Study guide

Fertility

FSH stimulates Sertoli cells to make sperm. Spermatogenesis takes 74 days to complete, they are made in seminiferous tubules where testosterone is required in the lumen. The little swimmers mature in the epididymis and are stored in the cauda. A fever can disrupt spermatogenesis for 3 months.

Risk factors for infertility in females are:

age>35
PCOS
PID
h/o tubal ligation
endometriosis

Risk factors for infertility in males are:

varicocele
h/o STD's
trauma to testicles
ejaculation disorders
endocrine disorders
1. thyroid (hypo= ^ in prolactin
2. hypo/hypergonadotropic
prostatitis
radiation
h/o cryptoorchidism, testicular torsion
DM
h/o surgery
fever
mumps (after puberty)
liver disease
drugs - chemotherapy, cimetidine, colchicine, sulfasalazine, allopurinol, spironolactone, TCA's, dilantin

CF, kartagener's, Young syndrome, myotonic dystrophy, CBAVD, radiation, pesticides

Semen analysis and sperm tests

fructose - made by seminal vesicles, if absent = obstruction, agenesis ect.
leukocytes - if >1million=culture semen, urine, prostate secretions, swab urethra
vitality - trypan blue, osmotic, eosin

Clomiphene citrate blocks estradiol negative feedback at the level of the hypothalamus and pituitary gland

POST VASECTOMY
Post vasectomy, sperm retrieval with IVF/ICSI is preferred to surgical reconstruction if (1) advanced female age; (2) female factors requiring IVF are present; (3) the chance for success with sperm retrieval/ICSI exceeds the chance for success with surgical treatment, or (4) sperm retrieval/ICSI is preferred by the couple for financial reasons."
Average time to conception after vasectomy reversal is 12mo

Fertility

QUIZ