Posted by: Have nots | 2009/02/11


Dear Fertility Doc

I am 41 yrs old and married for 11 years. Have not been able to father a child. I was diagnosed with azoospermia in 1999.
In 1999, I also had 4 testicular biopsies (with different doctors) and each one came back that no sperm cells could be found.
However, all my hormones (FSH, testosterone, prolactin and LH) were all normal.
How is it possible that no sperm is formed although the hormone levels are normal? What is the cause and is there any treatment for this?
Besides a kidney problem at age 7, I have no other medical conditions.
I have recently done another hormone test and is as follows:

FSH: 9.6 (1-19)
LH: 3.9 (1-9)
testosterone: 15.99 (9.9-27.8)

Thanking you in advance

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Our expert says:
Expert ImageFertility expert

Dear Have Nots

Since the hormone production is from a different source as the actual sperm themselves is quiet acceptable to have a normal hormone profile, an adequate testicular volume and normal sexual function despite being azoospermic. However it is sometimes also possible to have very small areas of reasonable sperm production striated within the testis and these areas may have been missed in previous biopsy. Occasionally in cases such as these it is worth a radical testicular procedure were the entire testicle is explored at one sitting to detect random areas that may contain very premature or immature sperm production cells which can be used in a fertility treatment program. Such a procedure needs to be done by a fertility specialist in conjunction with a Urologist for optimal results.

Answered by: Dr M. I. Cassim

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