2. (58 pts) In the future you are a famous reproductive endocrinologist running a fertility clinic and you are working with the following 28 year old males.Allen has very elevated plasma leptin and resistin levels and very low plasma adiponectin levels.Bill is an athletic trainer who consumes a low fat, high protein and high fiber diet. His BMI and body fat percent are normal. During gestation Bill’s mother smoked 2 packs of cigarettes per day.Carl consumes a perfectly balanced diet (recommended levels of dietary fat and fiber). His BMI and percent body fat are normal and equal to Bill’s values. At 20 years of age Carl had a vasectomy, but 7 months ago he decided he wanted to have kids and had a reversal surgery (the cut vas deferens for each testicle was reconnected).Dan works for a pesticide company and for the past year he has been exposed to a chemical that he absorbs and is acting as a highly effective (100%) LH antagonist. His BMI and his body fat content are equal to Carl’s values.Evan is an Olympic swimmer that has been taking a completely effective aromatase inhibitor and LH agonist for the past 2 years. His BMI and body fat are equal to Carl.Fred consumes a high fat and low fiber diet. He is a truck driver that spends 70 hours a week driving a truck back and forth from Georgia to Texas. He exercises regularly, so despite his diet and job his BMI and body fat values are equal to Carl.George has an undiagnosed genetic mutation that renders one of his proteins nonfunctional. He had a normal puberty. His plasma LH, testosterone, activin and estrogen levels are normal, but his inhibin B levels are barely detectable, his androgen binding protein levels are low and he is infertile due to azoospermia from the lack of sperm production. His BMI and his body fat content are equal to Carl’s values.Henry works for a pesticide company and 5 days a week he is exposed and absorbs a chemical that increases the activity of 5-alpha reductase by 75%. His BMI and body fat content are equal to Carl’s values. Henry has worked at the pesticide company for 1 year.Ian is a high school biology teacher. He consumes a perfectly balanced diet (recommended levels of dietary fat and fiber). His BMI and percent body fat are normal and equal to Carl’s values.a)Compare and contrast (rank) free plasma estradiol levels between Allen, Bill, Dan, Fred and Henry (explain your answer, 15 pts).b)Compare and contrast (rank) plasma total testosterone levels between Carl, Dan, Evan, Henry and Fred, (explain your answer 15 pts).c)You ask all the men except George to come in to the clinic for a semen donation after abstaining from sex for three days. However, from the questioning of the men at the time of the donation you discover that Henry has had intercourse and ejaculated 3 times in the last 24 hours. Based on the information given, whose semen would you use for artificial insemination to ensure the greatest chance of fertility and explain why you made this choice and also explain the biology behind why you did not choose each of the other men (18 pts).d)Based on the information given, George is most likely suffering from 1 of 2 possible genetic mutations that effect his reproductive endocrine system. Please describe very specifically what the 2 most likely genetic mutations are that he is suffering from (so what 2 proteins could be mutated and nonfunctional) and then describe the easiest therapeutic way without genetic testing that you could determine which of the 2 mutations he is actually suffering from (10 pts).
