Male infertility

Subfertility refers to:

A. Complete infertility
B. Reduced probability of conception
C. Hormonal deficiency
D. Absence of sperm

B. Reduced probability of conception

Male infertility can occur at which levels?

1. Sperm production

2. Transport

3. Endocrine

4. Genetic

A. 1, 2, 3 only
B. 1 and 4 only
C. 1, 2, 3, 4
D. 2 and 3 only

C. 1, 2, 3, 4

Which is a pre-testicular cause?

A. Varicocele
B. Cryptorchidism
C. Hyperprolactinaemia
D. Vasectomy

C. Hyperprolactinaemia

Name 3 pre-testicular causes

hyperprolacinaemia, excess androgens, systemic illness

Name 3 testicular causes

varicoele, cryptorchidism, mumps orchitis

name 3 post-testicular cause

epididymal, vas deferens, ejaculatory duct obstruction

Normal sperm concentration is:

A. >5 million/mL
B. >10 million/mL
C. >15 million/mL
D. >50 million/mL

C. >15 million/mL

Normal sperm morphology is:

A. >1%
B. >2%
C. >4%
D. >10%

C. >4%

Oligozoospermia refers to:

A. Poor motility
B. Low count
C. Abnormal morphology
D. Dead sperm

B. Low count

Minimum number of semen analyses required:

A. 1
B. 2
C. 3
D. 4

B. 2

What are other causes of infertility (3)

klinefelter syndrome, CFTR mutations, smoking

two ways in which male infertility is evaluated

semen analysis and genetic testing

three treatments for male factor infertility

repair varicocele, ART, treat endocrine abnormalities

Low testosterone + high FSH + high LH suggests:

A. Secondary hypogonadism
B. Primary testicular failure
C. Obstructive azoospermia
D. Normal physiology

B. Primary testicular failure

Low testosterone + low/normal FSH + low/normal LH suggests:

A. Primary failure
B. Secondary hypogonadism
C. Obstruction
D. Normal

B. Secondary hypogonadism

Normal testosterone + high FSH suggests:

A. Obstruction
B. Spermatogenic failure
C. Normal fertility
D. Hyperprolactinaemia

B. Spermatogenic failure

Normal hormones + azoospermia + normal testes suggests:

A. Primary failure
B. Obstructive azoospermia
C. Klinefelter syndrome
D. Endocrine disorder

B. Obstructive azoospermia

A man has bilateral absence of vas deferens. Most likely cause?

A. Varicocele
B. CFTR mutation
C. Klinefelter syndrome
D. Hormonal imbalance

B. CFTR mutation

A patient with anosmia and infertility likely has:

A. Klinefelter syndrome
B. Kallmann syndrome
C. Varicocele
D. Prolactinoma

B. Kallmann syndrome

A patient with gynecomastia and XXY karyotype:

A. Kallmann syndrome
B. Klinefelter syndrome
C. Varicocele
D. Hyperthyroidism

B. Klinefelter syndrome

A man with infertility and visual field defects:

A. Varicocele
B. Prolactinoma
C. CFTR mutation
D. Epididymitis

B. Prolactinoma

Varicocele affects fertility by:

A. Hormonal excess
B. Increased testicular temperature
C. Reduced blood flow only
D. DNA mutation

B. Increased testicular temperature

Most common side of varicocele:

A. Right
B. Left
C. Bilateral equally
D. Central

B. Left

Right-sided varicocele suggests:

A. Normal variant
B. Renal pathology
C. Hormonal imbalance
D. Infection

B. Renal pathology

Cryptorchidism primarily affects:

A. Leydig cells
B. Spermatogenesis
C. Hormone production only
D. Seminal fluid

B. Spermatogenesis

Mumps orchitis may lead to:

A. Increased fertility
B. Testicular atrophy
C. Hyperplasia
D. Increased testosterone

B. Testicular atrophy

Klinefelter syndrome karyotype:

A. XY
B. XXY
C. XYY
D. XXX

B. XXY

Post-ejaculatory urine test is used for:

A. Infection
B. Retrograde ejaculation
C. Hormone levels
D. Morphology

B. Retrograde ejaculation

Best treatment for obstructive azoospermia:

A. Hormones
B. Surgery
C. Lifestyle only
D. Antibiotics

B. Surgery

Exogenous testosterone causes infertility by:

A. Increasing sperm production
B. Suppressing FSH and LH
C. Increasing motility
D. Improving morphology

B. Suppressing FSH and LH

Varicocelectomy improves semen parameters in:

A. 10–20%
B. 30–40%
C. 60–70%
D. 90–100%

C. 60–70%

Which condition is MOST likely with normal hormones and azoospermia?

A. Primary testicular failure
B. Obstruction
C. Klinefelter
D. Endocrine disorder

B. Obstruction

Which hormone pattern suggests androgen abuse?

A. High LH
B. Low LH
C. High FSH
D. Low testosterone

B. Low LH

Elevated FSH indicates:

A. Normal spermatogenesis
B. Obstruction
C. Seminiferous tubule damage
D. Increased testosterone

C. Seminiferous tubule damage

Leukospermia is defined as:

A. >1 million sperm
B. >1 million leukocytes
C. No sperm
D. Dead sperm

B. >1 million leukocytes

Cryptozoospermia means:

A. No sperm at all
B. Sperm only seen after centrifugation
C. Dead sperm
D. Low motility

B. Sperm only seen after centrifugation

Which condition is MOST likely to benefit from surgery?

A. Klinefelter syndrome
B. Varicocele
C. Genetic infertility
D. Hormonal deficiency

B. Varicocele

Which are causes of obstructive azoospermia?

1. Vasectomy

2. CFTR mutation

3. Epididymal blockage

4. Varicocele

A. 1, 2, 3 only
B. 1 and 4 only
C. 2 and 4 only
D. All of the above

A. 1, 2, 3 only