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13.1 Have a look around the laboratory area where you are currently working or studying and compile a list of the laboratory equipment that is available to you which you would use in semen analysis. Discuss what else you would need to do to set up a successful semen analysis service.
The student should note down a list of basic equipment that is available in most laboratories, such a microscopes with suitable optics, pipettes, incubators, glass slides, counting chambers, reagent solutions, etc. The student should then go on to describe the additional equipment and reagents that are specific to semen analysis work, as detailed in section 13.5 of the chapter.
13.2 Discuss the essential features of a patient information leaflet that will cover all of the details required for the successful production and safe transport of semen samples to the laboratory. Produce a simple, compact sample leaflet that will fit on one side of A4.
The student should discuss and interpret the material contained in section 13.4 of the chapter with the aim of producing a sample leaflet. Health and safety matters should also be mentioned in the student answer.
13.3 Discuss the lifestyle questions that could be asked of a young male patient presenting with a sub-optimal infertility screen profile and the advice that might be given to help him improve his fertility.
This question relates to the information in section 13.7 i.e.:
- A history of reproductive tract infections or sexually transmitted diseases.
- Exposure to environmental pollutants, e.g. agricultural chemicals.
- Male athletes exposed to conditions which might lower sperm counts.
- Alcohol abuse.
- Use of tobacco/recreational drugs.
- Medicinal drugs, especially steroids.
- Previous testicular surgery or recent trauma.
The student should compile a series of simple discrete questions to determine the patient’s history and then be able to comment on the significance of the information collected.
13.4 What are the causes male infertility?
In your answers consider the following:
Sperm production problem:
- Chromosomal or genetic causes
- Undescended testicles
- Infections
- Torsion
- Radiation damage
Blockage of sperm transport
- Infections
- Prostate-related problems
- Absence of vas deferens
Sexual problems
- Retrogrades ejaculation
- Failure of ejaculation
- Prostate surgery
Hormonal issues
- Pituitary tumour is
- Congenital lack of LH/FSH
- Anabolic steroid abuse
Sperm antibodies
- Vasectomy injury or infection in the epidermis
13.5 How can male infertility be treated?
In your answers consider the following:
Often an exact cause of infertility cannot be identified. The ultimate goal of treating male infertility is to create a pregnancy. Ideally the cause of infertility is reversible and conception can result from natural sex.
Varioceles can be repaired with surgery block of abnormal veins. Hormonal issues can sometimes be treated with medicine. Obstructions in the sperm transport system can sometimes be corrected. In cases where there are no sperms present in the ejaculate, sperm can often be retrieved directly from the testicles or epididymis using sperm retrieval techniques.
Changing Lifestyles factor may be useful in improving sperm quality. Moderate exercise, stopping smoking, reducing stress and avoiding recreational drugs.
Assisted reproductive techniques (ARTs) offer men with very low or abnormal sperms to conceive.