DEPARTMENT OF OBSTETRICS, GYNECOLOGYand REPRODUCTIVE SCIENCES

DEPARTMENT OF OBSTETRICS, GYNECOLOGYand REPRODUCTIVE SCIENCES

Spermatogenesisand

Testicular Function

Spermatogenesisand

Testicular Function

www.umanitoba.ca/womens_health

REPRODUCTION II - BLOCK IV

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regardless of whether it is a general, specialtyor subspecialty field, you will have to deal withpatient infertility issues!

In your medical practice...

DID YOU KNOW THAT...

WHAT THIS LECTURE IS REALLY ABOUT!

MOST COUPLES PLAN TO HAVE CHILDREN. ABOUT 15% EITHERHAVE TROUBLE CONCEIVING OR CANNOT CONCEIVE AT ALL.

INFERTILITY IS A SUB-SPECIALTY DEALING WITH THE DIAGNOSISAND TREATMENT OF CONDITIONS THAT PREVENT WOMEN FROMGETTING PREGNANT.

IN ABOUT 40% OF COUPLES, THE INFERTILITYPROBLEM IS DUE TO MALE INFERTILITY.

FEW CASES OF MALE INFERTILITY ARE TREATABLE.

DIAGNOSIS OF MALE INFERTILITY RELIES ALMOST EXCLUSIVELYON A GOOD HISTORY AND AN ANALYSIS OF THE SEX CELLS(I.e., the semen analysis).

14500

15000

15500

16000

16500

17000

17500

19

86

19

87

19

88

19

89

19

90

19

91

19

92

19

93

19

94

19

95

19

96

19

97

19

98

Manitoba Fertility Rate

Year

Num

ber

of

Birth

s

14% declinefrom 1990

1820000

1835000

1850000

1865000

1880000

1895000

1910000

1925000

1940000

19

99

20

05

20

10

20

16

20

21

20

27

20

33

20

38

20

44

20

49

20

55

CANADA: 1999 to 2050Population 0 to 4 years

YEAR

Po

pu

latio

n

In developed countries:

about 15% of couples of reproductive age are infertile! 

The infertility rate in Hutteritecommunities is only 3%!

INFERTILITY: Diminished or absent fertility; does not imply

as irreversible a condition as sterility.

MALE INFERTILITY:

Primary infertility is the term used to describe a couplethat has never been able to conceive a pregnancy, after a minimum of one year of attempting to do so throughunprotected intercourse.

Secondary infertility is the term used to describe coupleswho have previously been pregnant at least once, but havenot been able to achieve another pregnancy

Approximately 30 to 40% of all infertility is due to a "male" factor...

DIAGNOSIS BY S/A ON 1497 MEN

STERILE

INFERTILE

SUBFERTILE

FERTILE

4

24

33

39

PERCENT SEEKINGINFERTILITY CONSULT

1 bladder2 seminal vesicle3 prostate4 urethra5 vas deferens6 epididymis7 testis8 penis

Testes (7) not only produce sperm,but also synthesise andsecrete the male sex hormone testosterone.

Testosterone controls spermatogenesis, the development of male secondary sexual characteristics and male behaviour

A - Seminiferous tubules (containgerm (sex) cells & Sertoli cells [thatare somatic cells]).

B - Interstitial cells (or Leydigcells) produce testosterone inresponse to LH from the pituitarygland.

C - Lumen of a seminiferoustubule (with swirl of sperm tails)