Answer 4

3.

Question 5

The Lower Reference Limits for Progressive Motility (PR, %)

1. 26 (25-27)
2. 28 (27-29)
3. 30 (29-31)
4. 32 (31-33)
5. 34 (33-34)

Answer 5

4.
but according to WHO 6th edition 2021
30%

Question 6

The Lower Reference Limits for Vitality (Live Spermatozoa, %)

1. 54 (52-56)
2. 55 (53-57)
3. 56 (54-58)
4. 57 (55-59)
5. 58 (56-60)

Answer 6

5.
but according to WHO 6th edition 2021
vitality 54%

Question 7

The Lower Reference Limits for Sperm Morphology (Normal Forms, %)

1. 2 (1-3)
2. 4 (3-5)
3. 6 (5-7)
4. 8 (7-9)
5. 10 (9-11)

Answer 7

2.

Question 8

The Lower Reference Limits For PH

1. >6.5
2. >6.7
3. >=6.9
4. >7
5. >=7.2

Answer 8

5.

Question 9

Lower Reference Limits for MAR Test (Motile Spermatozoa with Bound Particles, %)

1. <40%
2. <50%
3. <=60%

Answer 9

2.

Question 10

The Lower Reference Limits for Immunobead Test (Motile Spermatozoa with Bound Beads, %)

1. <40%
2. <50%
3. <=50%
4. <=60%

Answer 10

3.

Question 11

The Makler Chamber is Disposable

1. Yes
2. No

Answer 11

2.

Question 12

The Working Volume on counter chamber is10um between Lid and Base.

1. Yes
2. No

Answer 12

1.

Question 13

if you count on average 20 sperm per row, this is 20 million per/ml

1. Yes
2. No

Answer 13

1.

Question 14

If You Count on Average 20 Sperm Over the Whole Grid, The Concentration is 20 Million/ml

1. Yes
2. No

Answer 14

2.

Question 15

The Makler Chamber Loses Its Efficiency with Sample of Low or High Concentration.

1. Yes
2. No

Answer 15

1.

Question 16

Sperm Cannot Swim Normally in The Makler Volume

1. Yes
2. No

Answer 16

1,

Question 17

Motility and Morphology Can Be Estimated on The Makler Chamber

1. Yes
2. No

Answer 17

1.

Question 18

WHO (2010) NOT Recommends the Use of The Makler Chamber.

1. Yes
2. No

Answer 18

1.

Question 19

Bubbles Will Interfere with The Counting Accuracy

1. Yes
2. No

Answer 19

1

Question 20

the Makler is a valuable tool for IVF laboratories because of its easy and lack of fixatives needed.

1. Yes
2. No

Answer 20

1

Question 21

The Grid Is 1 mm X 1 mm

1. Yes
2. No

Answer 21

1

Question 22

sperm maybe immobilized for counting by placing in a 50-60ºc water bath for several minutes.

1. Yes
2. No

Answer 22

1

Question 23

Each Makler chamber needs to be calibrated against a Haemocytometer estimate for accreditation purposes

1. Yes
2. No

Answer 23

1

Question 24

what information should be recorded on a semen sample for diagnostic or therapeutic purposes.?

Answer 24

Unequivocal identification of the patient

Duration of sexual abstinence

Completeness of collection

Time at sample was produced

Transport temperature conditions

Current medication

Collection container

Question 25

what information should be recorded on a semen sample for **post vasectomy semen analysis**?

Answer 25

* Unequivocal (unambiguous) identification of the patient * Completeness of collection * Collection container

Question 26

what is the minimum requirement for patient identifiers at collection 1. One 2. Two 3. Three 4. Four 5. Five

Answer 26

3.

Question 27

which of these identifiers are suitable for identification of a sample? 1. Title 2. First Name 3. Middle Name 4. Surname [LastName] 5. Date of birth 6. Place of birth 7. Age 8. Passport Number 9. Mothers Maiden Name 10. Partners First Name 11. Partners Last Name

Answer 27

2, 4, 5, 8

Question 28

Rejection of Samples are Rare but The Reference Cites Another Study Suggesting the Rate of Rejection of Samples is in the order of: 1. 0.2% 2. 0.5% 3. 0.8% 4. 1.2% 5. 1.9%

Answer 28

2.

Question 29

which of the following statements on sexual **abstinence** is true: 1. Abstinence has no bearing on volume, concentration and motility 2. _Prolonged abstinence could increase seminal volume_ 3. _Prolonged abstinence could increase sperm concentration_ 4. Prolonged abstinence could increase sperm motility 5. _Prolonged abstinence could increase the number of degenerating and dying sperm in the epididymis_ 6. _The recommended period of abstinence is 2-7 days_ 7. _A preferred duration is 3-4 days_ 8. Ejaculation and sexual abstinence mean the same thing 9. It's OK to ask the partner when the last sexual activity occurred 10. Samples that have a normal profile but exceed the abstinence period must be rejected

Answer 29

2, 3, 5, 6, 7

Question 30

It is impossible to characterize a man’s semen quality from evaluation of a single semen sample. 1. Yes 2. No

Answer 30

1.

Question 31

It is helpful to examine two or three samples to obtain baseline data 1. Yes 2. No

Answer 31

1

Question 32

The Minimum Period of Abstinence Is?

Answer 32

2 days

Question 33

The Maximum Period Of Abstinence Is?

Answer 33

7 days

Question 34

The time between collection and the start of the investigation should not exceed..?

Answer 34

1 hour

Question 35

Ordinary Latex Condom May affect.....?

Answer 35

Sperm Motility

Question 36

Coitus Interruptus is Not a Reliable Means Of Semen Collection.

Answer 36

true

Question 37

A Postcoital Test May Provide Some Information About Spermatozoa.

Answer 37

true

Question 38

A High Percentage of **Immotile** and **Non-Viable Sperm** May Indicate..?

Answer 38

**Epididymal Pathology**

Question 39

Eosin Y is a vital Dye 1. Yes 2. No

Answer 39

1

Question 40

Nigrosine is a vital Dye Used to assess morphology

Answer 40

Nigrosin is not a vital Dye but Used Only To Improve Background

Question 41

Using Eosin-Nigrosin, Red Or Pink Head Indicate the Sperm is Healthy

Answer 41

false * Using Eosin-Nigrosin, **Clear** Or **Unstained Heads** Indicate The Sperm is Healthy

Question 42

WHO 2010 Recommends 2 Counts Of ................ Sperm each

Answer 42

WHO 2010 Recommends 2 Counts Of 200 Sperm each

Question 43

The total number of membrane intact sperm in the ejaculate is of biological significance 1. Yes 2. No

Answer 43

1

Question 44

Some Commercial Dyes are hypotonic and when used may increase the number of....?

Answer 44

Some Commercial Dyes are hypotonic and when used may increase the number of **non-viable sperm**

Question 45

After sperm staining, Clear sperm heads and a pink midpiece are considered healthy 1. Yes 2. No

Answer 45

1

Question 46

The Lower Reference Limit for the percentage of membrane-intact sperm is ...?

Answer 46

The Lower Reference Limit for the percentage of membrane-intact sperm is **58%**

Question 47

The HOS Test is an alternative to .............Studies

Answer 47

The HOS Test is an alternative to **Dye Exclusion** Studies

Question 48

HOS test Can be used for sperm selection for ICSI

Answer 48

true

Question 49

the lower reference for the HOS test is **different** from the Eosin Dye test

Answer 49

false the lower reference for the HOS test is similar to the eosin dye test **(58%)_**

Question 50

All sperms with swelling tails are considered.............

Answer 50

a live sperm

Question 51

for therapeutic use, media diluted 1 to 1 with sterile water is ok

Answer 51

true

Question 52

in HOS sperm with no tail swelling are considered ............

Answer 52

Dead

Question 53

which of these conditions may use the HOS test to select sperm for ICSI 1. Azoospermia 2. Asthenospermia 3. Immotile Cilla Syndrome 4. Kartagener's syndrome 5. Primary ciliary dyskinesia (PCD) 6. Teratozsoospermia 7. Epididymal spermatozoa

Answer 53

3, 4, 5 * Immotile Cilla Syndrome: * Kartagener's syndrome * Primary ciliary dyskinesia (PCD) **Kartagener's Syndrome** , **Immotile Cilia Syndrome,** or a **Primary Ciliary Dyskinesia (PCD)**, is a rare autosomal recessive genetic disorder caused by defect in the tiny hair like structure, the cilia lining the respiratory tract (upper and lower), sinuses, eustachian tubes, middle ear and fallopian tubes. strongly related with **infertility**

Question 54

Semen Samples Should be Mixed but a Vortex Mixer should be .......

Answer 54

A Vortex Mixer should be avoided

Question 55

Semen Samples Should be Mixed but Incomplete Mixing May Produce..................

Answer 55

Incomplete Mixing May Produce Large Variations Between Replicates

Question 56

Bubbles after Mixing the semen sample Indicate .................

Answer 56

**Bubbles** after Mixing the semen sample Indicate **Excessive Mixing**

Question 57

a chamber depth of less than 20um may influence .........

Answer 57

a chamber depth of less than 20um may influence ***motility***

Question 58

A Chamber depth of greater than **50um** may make .................

Answer 58

A Chamber depth of greater than 50um may make assessment problematic.

Question 59

Agglutination................... Aggregation..............

Answer 59

Adherence of **motile sperm** to other **motile sperm** is called **Agglutination 0,1,2,3** **⇔** Adherence of **immotile** **Sperm** to **Mucus or non-sperm Cells** is Called **Aggregation** if ***motile sperm*** adhere to immotile sperm or***non-sperm cell* ⇒ non-specific Aggregation**

Question 60

Agglutination Grades: zero (0)........... ONE................... TWO.......... THREE........

Answer 60

**Agglutination** * Grade 0 = no adhesion (no) * Grade 1 = adhesion Greater Than **10%** (Isolation) * Grade 2 = adhesion Greater Than **30% (Moderate)** * Grade 3 = Greater Than **50%** (larege)

Question 61

The Initial Microscopic Investigation of a semen analysis should contain an estimate of sperm agglutination and/or aggregation.

Answer 61

true

Question 62

a chamber depth of less than 20 um constrains the rotational ....... of spermatozoa

Answer 62

a chamber depth of less than 20 um constrains the rotational **movement** of spermatozoa

Question 63

If the chamber is too deep, it will be difficult to assess spermatozoa because ............

Answer 63

if the chamber is too deep, it will be difficult to assess spermatozoa ## Footnote **as they move in and out of focus.**

Question 64

its OK, If the number of spermatozoa per visual field varies considerably,

Answer 64

If the number of spermatozoa per visual field varies considerably, the sample may not be homogeneous. in such cases, the semen sample should be mixed again thoroughly and a new slide prepared.

Question 65

Lack of Homogeneity may also result from..........

Answer 65

**Abnormal Consistency** **Abnormal Liquefaction** **Aggregation Of Spermatozoa** **Sperm Agglutination**

Question 66

The adherence either of **immotile** spermatozoa to each other or of **motile spermatozoa** to mucus strands, non-sperm cells or debris is considered to be..........

Answer 66

**Nonspecific Aggregation:** * **immotile spermatozoa**⇔ each other * **motile spermatozoa** ⇔ Mucus strands, non-sperm cells or debris **Remember** Motile Sperm to sperm► **Agglutination** 0,1,2,3 (0,10,30,50%) Immotile sperm to cells⇒ **Aggregation** immotile sperm to each other⇔ non specific aggregation motile sperm to cells► non specific aggregation

Question 67

Any motile spermatozoa that stick to each other by their heads, tails or midpieces should be noted. (agglutination)

Answer 67

true

Question 68

Motile spermatozoa stuck to cells or debris or Immotile spermatozoa stuck to each other considered ............ a. Aggregation b. Agglutination

Answer 68

a.

Question 69

The presence of **Agglutination** is not sufficient evidence to deduce an immunological cause of infertility, but is suggestive of the..................................

Answer 69

The presence of agglutination is not sufficient evidence to deduce an immunological cause of infertility but is suggestive of more diagnostics tests may required ## Footnote **the presence of anti-sperm antibodies and further testing is required**

Question 70

True or false: The assessment of sperm motility and concentration is independent of severe Agglutination

Answer 70

False

Question 71

The basis for assessing sperm morphology in the 5th edition (2010)....................

Answer 71

The basis for assessing sperm morphology in the 5th edition (2010) was **strict criteria**

Question 72

Zona Pellucida bound sperm are similar to normal **strict criteria** based spermatozoa

Answer 72

true

Question 73

Normal sperm are defined largely by those in cervical mucus by ........

Answer 73

**Strict Criteria**

Question 74

The 5th centile of a fertile morphology in population is .........

Answer 74

**4%** ## Footnote 4% is the 95% cutoff → a range of sperm morphology from a fertile population

Question 75

According to (**Early Liberal Methodology)** implies most sperm were ...... .........while **Strict Criteria** implies most sperm are .........

Answer 75

According to (**Early Liberal Methodology)** implies most sperm were **_Normal_** while **Strict Criteria** implies most sperm are **_Abnormal_** (The Introduction of Strict Criteria has in itself decreased the normal range.)

Question 76

Globospermia is a .......... condition

Answer 76

Globospermia is a **genetic** condition -not aquired

Question 77

Non-Genetic Conditions that affect sperm morphology may be reversible with treatment

Answer 77

true

Question 78

The Prognosis for **Short Tailed Syndrome** is good with ICSI.

Answer 78

false The Prognosis for Short Tailed Syndrome is **Very Poor** Even with ICSI

Question 79

Elongated sperm heads are thought to be .................

Answer 79

**Elongated sperm heads** are thought to be **stress induced**

Question 80

Cytoplasmic residues are associated with the production of................

Answer 80

Cytoplasmic residues are associated with the production of **ROS**

Question 81

In the 5th edition WHO manual, the Dimensions of a normal sperm head is: a. 4.1um x 2.8um b. 1.4um x 2.8um c. 2.3um x 2.6 um

Answer 81

a.

Question 82

The acrosome index is not predictive of ........rates

Answer 82

The acrosome index is not predictive of **IVF rates**

Question 83

in this figure Identify The Cell Type Of Cell # 1, 2, 3

Answer 83

1. Macrophage 2. Abnormal spermatozoon 3. (dividing) spermatid

Question 84

in this figure Identify the cell type of cell # 4,5, 6 and 7.

Answer 84

4. Abnormal spermatozoon 5. Spermatocyte 6. Abnormal spermatozoon 7. Abnormal spermatozoon

Question 85

in this figure Identify the cell type of cell # 8, 9, 10, and 11

Answer 85

8. Cytoplasm 9. (dividing) spermatid 10. Spermatocyte 11. Degenerating spermatid

Question 86

An assessment of the **degree of spermatogenesis** found in a testicular biopsy.....

Answer 86

**Johnson Score**

Question 87

Johnson Score 1- .... 2- ..... 3- ... 4-5 ...... 6-7 ..... 8-10 .......

Answer 87

Johnson Score after testicular biopsy 1- No cells are present in a tubule 2- Only Sertoli Cells can be Identified 3- Only Spermatogonia 4-5: Spermatocytes 6-7: Spermatids 8-10: Spermatozoa

Question 88

There is a correlation between **testicular size** and the **Johnson score**.

Answer 88

true

Question 89

Sertoli cell-only syndrome (del Castillo) also called Germ cell aplasia has a john score of..........

Answer 89

2

Question 90

**Subnormal** spermatogenesis has a Johnson score of:

Answer 90

**3-7**

Question 91

The Johnson Score for **normal spermatogenesis** is:

Answer 91

**8-10**

Question 92

Klinefelter's Syndrome (XXY) 1. Acquired 2. Congenital

Answer 92

2.

Question 93

Mumps Orchitis 1. Congenital 2. Acquired

Answer 93

2. **Mumps Orchitis** * Pain and swelling of the testicle (orchitis) affects up to 1 in 3 males who get mumps after puberty. * The swelling is usually sudden and affects only one testicle. The testicle may also feel warm and tender.

Question 94

Cryptorchidism 1. Congenital 2. Acquired

Answer 94

**1** -undescended testis ## Footnote **Cryptorchidism** One or both of the testes **fail to descend** from the abdomen into the scrotum.

Question 95

Anorchia 1. Congenital 2. Acquired

Answer 95

1. ## Footnote **Anorchia** Absence of both testes at birth.

Question 96

Epididymo-Orchitis 1. Congenital 2. Acquired

Answer 96

**2.** * An **inflammation** of the tube that stores and carries sperm, and/or of the testicle. * It is normally caused by infection, most often a sexually transmitted infection or a urinary tract infection. * Antibiotics are usually effective in clearing the infection

Question 97

Torsion **(Maturation Arrest)** 1. Congenital 2. Acquired

Answer 97

**1**. **Testicular torsion** is a condition where an individual’s testicle **rotates** around the spermatic cord, blocking blood flow to the area. It occurs most often in babies during the first year of life or adolescence. Testicular torsion is an emergency that requires immediate medical attention, ideally within 6 hours. If a person waits longer to get treatment, they risk losing the testicle

Question 98

Sickle Cell Disease 1. Congenital 2. Acquired

Answer 98

1. Sickle cell Disease (SCD)is an inherited disorder which causes red blood cells to become "sickled." Because of this, these sickled red blood cells have a difficult time moving through the blood vessels and cause occlusion of the vasculature. males with SCD, with rates as high as 91%. Low sperm density, low sperm counts, poor motility, and increased abnormal morphology occur more frequently in males with SCD than in controls

Question 99

Noonan's Syndrome 1. Congenital 2. Acquired

Answer 99

1. ## Footnote **Noonan syndrome** is a common genetic disorder characterized by facial anomalies, congenital heart defect, short stature, webbed neck, chest deformities in male : **undescended testes. Lead to** defective in **spermatogenesis​**

Question 100

**Myotonic Muscular Dystrophy.** 1. Congenital 2. Acquired

Answer 100

1. -Autosomal Dominant disorder -Genetic mutation on chr -19 - cause rising of GnRH, LH, FSH and low T -testicular atrophy -infertility ## Footnote **Myotonic Muscular Dystrophy.**

Question 101

What proportion of infertile men have azoospermia? 1. 5% 2. 8% 3. 11% 4. 13% 5. 15%

Answer 101

5.

Question 102

Obstructive Azo-(OA) and NOA are: 1. Managed by the same medical and/or surgical options 2. Managed by different medical and/or surgical options

Answer 102

2.

Question 103

Diagnosis of OA or NOA include:............

Answer 103

* _Thorough history taking_ * _Physical examination_ * _Possibly laboratory testing_ * _Possibly genetic testing_

Question 104

What Proportion of Azoospermia is Due To OA 1. 30% 2. 40% 3. 50% 4. 60% 5. 70%

Answer 104

2. **40%** of **Azoospermi**a is due to : Obstructive Azoospermia (**OA)** While * **60%** Due to **NOA**

Question 105

what is true about OA 1. OA is a consequence of a physical blockage 2. OA may occur anywhere along the male excurrent ductal system 3. FSH and LH are usually normal 4. FSH is low but LH is normal 5. Testes volume is increased due to the blockage 6. Blockage can be unilateral or bilateral

Answer 105

1, 2, 3, and 6

Question 106

What is true about NOA 1. may be caused by toxic exposures 2. may be caused by abnormal testicular development 3. may be caused by trauma 4. may be due to primary testicular failure 5. may be due to secondary testicular failure 6. may be due to tertiary testicular failure

Answer 106

1, 2, 4, 5.

Question 107

Ambiguous (unclear) NOA May Present As: 1. Increased FSH and normal volume testis 2. Increased FSH and increased tests volume 3. Normal FSH and small tests 4. Normal FSH and normal testis volume 5. Reduced FSH and small testis volume 6. Reduced FSH and normal testis volume

Answer 107

1, 3, 4,

Question 108

Acquired Causes of obstruction of the vas deferens may include: 1. Vasectomy 2. Iatrogeneic injury following inguinal hernia surgery 3. Abstinence 4. Vasography

Answer 108

1, 2 and 4

Question 109

Acquired causes of **obstruction** of the **epididymus** may include: 1. vasal obstruction 2. prolonged vasectomy 3. epididymal rupture after excessive intratubal pressure 4. scrotal trauma 5. pelvic injury 6. previous PESA or MESA surgery 7. epididymal biopsy 8. abstinence

Answer 109

1, 2, 3, 4, 5, 6and 7

Question 110

Congenital OA may result in

Answer 110

Congenita Unilateral Absence of Vas Difference (**CUAVD**) or (not and) ⇒ **CBAVD**

Question 111

OA may result from: 1. **_severe** inflammation of the epididymis (epididymitis) 2. severe inflammation of the prostate 3. severe inflammation of the seminal vesicles 4. upper genitourinary tract infection 5. lower genito-urinary tract infection

Answer 111

1, 2, 3, and 5

Question 112

Ejaculatory Duct Obstruction (**EDO**) can result from 1. Abstinence 2. Trauma 3. Infection 4. Surgery 5. Congenital Mullerian duct cysts

Answer 112

2, 3, 4 and 5

Question 113

Ejaculatory Duct Obstruction (**EDO**) is characterized by 1. low semen volume 2. clear, watery appearance 3. low pH 4. absent fructose

Answer 113

all are true

Question 114

Etiology of OA may be include:.......

Answer 114

* Surgery * Infection * congenital abnormalities * possibly prior successful fertility * vasectomy

Question 115

Physical Examination may revel:

Answer 115

* vasal gaps * site or prior vasectomy * the presence of granuloma * epididymal gaps or abnormalities

Question 116

The Presence of granuloma at a previous vasectomy site is an indication of......................

Answer 116

**successful microsurgical vasectomy reversal** **Note:** **Vasectomy reversal** is **surgery to undo a vasectomy**. During the procedure, a surgeon reconnects each tube (vas deferens) that carries sperm from a testicle into the semen. After a successful vasectomy reversal, sperm are again present in the semen.

Question 117

Elevated FSH after vasectomy may suggest the need for ........................................

Answer 117

Elevated FSH after vasectomy may suggest the need for **IVF/ICSI after reversal**

Question 118

A husband may still remain fertile if unilateral obstruction is diagnosed

Answer 118

true

Question 119

A Partial Obstruction may result in: 1. _Oligospermia_ 2. _Oligoasthenoteratospermia_ 3. _polyspermia_ 4. _asthenozospermia_

Answer 119

1,2

Question 120

Clients with **Unilateral** or **Bilateral** Absence of The Vas Deferens need to make these diagnosis:

Answer 120

1. testing for **CFTR** 2. testing and counselling of partner if CFTR is positive 3. renal ultrasound if CUAVD to test for renal agenesis

Question 121

Positive Antisperm Antibodies and Vasa Obstruction Indicates: 1. Active spermatogenesis 2. testicular biopsy unnecessary prior to microsurgical reconstruction

Answer 121

true

Question 122

Clients with Unclear Etiology of Azoospermia may warrant a testicular biopsy with these parameters. 1. normal testes volume 2. Clear ejaculates 3. normal vasa 4. negative antisperm antibodies 5. normal FSH levels 6. decreased T

Answer 122

1, 2, 3, 4 and 5 Testicular Biopsy decision need: * normal testes volume * Clear ejaculates * normal vasa * negative antisperm antibodies * normal FSH levels

Question 123

Low Semen Volume, Clear Appearance, Low PH, Absent Fructose ⇒indicate..........

Answer 123

**Ejaculatory duct obstruction**

Question 124

Normal Semen Volume, FSH, LH and Testosterone indicate........

Answer 124

**Obstructive Azoospermia OA**

Question 125

Decreased Semen Volume and Testosterone, Elevated FSH and LH.

Answer 125

**Non-Obstructive Azoospermia-NOA** **primary testicular failure**

Question 126

Decreased Semen Volume, Testosterone, FSH and LH.

Answer 126

**Non-Obstructive Azoospermia-NOA** **hypogonadotrophic hypogonadism**

Question 127

Sertoli cell hormones.................

Answer 127

during fetal period, Sertoli cells secrete AMH for male development at puberty Sertoli cells secrete ABP, and inhibin