Keys to Fertility Trivia Quiz

Answer: False

This is absolutely not true. A male is as much part of a successful conception as a woman is. There are many conditions in which an abnormality in the man is the cause for failure of conception. For conception, a man's sperm has to gain entry into a woman's ovum by penetrating its outer membranes.

There are a lot of situations where this does not happen properly and it may be due to abnormalities in either the man or the woman or both. Only with proper investigations can it be evidenced if the problem lies with the man or the woman.

Answer: Fertility does not return once used

All that oral contraceptive pills do is to prevent ovulation. They do not have any effect on the fertility of a woman in the long term. In fact some studies have shown that they may help in preserving fertility. Once the pills are stopped, fertility returns within a few days. Most pills act via hormonal actions. There are many different types of pills like combined pills which use action of both estrogen and progesterone. There are also estrogen free pills or progesterone only pills. Side effects like weight gain, thromboembolism and change in lipid profile have been observed with these pills. Outside of contraception, these pills can be used for menstrual cramps, endometriosis, amenorrhea and premenstrual syndrome.

Fertile woman who do not want to get pregnant should be advised to used these pills as they do not affect fertility.

Answer: Cryptorchidism

Cryptorchidism is a condition that only happens in men. It implies the absence of one or both testes from the scrotum; usually it is the absence of only one testis. It is most commonly diagnosed in childhood and can be due to a birth anomaly. The failure of one testes to descend is a very common cause of cryptorchidism. Maternal diabetes is another cause as is Down syndrome.

The undescended testis can be found most commonly lodged in the inguinal canal. This can lead to reduced formation of sperms (spermatogenesis) and thus infertility. Cryptorchidism is also linked with the increased risk of testicular cancer.

It can lead to a lot of psychological problems. Treatment includes hormonal therapy and also surgeries like orchiopexy, in which the testis is returned to the scrotum.

Answer: Oligospermia

Oligospermia can be related to infertility. Some of the causes for this condition are smoking, excess alcohol consumption, old age, Klinefelter's syndrome and trauma. Infections like malaria and mumps can also cause this. Prostatitis and duct obstruction have caused reduced sperm count. Treatment for this condition would include stopping substance abuse and reducing weight. Surgeries for conditions like hydrocoele and varicocoele would also be ideal if oligospermia is caused by these conditions. Hormones like testosterone and human chorionic gonadotropin are beneficial.

Asthenospermia is the reduced motility of sperms. Teratospermia refers to a condition in which the sperms have an abnormal morphology. Necrospermia refers to a condition in which the sperm cells are dead.

Answer: Temperature of seminal fluid

Semen analysis is a common method of checking viability of sperms. It involves the analysis of semen for parameters like volume and pH of seminal fluid, viscosity, percentage of motility, sperm count concentration of sperm and morphology of sperms. A fresh specimen of semen is needed; a condom specimen is not recommended. Ideally, it should be collected after 3 to 5 days of abstinence. If the first analysis reveals abnormal findings, it should be done again after a month of good health practices.

Normal values of some of the parameters are:
Volume of seminal fluid = 1.5 to 3 ml
ph = 7.2 or greater
Sperm concentration = 15 million/ml or greater
Sperm count = 39 million or greater

Answer: True

This is absolutely true! These antibodies have been named antisperm antibodies (ASA). Other than in cervical mucus, they can be found in the seminal plasma itself or in the blood. The antibodies are immunoglobulins that act against sperms. This can lead to infertility and is commonly called immunologic infertility.

Male antisperm antibodies are, in normal men, not seen because the blood-testis barriers keeps the sperm away from the immune system. But in some conditions a leakage of sperm or an abnormality in this barrier may cause the antibodies to destroy the sperm.

Female antisperm antibodies can be found in cervical or vaginal secretions and kill the sperm before they can cause fertilization leading to infertility.

These are a number of tests that can identify the presence of these antibodies. Steroids are commonly used to treat immunologic infertility.

Answer: Fallopian tubes

It is the inflammation of one or both fallopian tubes. This may be due to may conditions. One of the causes is genital tuberculosis. Other causes are Asherman's syndrome and sexually transmitted diseases like chlamydia. The fallopian tubes are an important part of reproduction as the transport of the ovum and fertilized occurs through the tubes. If the tubes are inflamed or blocked, this does not happen and can lead to infertility.

Adhesions of the tubes to other pelvic structures and malformations of the tube during embryogenesis or trauma can also cause infertility.

Answer: Hysterosalpingography

Hysterosalpingography is a radiological procedure and is very important in checking for infertility that occurs due to reasons involving the fallopian tubes. A dye is injected into the uterine cavity and an X-ray is taken to visualize the uterine cavity and fallopian tubes. If the tubes are patent, the dye will spread through the abdomen and smear adjacent bowel. If there is a block, the spilling will not occur and the site of the block can be seen. Uterine fibroids and congenital malformations can be seen.

Some of the complications of HSG are infection, allergic reactions or pain.

Answer: Cervical mucus

A specimen of the cervical mucus is taken from the cervix with the use of a platinum loop or a pipette. It is spread over a slide and seen under a low power microscope. There should be a characteristic fern like pattern of the mucus during ovulation which disappears after ovulation.

This ferning occurs due to sodium chloride in the presence of oestrogen. Under the effect of progesterone, the ferning pattern disappears. If the ferning pattern does not disappear and remains throughout the menstrual cycle, then it indicates absence of ovulation and an infertile state.

Answer: Assisted Reproductive Technology

ART is used as a treatment to infertility where gametes are manipulated. Some of the indications of this technology are endometriosis, male infertility like azoospermia, unexplained infertility and absent fallopian tubes.

Some the methods of ART are in vitro fertilization (IVF), gamete intrafallopian transfer (GIFT), zygote intrafallopian transfer (ZIFT) and intracytoplasmic sperm injection (ICSI). Surrogacy is also considered as a method of ART. Some of these methods are expensive and adoption is advocated instead.

In vitro fertilization involves the induction of ovulation in a woman, aspiration of the ovum and insemination of that oocyte with sperms. After the formation of the embryo outside of the body of the woman, it is transferred into her uterine cavity. Some of the complications of this are multiple pregnancy and ectopic pregnancy.