LAST case study!

613 Posts

Specializes in student; help!.

yeah. i know. a year later. but babies take up a lot of time. :loveya:

this one is reproductive, and since i found a fantastic values site (labcorp is awesome), i think i've got it nailed down, but i'm always looking for ideas i didn't think of.

ana (age 23) and mike (age 30) have been trying to conceive a child for the last 2 years. both appear healthy, eat well and are in training for a 100 mile bike race next month. frustrated with their inability to conceive, they have consulted a fertility specialist who conducted a number of tests.

ana

serum estradiol

follicular phase 80 pg/ml

midcycle 300 pg/ml

luteal phase 70 pg/ml

serum progesterone

follicular phase 0.9 ng/ml

luteal phase 18 ng/ml

serum fsh follicular phase 20 mu/ml

midcycle 80 mu/ml

luteal phase 5 mu/ml

serum lh

follicular phase 18 miu/ml

midcycle 130 miu/ml

luteal phase 15 miu/ml

mike

serum testosterone 500 ng/ 100ml

serum fsh 15 mu/ml

serum lh 15 mu/ ml

semen analysis

volume 3 ml

sperm count 3 x 106/ml

sperm motility 30%

sperm morphology 50% normal

according to the lab sites i've found, she has high follicular and midcycle fsh, high follicular and midcycle lh, and he has high lh and low motility. i think she has ovarian failure and he *may* have an androgen receptor insensitivity, but he may also just have low motility because he's sitting on his testicles so much with the training and it's affecting his sperm. otoh, if he really does have high lh, it may be that his sperm aren't maturing normally. because lh secretion is pulsatile, though, and i don't know anything about their draws, i'm just guessing, really. since high lh and fsh may indicate menopause, it does support my ovarian failure theory. she doesn't have a ratio that supports pcos.

thoughts? i'm trying *really* hard not to read into the case, like i did with the others. what she gave me is what i have, no more, no less. but that kind of leaves me stumped. i feel like i can go in different directions and as long as i can back up my theory, it's all good. that's a little frustrating.

and one more year before i start my adn classes. can i get a what-what for fall '10? :chuckle