Infertility Pretesticular Endocrine Hypogonadotropic hypogonadism Coital disorders Erectile

Pretesticular Endocrine Hypogonadotropic hypogonadism Coital disorders Erectile dysfunction Psychosexual Endocrine , neural , or

Posttesticular Obstructive Epididymal Congenital Infective Vasal Genetic : cyctic fibrosis Acquired : vasectomy Epididymal

Testicular Genctic Klinefelter’s syndrome Y chromosome deletions Immotile cilia syndrome Congenital Cryptorchidism Infective (orchitis)

Grugs that Can Impair Male Fertility Impaired spermatogenesissulfasalazine, methotexate, nitrofuantion, colchicines, chemotherapy Pituiay suppression-testosterone

semen analysis terminology normozoospermia – all semen parameters normal Oligozoospermia – reduced sperm mumbers

Normal seminal fluid Analysis Volum : 2 -5 cc Liquefaction : 20 -60 minutas

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Infertility

Pretesticular Endocrine Hypogonadotropic hypogonadism Coital disorders Erectile dysfunction Psychosexual Endocrine , neural , or vascular Ejaculatory failure Psychosexual After genitourinary surgery Neural Drug related

Posttesticular Obstructive Epididymal Congenital Infective Vasal Genetic : cyctic fibrosis Acquired : vasectomy Epididymal hostility Epididymal asthenozoospermia Accessory giand infection Immunologic Idiopathic Postvasectomy

Testicular Genctic Klinefelter’s syndrome Y chromosome deletions Immotile cilia syndrome Congenital Cryptorchidism Infective (orchitis) Antispermatogenic agents Heat Chemotherapy Drugs Irradiation Vascular Torsion Varicocele Immunologic Idiopathic

Grugs that Can Impair Male Fertility Impaired spermatogenesissulfasalazine, methotexate, nitrofuantion, colchicines, chemotherapy Pituiay suppression-testosterone injections, gonadotophin-releasing hormone analogues Antiandoenic effects-cimetidine, spionolactone Ejaculation failue-a blockers, antidepessants, phenothiazines Erectile dysfunction-B blockers, thiazided diuretics , metoclopramide Dugs of misuse-anaolic steroids , cannabis, heroin, cocaine

semen analysis terminology normozoospermia – all semen parameters normal Oligozoospermia – reduced sperm mumbers Mild to moderate : 5 -20 milion / ml of semen Severe <5 milion/ml of semen Asthenozoospermia – reduced sperm motility Teratozoospermia – increased abnormal forms of sperm Oligoasthenoteratozoospermia – sperm variables all subnomral Azoospermia – no sperm in semen Aspermia (anejaculation ) – no ejaculate (ejaculation failure) Leucocytospermia – increased white cells in semen Necrozoospermia – all sperm are non- viable or non – motile

Normal seminal fluid Analysis Volum : 2 -5 cc Liquefaction : 20 -60 minutas Visquesity : 2 cm PH: 7/2 -7/8 Sperm concen teration > 20 million/ml Motility >50% Morphology >50% WBC< 1 million/ml Round cell <5 million /ml Vitality >60%

Assisted Reproductive Techniques (ART)