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Q. What are the tests urologist may order for low testosterone?

Answered by
Dr. Shahil Khant
and medically reviewed by Dr. Hemalatha
This is a premium question & answer published on Jan 07, 2017 and last reviewed on: Mar 13, 2021

Hi doctor,

We are planning for a baby but I have a low sex drive. I am having sex twice a month. I have fatigue, stress, and low energy. I am standing for almost ten hours a day due to my job. After doing our routine check-up, we are planning to do IVF. The doctor advised me to do a semen analysis and he referred me to a urologist. I do not know the reason behind it. Can you please tell me the reason? What are the tests done? I am taking testosterone shots for the past two months as my testosterone levels are low. I have a total testosterone level of 225.2 ng/dL and free testosterone direct of 5.9 pg/mL. Kindly go through my semen report and provide us a suggestion.

#

Hi,

Welcome to icliniq.com.

I have gone through the sent reports (attachment removed to protect patient identity). Please mention the months planned for having a baby. All the parameters are fine except for two things. Your serum testosterone is low and semen analysis shows that your sperm count is low. You have 5 million per mL. Usually, it should be more than 50 million per mL. Sperm motility is also less in your semen analysis. Your reports suggest that your testes are not working promptly and so you have low testosterone and abnormal sperm parameters. These factors cause problems in conceiving.

It is necessary to find the cause of the low sperm count and testosterone. You need to consult a urologist for a physical examination. It helps to identify the cause of your malfunction of testes. I suggest you do an ultrasound of the scrotum with a color doppler. It helps to determine the size of the testes and other problems like varicocele. You need to do some blood tests like serum FSH (follicle-stimulating hormone) and serum LH (luteinizing hormone) to know whether it is a primary or a secondary testicular failure.

Thank you doctor,

We got married three years back. We did not plan anything. We just started around six months to have a baby. I am taking testosterone shots. How to increase my sperm count?

#

Hi,

Welcome back to icliniq.com.

Before going for extensive evaluation and treatment, you need to try for six months. We can wait for a year before starting an invasive treatment. Infertility is referred to as failure to conceive after a year of repeated trying. I suggest you do a basic evaluation and wait for some time. Meanwhile, you can take medicines to improve your sperm count.

If we cannot find the reason for your low sperm count, then you can undergo ART (assisted reproductive technology). In this, we take good sperms from your semen or testes and it is injected into your partner. ART is usually done by a gynecologist and requires two to three cycles. It is not done in a month. At present, I suggest you do some basic tests, evaluation and start with medical management. I suggest you take tablets containing Carnitine, Coenzyme Q 10, and zinc thrice daily. Consult your doctor soon and take treatment accordingly.

Thank you doctor,

After taking your recommendations, I did all my basic tests. I am consulting my doctor regularly. I am attaching the reports. My urologist told me that my testicles and prostate are fine. He suggested me to take Clomid 50 mg once a day for 25 days. I took it for a month and went to my endocrinologist. She ordered to do some blood tests. I had some improvement in my testosterone levels, LH, FSH. We are trying for kids as usual. My urologist suggested me to take Proxeed plus. Do I need to wait for some time before doing IVF? What is your suggestion after going through my reports?

#

Hi,

Welcome back to icliniq.com.

I have gone through the reports and they seem to be good. You are responding well to the treatment and you are doing good. You can try for four to six months before doing IVF (in-vitro fertilization). I think that your partner can get conceived naturally. You do not require any tests at present. You need to repeat semen analysis after a month. Continue taking the medicines as prescribed.

Thank you doctor,

I have some questions to ask you.

#

Hi,

Welcome back to icliniq.com.

Please ask your questions and attach your reports.

Thank you doctor,

I did my semen analysis before a month and I am attaching it. My urologist told me to take Clomid 50 mg once a day for 25 days and to stop taking it for five days. Now I am taking it for five months. My reports look good when compared to the first one but my morphology is low. We are having sex quite often for the past two months but she did not get conceived till now. What can I do to get a normal sperm morphology? Do I need to continue taking Clomid till my partner gets conceived? Does morphology play an important role in infertility? What are the other options?

#

Hi,

Welcome back to icliniq.com.

I have gone through the semen report and it is very much improved when compared to the first one. Your morphology is also improved a little bit. You need to continue taking Clomid and Thyroxine. Try to take antioxidants in your diet. take a tablet containing Carnitine, coenzyme Q, and zinc. Really only one sperm is required for pregnancy. Your count is normal but your morphology is less and it is not zero. So continue taking medications and do not lose hope.


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