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A 41-year-old man comes to your office with his wife because she has been unable to conceive with him. He is married for the first time. His wife has two children by her previous marriage. The patient is well with no risk factors for heart disease. As a child, he had the usual communicable diseases, including chickenpox and mumps, and as an adult he received the recommended schedule of immunizations. The likely site of his infertility is

a. Pretesticular
b. Testicular
c. Posttesticular
d. Idiopathic


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The answer is b.

Mumps virus infection can directly affect the testicles, producing an orchitis, often very painful, and consequently infertility. Posttesticular causes are those that affect sperm transport, and pretesticular causes are those that affect the hormones that stimulate the testicles.