HASPI Medical Anatomy & Physio 16a
Case 3 - Anna and Arnold Ashton
-Anna is 41 and Arnold is 49. Arnold completed chemotherapy treatments within the last month because of lung cancer. Arnold has been a smoker for 26 years and has only quit within the last year. Their age plays a big factor in fertility issues. Certain cancer treatments can affect hormone levels and cause infertility. After chemo sperm production may slow down or stop. It has also been shown that smoking can increase infertility rates in both males and females. -Anna's estradiol levels are lower than expected, which can signify the beginning of menopause, especially due to her age. Arnold's semen is abnormal. His sperm count and motile sperm are low. The sperm concentration is low. The total functional sperm is low. His sperm volume was 0.9 ml. -Chemotherapy affected Arnold's sperm. Sometimes sperm production doesn't even come back after cancer treatments. They could try in vitro fertilization. Stem cell therapy is also reported to be promising. Their age could lower their chances of ever having kids.
Case 1 - Jenny and Jason Johnson
-Jason has been diagnosed with Celiac's disease. They already have a 4-year-old child. Males with Celiac disease are reported to have higher rates of abnormal sperm. -Jason is producing a lot of testosterone. Most of Jason's semen is non-functional and abnormal. This is affected by his disease which makes his body not respond properly to testosterone. -Jason's Celiac disease is playing a big role in this couple's infertility. First, you'd have to manage the underlying disease in order to help with fertility, so mostly drugs and lifestyle changes (diet and vitamin supplements)
Case 4 - Karen and Kevin Klaus
-They're both 38 years old. Kevin has two children from a previous marriage. Karen had an ectopic pregnancy that required surgical removal two years ago. Karen has endometrial tissue on the ovaries and outer surface of the uterus. She has begun to experience pelvic pain and heavy menstruation. Kevin has erectile dysfunction and the physician noted the presence of varicoceles on his testicles. Their age could have a big effect on fertility. Karen most likely has endometriosis which greatly diminishes their chances of pregnancy. Kevin's erectile dysfunction and varicoceles on his testicles are a common cause of low sperm production and decreased sperm quality, which can cause infertility. -Karen's estradiol levels are through the roof, which can signify the beginning of menopause. Kevin has elevated progesterone levels and is linked to his erectile dysfunction. Kevin has low testosterone which results in decreased production of sperm. He also has elevated estradiol levels which reduces sperm concentration in semen. Kevin has slightly elevated FSH levels. Kevin's semen analysis is most certainly abnormal, with a 0.2 ml volume of semen, 1 million sperm concentration/ml, total sperm count of 2.6 million, total motile sperm count of 1.8 million and only having 650,000 total functional sperm. -Karen's possible endometriosis is one of the most prominent reason for infertility. There's also the possibility of early menopause. Kevin's sperm is abnormal. ART and in vitro could help this couple conceive a child.
Case 2 - Tina and Thomas Tinkerson
-Tina has had two miscarriages. Tina sought natural fertility supplements and acupuncture. Tina has enlarged ovaries and several cysts on each ovary. Thomas noted past anabolic steroid use. The enlarged ovaries and cysts are a symptom of PCOS, which can cause irregular ovulation. Thomas's use of anabolic steroids harms male fertility by interfering with hormone signals that are needed to produce sperm. -Tina's LH levels are incredibly high (42.6 IU/L) as well as her testosterone levels. High LH levels in women means they're not ovulating and there's a possible issue with the ovaries. Her estradiol levels are a little higher than the normal hormone levels. Thomas's results are fairly normal, except for the sperm count, which is a little lower than expected. -Tina has an undiagnosed disease which may be causing fertility problems. My guess would be PCOS. To treat that disease, there's a number of medications and lifestyle changes, as well as hormone injections.