Looking for a bit of sperm production advise. I have had 2 seman analysis done both azoospermia. Urology have come to the conclusion that due to operations for a hernia as a baby, one of my testicles has failed, the other looks normal but the vas has been damaged causing the azoospermia.
We then went to an ivf clinic, they have demanded that I have the blood work done to check sperm production also karotype testing.
I have had some bloods done, but it appears the testosterone levels have not been done, I don’t know much about this subject so could be wrong.
Lh, fsh, and prolactane have all come back within range.
My question is, can it be possible for testosterone to be so low that no sperm is being produced but yet have zero symptoms of low test?
Really confused and I know there are some very knowledgeable people here. Thanks
Most importantly, LH and FSH can be in range and too low to produce adequate gonadal stimulation. Typically if the testes are unable to respond(primary hypogonadism) the LH and FSH are often elevated and/or above range. A small amount of testosterone is necessary for FSH to produce spermatogenesis but even below range should suffice. If you’re now azoospermic and considering exogenous testosterone don’t do it because it will only complicate things.
You should post the results of LH and FSH. If your testosterone was truly zero you’d probably know it.
And just so you’re clear and not misdirected by many here, LH (or hCG) will stimulate leydig cells producing testosterone. FSH+testosterone stimulates the Sertoli cells to produce sperm. Other than producing testosterone, hCG in no way will assist with fertility unless FSH is present. Most people that begin TRT will eventually have FSH/LH near zero.
Thanks for the info, Im absolutely convinced my only issue regarding fertility is the absent vas. I feel like the ivf clinic are just following protocol investigations for azoospermia and not really looking at the evidence.
I will be going back to gp to find out how they managed to not test for testosterone. And get them to run the bloods for it.
I’m 28, went fine through pubety, have gained over 50lb of lean muscle over 5 years, 10% body fat. I have a ridiculously high sex drive. To say I only really have one ball working I would assume its doing an ok job.
I have had very low ejaculate volume right from the start which is another indication that missing vas is the cause.
Well the plan is a surgical sperm retrieval, which is very expensive so I guess this hormone info will help assess the likelihood of it being a success.
I have read that obstructive azoospermia is often accompanied with a low volume, maybe I have damage or scar tissue causing other problems.
LH is pulsatile, so any one LH lab result does not carry much weight. FSH is a better indicator of your LH status than the LH lab result. FSH=6.7 is quite good and sort of expected with a single testicle. This means that your one testes does have more than enough FSH for fertility. For sperm retrieval, docs might have you on clomid to ramp things up. Please read the advice for new guys sticky for related info.
The blood tests I had run were the ones requested by the ivf clinic so assumed that they would suffice for an idea on sperm production.
Will look at requesting the others. I know this thread is not really t replacement related but thought this would be best place for it. I’m not undergoing or plan to under go replacement therapy.
[quote]C27 H40 O3 wrote:
And just so you’re clear and not misdirected by many here, LH (or hCG) will stimulate leydig cells producing testosterone. FSH+testosterone stimulates the Sertoli cells to produce sperm. Other than producing testosterone, hCG in no way will assist with fertility unless FSH is present. Most people that begin TRT will eventually have FSH/LH near zero. [/quote]