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

Answered by
Dr. Shahil Khant
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jan 07, 2017

Hi doctor,

We are planning for a baby, but there is low sex drive. I am having sex twice in a month. I feel fatigue, stress and low energy. In my job, I am standing for almost 10 hours a day. After a routine checkup, we went to for IVF. They ordered my semen analysis and my doctor referred me to the urologist. I do not know the reason. Can you please let me know the reason and the type of tests the urologist may order. I am taking testosterone shots from last two months as my testosterone levels are very low, total testosterone 225.2 ng/dL and free testosterone direct 5.9 pg/mL. Please explain my semen analysis report, which I have attached here for your reference. 

Dr. Shahil Khant

Andrology General Surgery Urology
#

Hello,

Welcome to icliniq.com.

I have seen all the reports sent by you (attachment removed to protect patient identity).

  • Since how many months you are planning for a baby?
  • All your reports are fine except two things. Your serum testosterone is on the lower side and the semen analysis shows that your sperm count is less.
  • You have 5 million per mL. Normally, it should be above 50 million per mL. Also, sperm motility is less in your semen analysis.
  • The above reports suggest that your testes are not working properly as you have low testosterone and abnormal sperm parameters. The above factors may give problem in conceiving.
  • Now, we need to find the cause of your low sperm count and testosterone. For that, a urologist will examine you physically to look for the cause of your malfunction of testes.
  • He will also advise ultrasound of scrotum with color Doppler. It will determine the size of the testes and any other problems like varicocele, etc.
  • He will also advise some more blood tests like serum FSH (follicle stimulating hormone) and serum LH (luteinizing hormone) to see if it is primary or secondary testicular failure.

Revert with the answer to the above question to an andrologist online --> https://www.icliniq.com/ask-a-doctor-online/andrologist


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Thank you doctor,

We have been married for 3 years and we did not plan before. We just started around six months ago. I am taking testosterone shots. Which medicine should I take to increase sperm count?

Dr. Shahil Khant

Andrology General Surgery Urology
#

Hi,

Welcome back to icliniq.com.

  • I think before you should go for extensive evaluation and treatment you should try for six months more. We usually wait for one year before starting any invasive treatment.
  • Infertility is defined as failure to conceive after one year of repeated trying. I suggest you can get a basic evaluation and do not go for any invasive (surgical) treatment if required.
  • Get yourself evaluated and start medical treatment, but the improvement of sperm count cannot be commented.
  • Also, we do not find any reason for your low sperm count. You need to undergo ART (assisted reproductive technology). In that, we take good sperms if available from your semen or surgically we take good sperms from your testes and inject them in your partner.
  • ART will be done by a gynecologist and it may require two or three cycles. It will not be done in a month.
  • At present, I suggest you get basic tests, evaluation and start with medical management.
  • I also suggest you tablet containing a combination of Carnitine, Coenzyme Q10 and Zinc thrice daily. Consult your doctor, discuss with him or her and take treatment with consent.

For further information consult an andrologist online --> https://www.icliniq.com/ask-a-doctor-online/andrologist


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