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