Male Reproductive Problems

Male Reproductive Problems
By:Fertilization Specialists
Joshua Prince
Preston Moore
Candace Lindler

Infertility
* Infertility is the inability of a couple to become pregnant
* 6.1 million people in the United States are effected

Treatment
Normospermia with functional defects
Asthenospermia and teratozoospermia
Oligospermia
Untreatable subfertility
Reversible toxin effects
Disorders of sexual function
Gonadotropin deficiency
Obstructive azoospermia
Sperm autoimmunity
Treatable conditions
Primary seminiferous tubule failure
Untreatable sterility
FREQUENCY (%)

TYPE OF INFERTILITY
Table 1. Classification Of Male Infertility By Effectiveness Of Medical Intervention To Improve Natural Conception Rate

* Sperm count equals the number of sperm per cm3 or cc
* The average has dropped in the past 20 years
* 85-90% are treated with medication or surgery
* Lifestyle changes

Normal Reproduction
* Ovulation
* Spermatogenesis
* Sperm meets with egg in fallopian tube
* Fertilization
* Implantation

Male Reproductive System
Female Reproduction System
Normal Spermatogenesis
Testes

* Normal Testes
* 10-14 grams
* Body of the testis
o Epididymis
o Spermatic Cord
* Embryonal Carcinoma
o hemorrhage and necrosis
* Spermatogonium (2N)
Differentiation
* Primary Spermatocyte (2N)
Meiosis I
* Secondary Spermatocytes
Meiosis II
* Spermatids
Differentiation
* Spermatozoa

Spermatogenesis
* Seminferous Tubules
90% of the testis
* Thousands of sperm per second although spermatogenesis 8-10 weeks
* Stored for months
* Degraded and deposited into the circulatory system if not ejaculated

Klinefelter Syndrome
* XXY instead of XX or XY
* usually male
* lower levels of testosterone
* improper formation of semineferous tubules

Bilateral Anorchia
* vanishing testes syndrome
* testes originally present but reabsorbed before or after birth

Oligospermia
* having too few sperm
* due to:
fever
excessive alcohol
smoking
varicocele
orchitis

Azoospermia
* total lack of sperm in ejaculate
* due to:
fever
undescended testicle
obstructions of seminal vesicles
testicle infection

Cryptorchidism
* 30% of males born premature
* 3% of males carried to term
* Predisposes the person to risk of torsion
* Androgen receptor
* Bilateral has six times the impact on infertility
* Increase in Temperature
* Testicular atrophy
* Treated at Childhood

Abnormalities
* Testicular torsion
of the spermatic cord cuts off the venous drainage, leading to hemorrhagic infarction
It is the twisting of the spermatic cords
Immediate treatment
* Testicular cancer

Illnesses
* Acute
o Hypogonadism
+ Suppression of gonadotropin secretion
o Fever
+ The elevated temperature can induce declines in sperm production for months
* Chronic
o elevated gonadotropin secretion
+ leading to primary testicular disorder

Orchitis
* testicle inflammation
* due to:
mumps
infection
trauma
STD
STDs
* Fibropapilloma
o papilloma virus
o induces testicular warts
o inhibits spermatogenesis
* Chlamydia and gonorrhea
o cause scar tissue which results in duct blockage and
o inhibits spermatogenesis

Stimulants
* Heroin and other opiates
o suppression of LH secretion
* Cocaine and Marijuana
o temporarily can decrease 50% of sperm count
o compounds bind to sperm receptors affecting motility and entry to the secondary oocyte
* Smoking Tobacco
o lowers sperm motility
o reduces sperm life

Age

* Hypoplasia via testicular degeneration
* Nutritional factors, systemic infections, toxins, and other environmental factors
* Basement membrane becomes thickened
* Folds and wrinkles leading to tubular collapse
* Can lead to immune-mediated inflammatory response
* DNA Fragmentation

Gynecomastia
* Testicular Failure
* Androgen receptors
* Cirrhosis
* Tumors
* Illegal steroid
* Feminine characteristics

Examination
* Inflammation would cause pain
* Lack of hair
o Androgen deficiency
* Normal volume equals 15 to 35 ml
* Small is equal to 5 ml or less and would also signal androgen deficiency
* Hard lumps would signal tumors
* Softness would signal reduced spermatogenesis

Varicoceli
* Enlarged and twisted varicose veins
* 15-20% of men
* Elevates the temperature
* Obstructs passage of semen
* Obstructs oxygen supply

Environmental
* Polychlorinated biphenyls
o Teratogens
+ bind to the aryl hydrocarbon receptor
+ mimic estrogen, inhibiting the Leydig cells
* Testosterone
o activates mitogen-activated protein kinase
* Pesticides
o DDT
+ mimics estrogen
* Free Radicals
* Emotional stress
o inhibits secretion of GnRH

Physical Obstruction to Gamete Movement
* Blocked or absent seminal ducts
* Seminal fluid disorders
* Retrograde ejaculation
* Inability to ejaculate

Blocked or Absent Ducts
* Bilateral congenital absence of the vas deferens
* Obstruction of the epididymis or vas deferens
* Mechanical blockage during hernia repairs
* Blocked seminal vesicles

Seminal Fluid Disorders
* Absent antioxidant factors
* Abundant circulating free radicals

Retrograde Ejaculation
* Reverse ejaculation into the bladder
* Causes:
o Prostate surgery
o Certain medications
o Diabetes
o Spinal cord injuries

Inability to Ejaculate
* Erectile dysfunction
o Diabetes
o Prostate surgery
o Urethra surgery
o Blood pressure medications

Hormonal Obstruction to Gamete Movement
* Endocrine disorders
* Steroids
* Unexplained low levels of needed hormones

Endocrine Disorders
* Pituitary disorder
* Feminization
* Kallmann’s syndrome
* Hypothyroidism
* Other Causes
o Steroid Use
o Unexplained low levels of hormones

Improper Fusion of Sperm and Egg
* Antisperm Antibodies
o Immobilization
o Agglutinating
o Sperm-cervical mucus interaction
o Penetration of the egg
o Sperm fertilization
o Zygote development

Improper Fusion of Pronuclei
* CD9 and CD81 antibodies
Miscarriage
* 50% of pregnancies
* occur early in development
chemical miscarriage
molar pregnancy

Chemical Miscarriage
* before pregnancy is know
* dies almost immediately after conception
* causes:

chromosomal abnormalities
uterine abnormalities
hormonal deficiency

Molar Pregnancy
* Complete
egg contributes no DNA
two copies of paternal chromosomes
* Partial
egg does contribute DNA
two copies of paternal chromosomes

References
Male Reproductive Problems