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male infertility

Etiology: - hypogonadism - genetic disease - 15% of cases of male infertility [4] - Klinefelter syndrome - cystic fibrosis - ciliary dyskinesia - tight underwear elevates scrotal temperatures, leading to testicular injury [5] Pathology: - azoospermia - UAP1 antigen implicated in antibody-mediated male infertility - deletion of pseudoautosomal region 1 (PAR1) causes male infertility - CATSPER1 down-regulated in patients lacking sperm motility Genetics: - may be associated with defects in GPX4 - other implicated genes TSPY2, SMCP Laboratory: - semen analysis (single best test) [3] - obtain after 48-72 hours of abstinence - repeat in 2 weeks for confirmation if abnormal [3] - sperm count (see azoospermia) - 8 AM serum testosterone [3] - see ARUP consult [1] Management: - endocrine consult if repeat semen analysis abnormal [3]

Related

hypogonadism

Specific

azoospermia deafness-infertility syndrome globozoospermia (round-headed spermatozoa) idiopathic oligospermia

General

sexual dysfunction

References

  1. ARUP Consult: Infertility The Physician's Guide to Laboratory Test Selection & Interpretation https://www.arupconsult.com/content/infertility
  2. Cooper TG, Noonan E, von Eckardstein S et al World Health Organization reference values for human semen characteristics. Hum Reprod Update. 2010 May-Jun;16(3):231-45 PMID: 19934213
  3. Medical Knowledge Self Assessment Program (MKSAP) 16, 17, 18, 19. American College of Physicians, Philadelphia 2012, 2015, 2018, 2022
  4. Krausz C, Chianese C. Genetic testing and counselling for male infertility. Curr Opin Endocrinol Diabetes Obes. 2014 Jun;21(3):244-50 PMID: 24739313
  5. Minguez-Alarcon L, Gaskins AJ, Chiu YH. Type of underwear worn and markers of testicular function among men attending a fertility center. Human Reproduction. Aug 8, 2018 PMID: 30102388 https://academic.oup.com/humrep/advance-article/doi/10.1093/humrep/dey259/5066758