Male and female infertility causes and assisted reproductive technology concepts (IVF, IUI, ovulation induction) tested on USMLE Step 1.
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- What is the most common identifiable cause of male infertility?
- Varicocele
- How does a varicocele impair fertility?
- It raises scrotal/testicular temperature, impairing spermatogenesis
- Karyotype of Klinefelter syndrome?
- 47,XXY
- What gonadotropin pattern is seen in Klinefelter syndrome?
- Hypergonadotropic hypogonadism (low testosterone, high LH and FSH)
- Congenital bilateral absence of the vas deferens (CBAVD) is associated with mutations in which gene?
- CFTR
- What two conditions does cryptorchidism increase the risk of?
- Infertility and testicular cancer
- Kallmann syndrome is caused by a deficiency of which hormone?
- GnRH
- What non-reproductive symptom classically accompanies Kallmann syndrome?
- Anosmia (inability to smell)
- What gonadotropin pattern is seen in Kallmann syndrome?
- Hypogonadotropic hypogonadism (low GnRH, LH, FSH, and testosterone)
- What is the WHO reference lower limit for normal semen volume?
- 1.5 mL
- What is the WHO reference lower limit for normal sperm concentration?
- 15 million sperm per mL
- What is the WHO reference lower limit for normal sperm motility?
- 40 percent
- Azoospermia is defined as the complete absence of ____ in the ejaculate.
- sperm
- Which lab test helps distinguish obstructive from nonobstructive azoospermia?
- Serum FSH (normal in obstructive, elevated in nonobstructive/testicular failure)
- What are the Rotterdam criteria used to diagnose?
- Polycystic ovary syndrome (PCOS), requiring 2 of 3: oligo/anovulation, hyperandrogenism, polycystic ovaries on ultrasound