Why you can

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(No Transcript)
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Fertilization Specialists
Joshua Prince
Preston Moore
Candace Lindler
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Infertility

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

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Treatment
Table 1. Classification Of Male Infertility By Effectiveness Of Medical Intervention To Improve Natural Conception Rate Table 1. Classification Of Male Infertility By Effectiveness Of Medical Intervention To Improve Natural Conception Rate
TYPE OF INFERTILITY  FREQUENCY ()
Untreatable sterility  12
Primary seminiferous tubule failure  12
Treatable conditions  18
Sperm autoimmunity  7
Obstructive azoospermia  10
Gonadotropin deficiency  0.50
Disorders of sexual function  0.50
Reversible toxin effects  0.02
Untreatable subfertility  70
Oligospermia  35
Asthenospermia and teratozoospermia  30
Normospermia with functional defects  5

• 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

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Normal Reproduction

• Ovulation
• Spermatogenesis
• Sperm meets with egg in fallopian tube
• Fertilization
• Implantation

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Male Reproductive System
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Female Reproduction System
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Normal Spermatogenesis
http//www.coolschool.ca/lor/BI12/unit15/U15L02.ht
m
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Testes

• Normal Testes
• 10-14 grams
• Body of the testis
• Epididymis
• Spermatic Cord
• Embryonal Carcinoma
• hemorrhage and necrosis

http//library.med.utah.edu/WebPath/MALEHTML/MALE0
82.htm
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Spermatogenesis

• Spermatogonium (2N)Differentiation
• Primary Spermatocyte (2N)Meiosis I
• Secondary Spermatocytes Meiosis II
• Spermatids Differentiation
• Spermatozoa

http//www.uh.edu/tgill2/image016.jpg
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Spermatogenesis Cont.

• Seminferous Tubules90 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

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Klinefelter Syndrome

• XXY instead of XX or XY
• usually male
• lower levels of testosterone
• improper formation of semineferous tubules

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Bilateral Anorchia

• vanishing testes syndrome
• testes originally present but reabsorbed before
  or after birth

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Oligospermia

• having too few sperm
• due to
• fever
• excessive alcohol
• smoking
• varicocele
• orchitis

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Azoospermia

• total lack of sperm in ejaculate
• due to
• fever
• undescended testicle
• obstructions of seminal vesicles
• testicle infection

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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

http//www.healthopedia.com/pictures/undescended-t
esticle.html
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Abnormalities

• Testicular torsion of the spermatic cord cuts
  off the venous drainage, leading to hemorrhagic
  infarctionIt is the twisting of the spermatic
  cordsImmediate treatment
• Testicular cancer

http//library.med.utah.edu/WebPath/MALEHTML/MALE0
83.html
http//library.med.utah.edu/WebPath/MALEHTML/MALE0
82.htm
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Illnesses

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

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Orchitis

• testicle inflammation
• due to
• mumps
• infection
• trauma
• STD

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STDs

• Fibropapilloma
• papilloma virus
• induces testicular warts
• inhibits spermatogenesis
• Chlamydia and gonorrhea
• cause scar tissue which results in duct blockage
  and
• inhibits spermatogenesis

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Stimulants

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

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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

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Gynecomastia

• Testicular Failure
• Androgen receptors
• Cirrhosis
• Tumors
• Illegal steroid
• Feminine characteristics

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Examination

• Inflammation would cause pain
• Lack of hair
• 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

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Varicoceli

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

http//www.aafp.org/afp/980215ap/junnila.html
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Environmental

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

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Physical Obstruction to Gamete Movement

• Blocked or absent seminal ducts
• Seminal fluid disorders
• Retrograde ejaculation
• Inability to ejaculate

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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

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Seminal Fluid Disorders

• Absent antioxidant factors
• Abundant circulating free radicals

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Retrograde Ejaculation

• Reverse ejaculation into the bladder
• Causes
• Prostate surgery
• Certain medications
• Diabetes
• Spinal cord injuries

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Inability to Ejaculate

• Erectile dysfunction
• Diabetes
• Prostate surgery
• Urethra surgery
• Blood pressure medications

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Hormonal Obstruction to Gamete Movement

• Endocrine disorders
• Steroids
• Unexplained low levels of needed hormones

http//www.erin.utoronto.ca/w3bio380/lecture3.htm
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Endocrine Disorders

• Pituitary disorder
• Feminization
• Kallmanns syndrome
• Hypothyroidism
• Other Causes
• Steroid Use
• Unexplained low levels of hormones

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Improper Fusion of Sperm and Egg

• Antisperm Antibodies
• Immobilization
• Agglutinating
• Sperm-cervical mucus interaction
• Penetration of the egg
• Sperm fertilization
• Zygote development

http//www.dulwichtherapyrooms.co.uk/fertilityclin
ic/4522296135
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Improper Fusion of Pronuclei

• CD9 and CD81 antibodies

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Miscarriage

• 50 of pregnancies
• occur early in development
• chemical miscarriage
• molar pregnancy

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Chemical Miscarriage

• before pregnancy is know
• dies almost immediately after conception
• causes
• chromosomal abnormalities
• uterine abnormalities
• hormonal deficiency

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Molar Pregnancy

• Complete
• egg contributes no DNA
• two copies of paternal chromosomes
• Partial
• egg does contribute DNA
• two copies of paternal chromosomes

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References

• http//www.wernermd.com/Azoospermia.html
• http//www.howtomakeafamily.com/experts/lewis/male
  _factor_infertility.htm
• http//infertility.health-info.org/male-infertilit
  y/male-infertility-sperm-disorders.html
• http//www.merck.com/mmhe/sec21/ch240/ch240e.html
• http//www.resolve.org/site/PageServer?pagenamelr
  n_jfm_mfed
• http//www.resolve.org/site/PageServer?pagenamelr
  n_jfm_mfaa
• http//upload.wikimedia.org/wikipedia/commons/b/b5
  /Gray8.png
• http//www.ncbi.nlm.nih.gov/books/bv.fcgi?indexed
  googleriddbio.section.1412

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References

• http//www.nature.com/ncb/journal/v3/n2/full/ncb02
  01_e59.html
• http//www.babycenter.com/0_molar- pregnancy_13636
  14.bc?Adcom.bc.common.AdInfo40575bc872
• http//www.wdxcyber.com/chemical_pregnancies.html
  
• http//www.merck.com/mmpe/print/sec19/ch282/ch282f
  .html
• http//uk.answers.yahoo.com/question/index?qid200
  61208102440AA2g80G
• http//www.varicocelespecialists.com/faq3.htm
• http//www.endotext.org/male/male7/maleframe7.htm
  
• http//copa.org/med/sperm.htm
• http//www.ivf.com/shaban.html
• http//www.ucalgary.ca/UofC/eduweb/virtualembryo/s
  permatogenesis.html

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Questions?