Physical Assessment Analysis

Intrroduction

Considering the man's physical and secondary assessment, it is evident that some of the tests revealed that the man has both normal and abnormal traits of fertility determination. For instance, the man had abnormal testis volumes. According to Richenberg et al. (2015), normal testis volumes are the appropriate sizes of the testis. During pre-pubertal stages, normal testis volume should be 1-3 ml. During puberty, testis volumes are 4 ml. After puberty and during adulthood, normal testis volume is 12-25 ml (Yang et al., 2015). Small testes can portray primary or secondary hypogonadism. Hypogonadism is a condition which leads to the decreased functional activity of the testes and leads to declined sex hormone biosynthesis. Hypogonadism may lead to partial or complete infertility in men.

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Adverse Results from Semen Analysis

The man depicted various abnormal findings. For instance, it was established that he had an azoospermia. This is a medical condition in which there was no sperm in the man's ejaculation. In addition, the man's ejaculate volume of 2.2 ml was below average. The average ejaculate volume is 3.7 ml. This means that the man's ejaculate is not normal.

Positive Indicators Analysis

In spite of the existence of abnormal conditions in the man, he depicted various positive signs. For instance, there was fructose in seminal plasma. The main aim of measuring the presence of fructose in the seminal plasma is that fructose is the primary carbohydrate source in seminal plasma. In addition, fructose is necessary for normal sperm motility. The man's testicle position was appropriate because he had descended testes. There were no inflammatory cells in his semen. The liquefaction time post-ejaculation was 25 minutes and it is within the required average of 20-30 minutes.

Analysis on Hormone Profile and Testicular Profile

The man's FSH (Follicle stimulating hormone) is elevated and was recorded at 34mIU/Ml. Elevated FSH levels were assessed to confirm menopause. FSH encourages testicular development and facilitates the release of an androgen-promoting protein by the Sertoli cells (Yang et al., 2015). This is required to sustain normal maturity of the sperm cell. In addition, a testicular biopsy was carried out to offer additional details to help in the diagnosis of the man's infertility. The testicular biopsy was an assessment to remove a sample of tissue from the man's left testis. The haematoxylin and Eosin stain was performed to show the Sertoli cell-only syndrome in the man.

Abnormal Sex Determination

In conclusion, the decision about abnormal sex-determination is based on the man's thorough clinical assessment which investigated the semen analysis, physical assessment, hormone profile, and testicular biopsy. From the woman's clinical assessment, it is clear that she was not the cause of the couple failing to get bear a child. The man's problem did not arise during embryogenesis of his male reproductive system. As supported by CMRM (2018), the evaluation of testicular biopsy was crucial in formulating a diagnosis encompassing clinical reproductive physiology, whether the issue is caused by infertility or form of hypogonadism. Conclusively, the type of abnormal sex-determination in the man is Sertoli-cell only (SCO) syndrome. This is supported by the semen analysis and testicular biopsy. The semen analysis indicates that the man's ejaculate volume is abnormal. As depicted in the testicular architecture from the biopsy, the SCO syndrome holds that men will have different levels of sperm production within their testicles.

References

Center for Male Reproductive Medicine & Vasectomy Reversal (CMRM). (2018). Causes of Male Infertility & Azoospermia | CMRM. Retrieved March 24, 2018, from https://www.malereproduction.com/male-infertility/causes.php

Richenberg, J., Belfield, J., Ramchandani, P., Rocher, L., Freeman, S., Tsili, A. C., & Dogra, V. (2015). Testicular Microlithiasis Imaging and Follow-up: Guidelines of the ESUR Scrotal Imaging Subcommittee. European Radiology, 25(2), 323-330.

Yang, Q., Huang, Y. P., Wang, H. X., Hu, K., Wang, Y. X., Huang, Y. R., & Chen, B. (2015). Follicle-stimulating Hormone as a Predictor for Sperm Retrieval Rate in Patients with Non-obstructive Azoospermia: A Systematic Review and Meta-analysis. Asian Journal of Andrology, 17(2), 281.