3 months of regular, unprotected intercourse.
2 years of regular, unprotected intercourse.
9 months of regular, unprotected intercourse.
1 year of regular, unprotected intercourse.
6 months of regular, unprotected intercourse.
history of mumps orchitis before puberty.
any couple questioning male fertility potential.
presence of female infertility risk factors.
patients with risk factors for male infertility.
failure to conceive after 1 year of regular, unprotected intercourse.
Baseline pregnancy rates for normal couples are 50% per cycle.
Primary infertility is defined as infertility that is primarily due to a male factor.
Optimal sexual frequency for couples attempting to conceive is every third day.
Ovulation kits measure midcycle follicle-stimulating hormone (FSH) levels to help time intercourse around ovulation.
Secondary infertility indicates prior conception with the current or previous partner.
raw egg white.
none of the above.
Tamsulosin causes an increase in antegrade ejaculation.
Finasteride results in dose-dependent reduction in sperm motility.
Marijuana increases serum testosterone levels.
Cimetidine inhibits androgen production.
Sulfalazine is associated with irreversible reduction in sperm count and morphology.
A rectal examination assessing for the presence of a midline cyst is important in the evaluation of a man with unilateral absence of the vas deferens.
The normal adult testis volume is 20 mL.
Assessment of the presence or absence of vas deferens is ideally performed with ultrasound.
A grade 2 varicocele is one that is visible through the scrotal skin.
A right-sided vericocele is of no consequence.
Two separate samples at least 7 days apart should be analyzed.
The most common cause of low-volume ejaculate is incomplete collection.
Abstinence of 2 to 7 days before a semen analysis is optimal.
Coitus interruptus is an accurate and reliable method of obtaining semen.
Only 50% of men will have a recognizable cause of infertility on the basis of the standard semen analysis.
The Endtz test is used to differentiate nonsperm round cells in semen between white blood cells and immature germ cells.
Normal sperm count is reported as greater than 40 million sperm per milliliter.
Antisperm antibodies usually manifest themselves through abnormal morphology.
Any degree of sperm agglutination is considered abnormal.
The acrosome compromises 20% of the sperm head.
Men with hypospadias may have an abnormal PCT.
The cervical mucus must be examined 2 to 8 hours after normal intercourse 1 day before ovulation.
Indications for a postcoital test include hyperviscous sperm, unexplained infertility, and low-volume sperm with unexplained infertility.
The most common cause of an abnormal PCT is improper timing of the test.
A normal result is 5 progressively motile sperm per high-power field (HPF) in the cervical mucus.
Enzymes important in the acrosome reaction include acrosin and trypsin.
An acrosome reaction test may be useful in patients with severe teratospermia and round-headed sperm.
In a PCT, good-quality mucus with shaking sperm indicate abnormal sperm penetration.
The acrosome reaction test and sperm penetration assay (SPA) are clinically important and relevant tests.
In the SPA, successful penetration is indicated by absent sperm heads within the oocyte cytoplasm.
Other conditions such as torsion, infection, and testicular trauma all may result in the breakdown of the blood- testis barrier and development of ASA.
Indirect ASA testing is done only in females.
Direct ASA testing detects antibodies bound to sperm.
Tight junctions between Sertoli cells regulate the blood- testis barrier.
Vasectomy is the most common cause of the development of ASA.
sperm agglutinating types of antibodies that cause the agglutination of sperm and reduced motility.
sperm immobilizing types of antibodies that result in shaking of sperm.
in a patient with ASA and inability to bind in a zona pellucida test, intracytoplasmic sperm injection (ICSI) is the treatment of choice.
acceptable normal values of ASA by World Health Organization (WHO) standards are less than 40%.
spermatotoxic antibodies that result in a complement- dependent destruction of sperm.
ROS levels for healthy donors are 2.5 × 104 cpm/20 million.
The chemiluminescence assay is not an accurate means to determine the presence of ROS.
The evidence does not suggest use of antioxidants in male infertility patients with elevated ROS.
ROS testing usually does not result in sperm damage or abnormal sperm parameters.
High levels of ROS are an independent marker of male factor infertility.
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