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บทที่ 11Male reproductive system - Coggle Diagram
บทที่ 11Male reproductive system
Male infertility
Semen analysis reference ranges
Color Grayish white
pH 7.3-7.8
Volume 2.0-5.0 ml
Sperm count 20-250 million/ml
Motility > 60% motile
% Normal sperm > 60%
Viscosity Can be poured from a pipet in droplets rather than a thick strand
Causes of male infertility
Pre-testicular causes
Post-testicular causes
Testicular causes
Increase estrogen
Suppresspituitary gonadotropinsecretion
Endogenous estrogen
hepatic cirrhosis, failure
obesity
** Exogenous estrogen
Suppress pituitary gonadotropin secretion
Endogenous androgen - rare
** Exogenous androgen(anaboric steroid )
Varicocele
Abnormal dilatation of the testicular veins in the pampiniform plexus
Incidence ~ 8-23 %
The most common identified cause of male infertility
left side predominate
“Bag of worms” sensation on palpation
Cryptorchidism (undescended testis)
4% of male newborns, completely descendin the first year
Gross:decreased the size of testis
Incidence is about 1% of child
75% unilateral at the inguinal region.
Morphology
Two macroscopic patterns: cauliflower and flat
Begins on the glans or inner surface of the prepuce near the coronal sulcus
Clinical course
Nonpainful until secondary ulceration and infection
Slow growing and local invation
A year or more before it is brought to medical attention
50% shows inguinal LN metas. at the time of diagnosis
Prognosis:
5 year survival without inguinal L.N. metas. = 66%
5 year survival with inguinal L.N. metas. = 27%