A 30-year-old man consults a gynecologist for the cause of his infeility. On questioning, he informs the doctor that he never suffered from any major illness in the past and also got married 5 years back. However, his physical examination reveals failure of testes to descend down in the scrotum. The semen analysis shows absence of spermatozoa. The blood lab repo shows plasma gonadotrophins, 12 Ru/24 hrs; Plasma testosterone, 7 ug/l and semen 2 ml. The factor responsible for the absence of spermatozoa in this patient is?
Primary infeility affects 15-20% of married couples. Apa from case history and physical examination, endocrine profile and semen analysis are essential to disclose the underlying cause. The testes have two distinct but related functions, both of which are under adenohypophyseal and hypothalamic control. The first one is the production and storage of ble spermatozoa, and the second one is the synthesis and secretion of androgenic hormones. Various factors that can induce sterility in men are: trauma, infections like mumps, environmental factors like excessive heat, medications, and drugs. Because of the failure of testes to descend into the scrotum, seminiferous tubules remain infantile in structure and due to greater temperature of the inguinal canal, they degenerate. However, the secondary sexual characteristics are not affected. Ref: Hoffman B.L., Schorge J.O., Schaffer J.I., Halvorson L.M., Bradshaw K.D., Cunningham F.G., Calver L.E. (2012). Chapter 20. Treatment of the Infeile Couple. In B.L. Hoffman, J.O. Schorge, J.I. Schaffer, L.M. Halvorson, K.D. Bradshaw, F.G. Cunningham, L.E. Calver (Eds), Williams Gynecology, 2e.
Degeneration of the epithelium of seminiferous tubules
Decreased secretion of gonadotrophins
Decreased concentration of testosterone
Hypofunctioning of the pituitary gland