| Author |
Megan Thomas |
| Case Study |
Steroids |
| |

Joe and Mary Smith had been trying to conceive a child
for the last several years. In July they decided to see a reproductive
physiology specialist after several years of doctor consultations. Dr.
Martine proceeded to ask health history questions searching for potential
problems.
From taking their health histories, Dr. Martine determined
Mr. Smith had been a star athlete in high school, and had even been recruited
heavily by universities until he had been diagnosed with severely high
blood pressure, potential athlerosclerosis and slightly elevated levels
of low-density lipoproteins. Blood was taken from both individuals and
a sperm sample was taken from Mr. Smith.
|
| Question |
What are the likely causes for infertilty for this couple?
|
| Getting Started |
Day 1
The class will be split into groups dependent upon where
their major career interests lie. For example: Pre-pharmacy, Pre-nursing,
etc.
Ask students to generate a list of questions they have
about the case.
1. What is this case about?
2. What are some of the important points that help to
diagnose the patient?
3. What questions would you like to ask the patient?came
up with, until all groups are satisfied that their questions are represented.
Instructor facilitates this activity.
|
| |
|
| Problem Solving |
These results are provided after students discuss the case:
The semen analysis results for Joe are as follows:
| Sperm Concentration (Millions/ml) |
~ 8 |
| Total Sperm Count (M/ejaculate) |
~ 10 |
| Motility (.5 - 2 hr after ejaculation) |
< 30 |
| Vitality (% live) |
45 % |
The results for male hormone levels:
| Hormone |
Normal Values |
Joe's Values |
| FSH |
1 18 mlU/ml |
0.9 mlU/ml |
| LH |
10 - 60 pg/ml |
30 pg/ml |
| Prolactin |
< 20 ng/ml |
25 ng/ml |
| Free Testosterone |
.95 - 4.3 ng/dl |
.98 ng/dl |
| Total Testosterone |
270 - 1100 ng/dl |
245 ng/dl |
| Progesterone |
.3 - 1.2 ng/ml |
.8 ng/ml |
The results for female hormone levels:
| Hormone |
Normal Levels |
Mary's Levels |
| FSH |
.4 - 4 ulU/ml |
2 ulU/ml |
| LH |
< 7 mlU/ml |
3.5 mlU/ml |
| Prolactin |
< 24 ng/ml |
30 ng/ml |
|
|
|
| Total Testosterone |
6 - 86 ng/dl |
30 ng/dl |
| Estradiol |
100+ pg/ml |
150 pg/ml |
| Progesterone |
< 1.5 ng/ml |
1.0 ng/ml |
DAY 2:
Take the students to the library to work on gathering resources. The library
has a computer laboratory that as a class we could use to search for information
and potential resources they could either contact or utilize.
DAY 3:
Laboratory activities will be utilized to increase knowledge and understanding.
Some examples of potential activites:
1. Utilize sea urchin sperm and eggs to run an experiment
that would illustrate fertilization.
2. Utilizing bull/sea urchin sperm, conduct an actual
sperm count with a hemocytometer.
3. Look at slides of sperm.
|
| Resources |
Handout on determining sperm counts.
Handout on normal/patient blood work.
Human Sperm in a Hemocytometer

How to Conduct a Sperm Count:
Count all sperm heads with more than half the sperm head
within the area indicated by a triple set of lines. For example, in this
square, there are 29 sperm counted. The sperm with an * were not counted
because these sperm were either more than half way outside of the counting
area or were not on the top or right side of the large square.

Web Based Resources
http://www.wisc.edu/ansci_repro/lab/procedures/hemacytometer/
http://www.il-st-acad-sci.org/androl1.html#whoi
http://www.wisc.edu/ansci_repro/lab/procedures/
... hemacytometer/hem%20grid%20examples.html
http://www.pinelandpress.com/faq/hormonelevels.html#male
http://www.nida.nih.gov/ResearchReports/Steroids/AnabolicSteroids.html
http://www.steroidsinfo.com/
Internet search engines:
Metacrawler.com
Ask.com
Organizations:
Public Health Organizations
University
Hospital
Pharmacy
Library |
| Artifacts |
Each group will be responsible for putting together an
informative pamphlet for a different special interest group.
The students will also put together a poster or blown
up version of their pamphlet for in class presentations.
|
| Assessment and Evaluation |
Each group will be responsible for putting together an
informative pamphlet for a different special interest group. The students
will also put together a poster or blown up version of their pamphlet for
in class presentations that will be peer reviewed and graded based on the
following criteria:
1. Determination of a target audience. Who do you want
the pamphlet to be distributed to? For example: Pharmacists, doctors, high
school athletic teams, etc.
2. Asthetics: Will your pamphlet catch the interest of
your target audience.
3. Scientific Content: Does your pamphlet describe the
science?
4. Is it well communicated: Is it easy to read, or just
a bunch of jargon?
5. A plan on how you are going to distribute the material
|