1. September 23th, 2010

2.  The inability to become pregnant after one year of vaginal intercourse without birth control.  Primary Infertility  Never had children  Secondary Infertility  Has had children in the past but is now unable to

3.  Infertility affects roughly 10-15% of couples in the reproductive age.  33% of the time it is due to problems with the woman  33% of the time it is due to problems with the male  33% of the time it is unknown

5. Quick, easy tests  Medical history and examination  Ejaculated sperm are evaluated  The sperm is checked for several factors  Sperm count between 20 to 100 million per mL is normal  Movement – 50% should be motile 1 hour after ejaculation  Morphology -Maturity and shape (quality)  Volume – 1 teaspoon us sufficient  Acidity – should be slightly acidic

6.  If sperm are deemed as abnormal he will see a specialist and experience more tests  Hormonal blood tests  Imaging tests  Testicular biopsy  Anti-sperm antibody tests  Human / Hamster / cow, egg / cervical mucus test

7.  The most common cause for male infertility is a problem with the sperm  Either low sperm count or sperm with poor quality.  Sperm with poor quality cannot move rapidly enough or in the right direction, or may be abnormally shaped.

8.  Some conditions that may contribute to sperm problems include:  Under-developed testes-usually arising after a mumps infection, a hernia surgery, an injury or birth defect.  Swollen veins in the scrotum.  Undescended testes-a problem often present from birth in which the testes remain in the body cavity. Normally they descend into the scrotum before birth.

9.  Infections, such as gonorrhea or tuberculosis, that block the ducts through which the sperm travel.  Exposure to metals such as leads, or chemicals such as pesticides.  Certain medications, example: corticosteroids and chemotherapy drugs  Injury to the testicles – Blunt trauma, penetrating, and degloving injuries.  Chronic prostate infections

10.  Autoimmunity, in which antibodies or cells of the man's immune system attack sperm cells, mistaking them for toxic invaders. The antibodies attach themselves to the sperm and may cause them to stick together, or may stop them from penetrating the cervical mucus or the egg.  What causes male autoimmunity?  Male autoimmunity can develop after vasectomy.

12.  In retrograde ejaculation the muscles of the urethra do not force the sperm out. Instead, the sperm travel backward into the bladder.

13.  Causes of retrograde ejaculation include:  Drugs such as tranquilizers or high blood pressure medicines.  Diseases such as diabetes or multiple sclerosis.  Neck, bladder or prostate surgery.  Spinal cord injury.

14.  Sexual difficulties such as impotence, premature ejaculation, or painful intercourse.  Genetic defects or structural problems  Hormonal problems (rare) may be present from birth or can develop from brain or pituitary gland tumours or radiation treatment.  STI’s - It has not been 100% proven that they can in men.

15.  Hormones - occasionally effective  Antibiotics - These may help treat sexually transmitted diseases and other infections.

16.  Corticosteroids - These drugs can aid men who make antibodies to reject their own sperm, but they may also have serious side-effects after long use.  Viagra - The medication improves blood flow to the penis, resulting in an erection. Studies have revealed that 70 percent of men who used Viagra improved their ability to maintain an erection.

17.  Varicose (or swollen) veins in the man's scrotum, helping to restore proper sperm movement.  An obstruction in the man's reproductive organs, including the epididymis, vas deferens and ejaculatory duct. These blockages can halt the sperm's passage or prevent it from mixing with semen.

18. 1. What is infertility? K (1) 2. How is a male discovered to be infertile? K (1) 3. What are three causes of weak sperm? K (1) 4. Why would a low sperm count or weak sperm cause infertility? I (1) 5. Explain what happens in a retrograde ejaculation. I (3) 6. Do you think retrograde ejaculation could be corrected? If so, explain what they would do? K (1) I(1)