Question 1: A couple presented to OPD with complaint of inability to conceive for the last 3 years. Husband was advised semen analysis. What is the WHO criterion for minimum sperm count per ml in normal semen?
- A. 30 million
- B. 40 million
- C. 15 million (Correct Answer)
- D. 10 million
Explanation: ***15 million***
- The **WHO 2010 criteria** for normal semen analysis specifies a lower reference limit for sperm concentration as **15 million spermatozoa per mL**.
- This count is considered the minimum threshold for **normal fertility potential** according to current international guidelines.
*30 million*
- While a higher sperm count, **30 million** is not the minimum threshold set by the WHO for normal semen analysis.
- A count of 30 million would be considered well within the normal range, but the question specifically asks for the *minimum* criterion.
*40 million*
- **40 million** is significantly above the minimum sperm concentration required for normal fertility as per WHO guidelines.
- This higher count would indicate robust spermatogenesis but is not the lower limit for defining normalcy.
*10 million*
- A sperm count of **10 million spermatozoa per mL** falls below the **WHO 2010 reference range** for normal sperm concentration.
- This value would likely be considered **oligozoospermia** and could indicate reduced fertility potential.
Question 2: The amount of iron lost per 28 day cycle in menstruating women is
- A. 8.5 mg
- B. 15.5 mg (Correct Answer)
- C. 12.5 mg
- D. 5.5 mg
Explanation: ***15.5 mg***
- The typical **iron loss** during a 28-day menstrual cycle in menstruating women is approximately **15-28 mg**, with an average of about **15.5 mg**.
- This calculation is based on average menstrual blood loss of **30-40 mL per cycle** and iron content of approximately **0.5 mg per mL of blood**.
- This physiological iron loss explains why menstruating women have **higher iron requirements** (18 mg/day) compared to men (8 mg/day).
- If dietary iron intake is insufficient to compensate for this loss, **iron deficiency anemia** can develop over time.
*5.5 mg*
- This value significantly **underestimates** the actual iron loss during menstruation.
- Such a low amount would not explain the increased iron requirements in menstruating women.
- This does not align with measured menstrual blood loss volumes.
*8.5 mg*
- This value is still **lower than the typical physiological range** of iron loss during menstruation.
- While closer than 5.5 mg, it underestimates the actual iron depletion that occurs.
*12.5 mg*
- This value is **within the lower range** but still below the commonly accepted average.
- While individual variations exist, standard teaching emphasizes higher values (15-28 mg range).