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Suggest Treatment For Azoospermia
Question: Hi Doctor,
I am suffering from azoospermia. My hormone level is normal. FSH-2.37,LH-2.76,Testoosterone-5.02. Tools used roche cobas e 411,Japan. VIDAS PC, Biomerieux France
Below in the Semen analysis:
Apperance: Whitish
Volume: 2ml
PH; 8.0
Viscosity: Normal
Sperm Count: 0
Pus Cells: 5 /hpf
Immature Germ cell: 3 /hpf
WBCs: 3 hpf
Epithelial cells: 1-2/hpf
Leucocytes: Occasional
Spermatogenic cells: Not seen
RBC: Occasional.
Please tell what does above semen analysis means. Also suggest what should I do. Is biopsy required?
Regards,
XXXX
I am suffering from azoospermia. My hormone level is normal. FSH-2.37,LH-2.76,Testoosterone-5.02. Tools used roche cobas e 411,Japan. VIDAS PC, Biomerieux France
Below in the Semen analysis:
Apperance: Whitish
Volume: 2ml
PH; 8.0
Viscosity: Normal
Sperm Count: 0
Pus Cells: 5 /hpf
Immature Germ cell: 3 /hpf
WBCs: 3 hpf
Epithelial cells: 1-2/hpf
Leucocytes: Occasional
Spermatogenic cells: Not seen
RBC: Occasional.
Please tell what does above semen analysis means. Also suggest what should I do. Is biopsy required?
Regards,
XXXX
Brief Answer:
Testicular aspiration cytology suggested
Detailed Answer:
Hello,
Thanks for posting your query on HealthcareMagic.
The interpretation of semen analysis is as follows:
The physical attributes- volume, pH, color and viscosity are within normal limits.
The microscopic examination shows presence of infection in the semen (suggested by presence of pus cells and white blood cells).
However, there is absence of any sperms in the semen.
The next step is to get a testicular aspiration cytology.
Normal hormones and lack of sperms on semen analysis suggests that the hormonal axis is normal and probably testis are producing normal sperms.
However, the sperms are not appearing in semen due to some kind of obstruction in the vas deferens or ejaculatory duct.
A testicular aspiration will determine whether sperms and their precursors are produced in the testis.
In case, testis show sperms and its precursors, assisted reproductive techniques can be used to bear children.
Consult your doctor for prescription of investigation.
Thanks and take care
Dr Shailja P Wahal
Testicular aspiration cytology suggested
Detailed Answer:
Hello,
Thanks for posting your query on HealthcareMagic.
The interpretation of semen analysis is as follows:
The physical attributes- volume, pH, color and viscosity are within normal limits.
The microscopic examination shows presence of infection in the semen (suggested by presence of pus cells and white blood cells).
However, there is absence of any sperms in the semen.
The next step is to get a testicular aspiration cytology.
Normal hormones and lack of sperms on semen analysis suggests that the hormonal axis is normal and probably testis are producing normal sperms.
However, the sperms are not appearing in semen due to some kind of obstruction in the vas deferens or ejaculatory duct.
A testicular aspiration will determine whether sperms and their precursors are produced in the testis.
In case, testis show sperms and its precursors, assisted reproductive techniques can be used to bear children.
Consult your doctor for prescription of investigation.
Thanks and take care
Dr Shailja P Wahal
Above answer was peer-reviewed by :
Dr. Yogesh D
Hi Doctor,
What is significance of immature germ cells in the semen? It is 3 /hpf
What is the significance of Leucocytes? Is is shown as occasional /hpf
What is the significance of Epithelial cells? It is shown as 1-2 /hpf
Also I had undergone below tests:
TRUS- Normal
Doppler USG scrotum - Normal (But 3 yrs back it showed chronic epididymitis)
Doctors after physical examination and on the basis of above reports said that hormone level is normal and size of testis is good so there must be sperm in testis. They are saying it is post inflammatory azoospermia.
Please suggest at the earliest.
Regards,
XXXX
What is significance of immature germ cells in the semen? It is 3 /hpf
What is the significance of Leucocytes? Is is shown as occasional /hpf
What is the significance of Epithelial cells? It is shown as 1-2 /hpf
Also I had undergone below tests:
TRUS- Normal
Doppler USG scrotum - Normal (But 3 yrs back it showed chronic epididymitis)
Doctors after physical examination and on the basis of above reports said that hormone level is normal and size of testis is good so there must be sperm in testis. They are saying it is post inflammatory azoospermia.
Please suggest at the earliest.
Regards,
XXXX
Brief Answer:
Infection/ inflammation should be ruled out.
Detailed Answer:
Hello and welcome again,
Presence of leukocytes and epithelial cells suggest presence of infection. Pus cells are a type of leukocytes which suggests a bacterial infection.
Presence of 3/hpf immature cells suggests that the pre-sursors to sperms are being formed.
The USG of scrotum is normal and hormones level is also normal, thus there is not atrophy of scrotum.
Normal sperms can be expected in the testis.
If there is evidence of any infection/ inflammation now, a course of antibiotic should be taken.
Consult your doctor for same.
Repeat semen analysis should be done after antibiotic course.
If results remain the same, an aspiration cytology needs to be done.
Thanks and take care
Dr Shailja P Wahal
Infection/ inflammation should be ruled out.
Detailed Answer:
Hello and welcome again,
Presence of leukocytes and epithelial cells suggest presence of infection. Pus cells are a type of leukocytes which suggests a bacterial infection.
Presence of 3/hpf immature cells suggests that the pre-sursors to sperms are being formed.
The USG of scrotum is normal and hormones level is also normal, thus there is not atrophy of scrotum.
Normal sperms can be expected in the testis.
If there is evidence of any infection/ inflammation now, a course of antibiotic should be taken.
Consult your doctor for same.
Repeat semen analysis should be done after antibiotic course.
If results remain the same, an aspiration cytology needs to be done.
Thanks and take care
Dr Shailja P Wahal
Above answer was peer-reviewed by :
Dr. Yogesh D
Dear Doctor,
I had taken below medicine then did semen analysis:
Doxy(100 mg) 2 times - 10 Days
Hetragen(100 mg) 3 times - 20 Days
After completion of above medicine taken below medicine:
Wysolone(5 mg) 3 times for 10 days,2 times for next 10 days and then 1 time for next 10 days.
Can you please give more light on Immature germ cells present in my semen?
Can you please suggest any medicine from ur side?
Can you please suggest any good doctor for this problem in Pune?
Regards,
Roshan
I had taken below medicine then did semen analysis:
Doxy(100 mg) 2 times - 10 Days
Hetragen(100 mg) 3 times - 20 Days
After completion of above medicine taken below medicine:
Wysolone(5 mg) 3 times for 10 days,2 times for next 10 days and then 1 time for next 10 days.
Can you please give more light on Immature germ cells present in my semen?
Can you please suggest any medicine from ur side?
Can you please suggest any good doctor for this problem in Pune?
Regards,
Roshan
Brief Answer:
Aspiration required for further management.
Detailed Answer:
Hello and welcome again,
Your history suggests that you have already taken a course of antibiotic.
No medication can be suggested at this point of time.
Interpretation of immature cells does not have any significance at this point of time.
What is indicated now is aspiration of bilateral testis and interpretation by an experienced pathologist.
You can consult your doctor for prescription of investigations and later consult an fertility expert in XXXXXXX
It will not possible to suggest any specific doctor at your place on the forum.
However, there are many good institutes in XXXXXXX like AFMC, B J Medical College, BVMC etc.
You can visit any of these and get good guidance and good management.
Thanks and take care
Dr Shailja P Wahal
Aspiration required for further management.
Detailed Answer:
Hello and welcome again,
Your history suggests that you have already taken a course of antibiotic.
No medication can be suggested at this point of time.
Interpretation of immature cells does not have any significance at this point of time.
What is indicated now is aspiration of bilateral testis and interpretation by an experienced pathologist.
You can consult your doctor for prescription of investigations and later consult an fertility expert in XXXXXXX
It will not possible to suggest any specific doctor at your place on the forum.
However, there are many good institutes in XXXXXXX like AFMC, B J Medical College, BVMC etc.
You can visit any of these and get good guidance and good management.
Thanks and take care
Dr Shailja P Wahal
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
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