Infertility: congenital absence of vas deferens: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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OBG · Infertility: congenital absence of vas deferens

Sample item

A 30-year-old man with chronic sinopulmonary infections has azoospermia, low semen volume with low pH and low fructose. His testes are of normal size and the vasa are not palpable. What is the likely cause and next step?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Congenital bilateral absence of the vas deferens; CFTR mutation testing for both partners

Congenital bilateral absence of the vas deferens is associated with CFTR gene mutations, and the seminal vesicles are often absent too, causing low volume, acidic semen and low fructose. Spermatogenesis is normal, so sperm can be retrieved from the epididymis or testis for ICSI. Both partners need CFTR testing because of the risk of cystic fibrosis in offspring.

Option by option

  • A. Varicocele; surgery

    Varicocele does not cause absent vasa.

  • B. Congenital bilateral absence of the vas deferens; CFTR mutation testing for both partners (correct)

    Correct. Absent vasa with normal testes points to CBAVD, and CFTR screening is needed.

  • C. Retrograde ejaculation; post-ejaculation urine

    Retrograde ejaculation shows normal fructose and sperm in urine.

  • D. Klinefelter syndrome; karyotype only

    Klinefelter syndrome gives small firm testes and high FSH.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this OBG question

What is the answer to this OBG question?

The best answer is B, Congenital bilateral absence of the vas deferens; CFTR mutation testing for both partners. Congenital bilateral absence of the vas deferens is associated with CFTR gene mutations, and the seminal vesicles are often absent too, causing low volume, acidic semen and low fructose.

Why is "Varicocele; surgery" not the answer?

Varicocele does not cause absent vasa.

Why is "Retrograde ejaculation; post-ejaculation urine" not the answer?

Retrograde ejaculation shows normal fructose and sperm in urine.

Why is "Klinefelter syndrome; karyotype only" not the answer?

Klinefelter syndrome gives small firm testes and high FSH.

What concept does this question test?

It tests Infertility: congenital absence of vas deferens in OBG. Spermatogenesis is normal, so sperm can be retrieved from the epididymis or testis for ICSI. Both partners need CFTR testing because of the risk of cystic fibrosis in offspring.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Infertility: congenital absence of vas deferens?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.