Brief Answer: Almost normal except the counts. Detailed Answer: Dear Mr. XXXXXXX Thanks for posting your query to me. I have carefully studied your semen analysis report, the following are my observations, 1. The volume is slightly high, but absolutely nothing to be worried about, we only worry about the volumes when they are low or significantly high. 2. Total sperm count/concentration seems to be low, please correct me if I am wrong, but the symbol you have used suggests that it is less than 20 million/ML, which should be above 20 million/ML. All other parameters, like the motility of sperms and the percentages of highly motile, moderately motile and sluggishly motile sperms are well within normal limits. It would clear some doubts I have about the correct expansions of the abbreviations you have used, so I request you to kindly write back with the full forms, or even better would be to attach a copy of the report with this query. The lower concentration of the sperms could be due to higher volume of the semen, which would mean, you might have had recent sexual activity. You may want to clarify that too. I wouldn't be too worried with your current report, but I would however suggest a retest after about a month, and refrain from masturbating or sexual intercourse for three days prior to getting this test repeated. I sincerely hope I have answered your question, please do write back with the information requested, so that I may understand the report better. Wishing you good health. Kind regards,

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Brief Answer: Go ahead with the testosterone injections. Detailed Answer: Hello Mr. XXXXXXX Thanks for writing back, In your report it says Sperm count <20, the normal range (in modern days is 20 to 40 million/ML), is 20 to 200 million/ML, so yes, a count of less than 20 million/ML is low and needs to be looked into. I understand that the numbers you have mentioned are correct, but I wanted to know the units that were mentioned along with those numbers. Natural ways to improve sperm counts include, 1. Wearing loose undergarments or none as much as possible. 2. Include garlic and onions in foods, 3. Regular exercise, 4. Never exposing your testes to high temperatures (Like keeping a laptop on the lap), 5. No smoking. Apart from these natural methods, I would suggest you to consult the urologist/andrologist and get yourself completely examined and investigated to look for any varicocele or other issues related to testicles. Along with the examination, your urologist will also ask you to undergo some important investigations like, ultrasound scan of the scrotum, hormone levels in the blood. Once you complete these, I will be in a better position to guide you further. As for your wife being on ovulation pills, I would suggest her to continue with that and if feasible, get a re-evaluation of her ovulation patterns and a basic set of investigations such as ultrasound, hormonal studies, and follicular studies done to confirm that she has no contributing problems. I hope I have answered your query, please do write back if you need any clarifications. Wishing you all the very best. Regards,

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Brief Answer: You are welcome, Detailed Answer: Dear Mr. XXXXXXX Thanks for choosing our services. I am happy to be of help. Take care.

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