A couple comes in for an infertility workup,having attempted to achieve pregnancy for 2 years.The woman,37 years of age,has always had irregular menstrual cycles but is otherwise healthy.The man has fathered two children from a previous marriage and had a vasectomy reversal 2 years ago.The man has had two normal semen analyses,but the sperm seem to be clumped together.What additional testing is needed?
A) Testicular biopsy
B) Antisperm antibodies
C) FSH level
D) Examination for testicular infection

Question

Quizplus · Accepted Answer

This scenario does not indicate that the woman has had any testing related to her irregular menstrual cycles.Hormone analysis is performed to assess endocrine function of the hypothalamic-pituitary-ovarian axis when menstrual cycles are absent or irregular.Determining the blood levels of prolactin,FSH,luteinizing hormone (LH),estradiol,progesterone,and thyroid hormones may be necessary to diagnose the cause of the woman's irregular menstrual cycles.A testicular biopsy is indicated only in cases of azoospermia (no sperm cells)or severe oligospermia (low number of sperm cells).Although unlikely to be the case because the husband has already produced children,antisperm antibodies may be produced by the man against his own sperm.Examination for testicular infection would be performed before semen analysis.Furthermore,infection would affect spermatogenesis.

A Couple Comes in for an Infertility Workup,having Attempted to Achieve