A 32-Year-Old Man Comes to the Clinic for an Infertility

question 405

Multiple Choice

A 32-year-old man comes to the clinic for an infertility evaluation.  The man and his 31-year-old wife have been trying to conceive for the last 15 months and have unprotected sexual intercourse several times per week.  The patient has no chronic medical conditions and takes no daily medications.  His wife has no known medical conditions and has a child from a previous marriage.  Her menstrual cycles are regular.  The patient's vital signs are normal.  On physical examination, the penis is uncircumcised and without lesions.  Bilateral testes are palpable within the scrotum and are normal in size.  There is no excessive firmness or tenderness within either testis.  The left testis is positioned lower than the right.  Superior to the left testis, there is a nontender clustered mass.  It does not transilluminate and decreases in size when the patient is supine.  A semen analysis shows a normal seminal volume but slightly reduced sperm count and decreased motility.  Which of the following is the most likely cause of this patient's infertility?

• A)Absence of vas deferens
• B)Ejaculatory duct obstruction
• C)Hydrocele
• D)Inguinal hernia
• E)Varicocele

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Definitions:

Visibility into Shipments

The ability to track and monitor the status of goods as they are transported from origin to destination, enhancing supply chain transparency.

Alignment

The arrangement or adjustment of elements in a straight line or correct positions, ensuring consistency and coordination towards shared goals.

Relationships

The connections and interactions between individuals or entities, which may be personal, professional, or commercial in nature.