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Fertility and Assisted Reproduction

The causes and issues of infertility

  • 3 things to know
  • Components 01, 02 and 03

Overview

Recall questions on how infertility is defined, sperm count and quality, blocked tubes, ovulatory disorders and endometriosis, anti-sperm antibodies, and the ethics of treatment and donated gametes.

What you need to know

Answer each one before you reveal it.

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Key term

How does a blocked vas deferens cause infertility, and what would a semen sample show?

Key term

What is meant by an ovulatory disorder?

Key term

Why do blocked oviducts prevent pregnancy?

Questions from this subtopic

Each one with the model answer underneath.

  1. 1

    How is infertility usually defined clinically?

    Model answer

    It is the failure to conceive after a year or more of regular unprotected intercourse.

  2. 2

    What sperm concentration is generally taken as the lower limit of the normal range, and why does a low count reduce fertility?

    Model answer

    Around 15 million sperm per cm³ of semen is taken as the lower limit, and because the vast majority of sperm are lost on the journey a low count makes it unlikely that any will reach and penetrate the oocyte.

  3. 3

    Give two ways in which sperm can be abnormal even when the count is normal.

    Model answer

    They may have abnormal morphology, such as a misshapen or double head or a coiled tail, and they may have poor motility, so in either case they cannot reach or penetrate the oocyte.

  4. 4

    How does a blocked vas deferens cause infertility, and what would a semen sample show?

    Model answer

    Sperm are made normally in the testis but cannot pass into the urethra, so the ejaculate contains no sperm at all even though hormone concentrations are normal; common causes are scarring after infection or a previous vasectomy, and congenital absence of the duct in men with cystic fibrosis.

  5. 5

    What is meant by an ovulatory disorder?

    Model answer

    It is a condition in which the ovary fails to release a secondary oocyte regularly or at all, usually because the hormonal control of the cycle is disturbed, as in polycystic ovary syndrome.

  6. 6

    Why do blocked oviducts prevent pregnancy?

    Model answer

    The sperm and the oocyte cannot meet in the oviduct, and even if fertilisation occurred the embryo could not travel down to the uterus to implant.

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