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MRCOG PART 2 SBAs and EMQs

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EMQ1502
SBA2115
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infertility

infertility Posted by Mahmoud Abubakr Nasr N.

A 32 year old woman and her 35 year old husband have been referred because of primary infertility. The woman has a regular 30 day cycle with a normal endocrine profile. The male has severe oligospermia with a normal endocrine profile. Clinical examination is normal with normal testicular size but the vas deferens is not palpable. What is the most appropriate next investigation?

the options were 

ultrasound scan testes

scan male for cystic fibrosis

 

the answer was scan for cystic fibrosis

don't i have to confirm the absence of vas by ultrasound first?

 

Posted by Mahmoud Abubakr Nasr N.

ok i got it

the diagnosis is clinical and no need for scan

Posted by Farrukh G.
  • The normal vasa can be palpated easily within the scrotum.
  • The diagnosis of unilateral or bilateral vasal agenesis is made by physical examination.
  • Imaging studies and surgical exploration generally are unnecessary for diagnosis but may help to identify other abnormalities associated with vasal agenesis.
  • About 25% of men with unilateral vasal agenesis and 10% with congenital bilateral absence of the vasa deferentia also have unilateral renal agenesis that may be identified by abdominal ultrasonography