Hi,
Thanks for writing in.
From your history and lab report of the semen analysis there are two issues which merit mention.
1. Preexisting varicocele happens to be a impediment to healthy sperm production by way of raised scrotal temperature.
2. Altered morphological features of the sperms.
I will address both these issues sequentially
1. Surgery for both hernia as well as varicocele may at times exert a temporary negative impact on spermatogenesis. The question now is whether the left varicocele has reduced , disappeared or increased. At times there is violent recurrence of the varicocele. So that needs to be ascertained by a scrotal doppler and comparing it with preoperative studies especially the velocity studies of testicular blood flow.
2. The semen analysis report reveals 3 findings
a) decrease in the sperm count
b) altered morphology with increased percentage
c) pus cells.

For healthy spematogenesis there are a few requirements
1.good blood supply to the testis
2.cooler scrotal temperatures
3.adequate intake of certain vitamins to improve sperm morphology.

I would therefore suggest the following measures now
1. Weight reduction in case if you are over weight. That has an inpact on the hormonal stimulus for sperm production
2. Keep the scrotal temperature on the cooler side by using cotton undergarments and washing the genitalia with cold water twice or thrice a day. Use loose pyjamas at night.
3. Avoid alcohol and tobacco at any cost.
4. Avoid cycling in case you visit the gym.
5. Cardio exercises in the form of walking for 45 minutes is the best way to improve the blood supply to the testicles.
6. Increase the consumption of sprouts in your diet.
7. Plenty of water to prevent ant urinary concentration or infection.
8. Vitamin supplements
a) Vitamin b complex for improving sperm morphology as well as sperm motiliy.
b) vitamin E to improve the gonadal epithelium thus helping to enhance spermatogenesis.
c) essential fatty acids (omega)to improve the vascular lining of the vessels supplying the region.
9. A short course of antibiotic to get rid of those pus cells suggestive of infection.
You do not require any hormonal supplements as the testes are producing sperms.
Follow this regimen strictly for 12 weeks and then repeat a semen analysis thereafter.
I hope this provides you with a road map .
With regards

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Hi,
Thanks for the feedback.
Stop riding the bike. Trauma to the testcles can be caused by 2 wheeler riding on bumpy roads.
Get a scrotal doppler done.That will help in the diagnosis.
I hope this answers your querry.
With regards

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