infertility

Question 1

what are 2 embyrological duct systems and what do they end up as

Answer 1

1. wolfian - epidyd, vas, seminal vesicles, ejac. duct

2. mullerian - uterur, fallopian tubes, upper vag

Question 2

what is sig. of this

Answer 2

wolfian system missing in 80% of CF

Question 3

what is most important hormone to measure

Answer 3

FSH

Question 4

what is FSH loop

Answer 4

FSH>sertoli cells>inhibin-ve>hypo>GNrh

Question 5

what is LH loop

Answer 5

LH>leydig cells>T-ve to>hypo> GNRH

Question 6

how long does sperm take to mature and sig. of this

Answer 6

70 days to be made
14 days to mature and travel
3 months before can assess Tx

Question 7

where does sperm mature

Answer 7

epididymis

• gain motility
• stabilize condense chromatin

Question 8

how long is epidid

Answer 8

6 meters

Question 9

where is semen from (3)

Answer 9

10% testes
60-70% seminal vesicles
20% prostate

Question 10

3 factors important about duration of infert. on Hx

Answer 10

1. primary vs. secondary
2. previous Tx
3. female factor

Question 11

5 other things to ask on Hx

Answer 11

1. childhood and dev.
   - cryptorchidism
   - pubertal dev.
2. med. Hx
3. surg. Hx
4. infections
   - STI, prostatitis, mumps
5. env. toxins
   - smoking, drugs, steroids, pestiticdes

Question 12

3 important types of meds, and the phase they affect

Answer 12

1. hormonal (pre-testicular)
   - andogens, anti androgens
2. gonadotoxic (testicular)
   - Chemo
   - ABs
3. spermatoctoxic (post- testicular)
   - Ca channel blockers

Question 13

4 parts of Phx

Answer 13

1. general appearance
2. CNS
3. breasts - gynecomastia
4. abdo scars or masses

Question 14

5 things to look at on genital exam

Answer 14

1. penile anat
2. teste size and consistency
3. presence of vas
4. epidyddimal congestion
5. varicocoel

Question 15

what is normal testes size

Answer 15

2x4 cm

15-22 CC

Question 16

3 grades of varicocele

Answer 16

1. with valsalva
3. out all the time

Question 17

what will FSH, LH, and T look like in pre-test. azoospermia

Answer 17

FSH- low
LH - low
T - low-normal

Question 18

what will FSH, LH, and T look like in test. azoospermia

Answer 18

FSH- high
LH - high/norm
T - norm

Question 19

what will FSH, LH, and T look like in post-test. azoospermia

Answer 19

FSH- norm
LH - norm
T - norm

Question 20

4 genetic issues to screen for

Answer 20

1. XXY - klinfelters
2. roberson translocation
3. XX male - no hope
4. Y chromo deletion

Question 21

what is seen in klinefleters

Answer 21

• gynecomastia
• eunuchoid
• delay puberty
• sterile

Question 22

what is Tx for klinefleter’s

Answer 22

• testicular sperm extraction
• find a few sperm in lobes of 50%
• IVF them fuckers in

Question 23

what is TESE success rate

Answer 23

micro - 49%

regular 33%