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Suggest Treatment For Azoospermia And Pain In Testicle
Question: Hi all,
i have been diagnosed with azoospermia and my doctor requested hormone tests and genetic analysis, such as chromosome karyotype which 46 xy, no Y deletions. no CFR carrier. I have no genetic problem and levels of hormone are in the normal range though testestorone is very low, my doctor put me on clomid for 3 months for tablet daily and again 9 months for 1 tablet every other day and my hormone level went up from below numbers, which have done february 2015 h
FSH from 10.4 to 19.2
LH from 9.6 to 18.2
testetrone from 12 to 36.
my doctor advised to undergo microdissection sperm retrieval and to continue the medication to increase my chance of retrievel of sperm. my micro dissection surgery has been scheduled september 4.2015.
I am also feeling some pain in my testicle.
could you please advise me as second opinion, chances of increasing sperm retrieval.
other information that may be helpful
age 33
weight: 162 kg ( Iam obese).
no smoking
no alcohol
i have been diagnosed with azoospermia and my doctor requested hormone tests and genetic analysis, such as chromosome karyotype which 46 xy, no Y deletions. no CFR carrier. I have no genetic problem and levels of hormone are in the normal range though testestorone is very low, my doctor put me on clomid for 3 months for tablet daily and again 9 months for 1 tablet every other day and my hormone level went up from below numbers, which have done february 2015 h
FSH from 10.4 to 19.2
LH from 9.6 to 18.2
testetrone from 12 to 36.
my doctor advised to undergo microdissection sperm retrieval and to continue the medication to increase my chance of retrievel of sperm. my micro dissection surgery has been scheduled september 4.2015.
I am also feeling some pain in my testicle.
could you please advise me as second opinion, chances of increasing sperm retrieval.
other information that may be helpful
age 33
weight: 162 kg ( Iam obese).
no smoking
no alcohol
Brief Answer:
Don't go for sperm retrieval just now.
Detailed Answer:
Hello XXXX and welcome to HCM.
You've been diagnosed to have Azoospermia, which means, no sperms are seen in the semen tested. On examination of your genitalia, i.e. penis, testis and scrotal contents above the testis, the Urologist / Andrologists' findings are not mentioned. The doctor looks for size of testis and Varicocele, which is confirmed by doing a scrotal scan. You have pain in the testis. that will be checked also.
You haven't mentioned about it.
Tab. Clomid is not treatrment for Azoospermia. You require a testicular biopsy test, to know the reason, why no sperms are seen in semen. After that's done, diagnosis can be narrowed and specific treatment can be decided. Urologist can guide you about further treatment.
Hope your doubts are cleared.
Don't go for sperm retrieval just now.
Detailed Answer:
Hello XXXX and welcome to HCM.
You've been diagnosed to have Azoospermia, which means, no sperms are seen in the semen tested. On examination of your genitalia, i.e. penis, testis and scrotal contents above the testis, the Urologist / Andrologists' findings are not mentioned. The doctor looks for size of testis and Varicocele, which is confirmed by doing a scrotal scan. You have pain in the testis. that will be checked also.
You haven't mentioned about it.
Tab. Clomid is not treatrment for Azoospermia. You require a testicular biopsy test, to know the reason, why no sperms are seen in semen. After that's done, diagnosis can be narrowed and specific treatment can be decided. Urologist can guide you about further treatment.
Hope your doubts are cleared.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Thanks for your quick respond, the urologist have examined my testicles and said it is slightly smaller in size, and no varicoceles problem, he is guesing you may have maturation arrest.
Rather than to have two surgeries biopsy and micro dissection go with the bigger one microdissection.
I am also worried about the side effect of microdissection as he advised I will need more testosterone after the surgery.
Please advise.
Thanks
Rather than to have two surgeries biopsy and micro dissection go with the bigger one microdissection.
I am also worried about the side effect of microdissection as he advised I will need more testosterone after the surgery.
Please advise.
Thanks
Brief Answer:
Biopsy must be done to decide further treatment.
Detailed Answer:
Hi again.
A testicular biopsy is always done to decide further course of treatment.
Depending on the report, micro-dissection may not be attempted in some cases, as it may not be successful. As you say, smaller sized testicles needs confirmation and evaluation with a scrotal scan. What was the reason to delay the biopsy and try out Clomid for a year?
I would rather do the smaller procedure like scan and biopsy.
Hope your doubts are cleared.
Biopsy must be done to decide further treatment.
Detailed Answer:
Hi again.
A testicular biopsy is always done to decide further course of treatment.
Depending on the report, micro-dissection may not be attempted in some cases, as it may not be successful. As you say, smaller sized testicles needs confirmation and evaluation with a scrotal scan. What was the reason to delay the biopsy and try out Clomid for a year?
I would rather do the smaller procedure like scan and biopsy.
Hope your doubts are cleared.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Thanks again, initially he put me clomid for three months and said we will check your semen. Again we checked the semen and the result still no sperm in the ejaculate.
He said the only way we can retrieve sperm is to do micro dissection and he put me on the que as this is government funded.
That is the reason to take 1 year.
Do you think i may need endoctrology before the testicular biopsy? Please advise
He said the only way we can retrieve sperm is to do micro dissection and he put me on the que as this is government funded.
That is the reason to take 1 year.
Do you think i may need endoctrology before the testicular biopsy? Please advise
Brief Answer:
A testicular biopsy is a must.
Detailed Answer:
Hi again,
In my opinion, a testicular biopsy is essential to know the reason for azoospermia.
Only after the report is available, one can decide whether the sperms aren't seen due to some block in the tubes through which the sperms come out from the testis (or) there's a problem in the sperms being formed inside the testis. Only after we have result of testicular biopsy, urologist can give a proper advice about further treatment.
Hope your doubts are cleared.
A testicular biopsy is a must.
Detailed Answer:
Hi again,
In my opinion, a testicular biopsy is essential to know the reason for azoospermia.
Only after the report is available, one can decide whether the sperms aren't seen due to some block in the tubes through which the sperms come out from the testis (or) there's a problem in the sperms being formed inside the testis. Only after we have result of testicular biopsy, urologist can give a proper advice about further treatment.
Hope your doubts are cleared.
Above answer was peer-reviewed by :
Dr. Prasad
The last question, is there any thing other than testicle biopsy to do to find out where the problem of azoospermia lies.
Thanks for your help.
Thanks
Thanks for your help.
Thanks
Brief Answer:
biopsy has no substitute.
Detailed Answer:
Hi again.
A biopsy cannot be replaced by any other test.
Hope you're clear now.
biopsy has no substitute.
Detailed Answer:
Hi again.
A biopsy cannot be replaced by any other test.
Hope you're clear now.
Above answer was peer-reviewed by :
Dr. Yogesh D
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