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Would Verioceletomy Helpin Onceiving In The Future When Diagnosed With Varicocele On Left Testis And Azoospermia?
Question: Hello doctor . After trying to concieve with my wife for a year i went to urologist , who found varicocele on left testis , i can feel mainly in the afternoon and later of the day like big bag of warms on my left side of the testicle . I went to spermiogram and it confirmed azoospermia. Totaly devastated . Went through hormonal profile .results are . Fsh 11,26 mlu/l Lh 6,1 mlu/l , testosterone 520 ng .
3 urologist did not find bilateral calcification on testis , but 4th probably thanks to better ultrasound found it . I am pretty concerned right now. First if i will ever be able to father a child ? Doc told that there is 80 percent of chance for that . And second because of reading about ghis calcifications :( ... all 4 doctors ruled out carcinoma. So i am trying to belive them .
What is your thought on situation pls ? None of them suggest me a varicoceletomy . Would u think it could help me pls ?
3 urologist did not find bilateral calcification on testis , but 4th probably thanks to better ultrasound found it . I am pretty concerned right now. First if i will ever be able to father a child ? Doc told that there is 80 percent of chance for that . And second because of reading about ghis calcifications :( ... all 4 doctors ruled out carcinoma. So i am trying to belive them .
What is your thought on situation pls ? None of them suggest me a varicoceletomy . Would u think it could help me pls ?
Brief Answer:
can conceive, require certain further details from your side.
Detailed Answer:
Hello,
I have read your query thoroughly.
* As the hormone levels are within normal range, the sperm production seems to
be not at fault most likely. The issue behind azoospermia indicates possible
blockage at seminal vesicles.
* My guidelines as per the detailed study of the case and need for further
discussion are
- All calcification do not show up cancer, when no other symptoms are present, do
not panic for that part.
- There are all chances of you to become father with provided reports till now.
- If available, kindly provide me detailed reports as scanned copy in attachment
while you go for follow up discussion.
- Any work up done on part of your wife, which is equally important
simultaneously.
- Do you smoke or drink alcohol ?
Awaiting for your response.
Regards.
can conceive, require certain further details from your side.
Detailed Answer:
Hello,
I have read your query thoroughly.
* As the hormone levels are within normal range, the sperm production seems to
be not at fault most likely. The issue behind azoospermia indicates possible
blockage at seminal vesicles.
* My guidelines as per the detailed study of the case and need for further
discussion are
- All calcification do not show up cancer, when no other symptoms are present, do
not panic for that part.
- There are all chances of you to become father with provided reports till now.
- If available, kindly provide me detailed reports as scanned copy in attachment
while you go for follow up discussion.
- Any work up done on part of your wife, which is equally important
simultaneously.
- Do you smoke or drink alcohol ?
Awaiting for your response.
Regards.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Hello doctor. Thank you for your quick answer .
As regards me i am non smoker never drink alcohol , regularly workout 5 times a week , playing football and ice hockey 4 times a week .
My wife has done some testing in gynecologist . She seems very much allright .
Regarding my results . It is all written in slovak lamguage . Does it mind . ? Should i send it anyway .
There is only written . Varicocele sin L , and syndrome star by night plus azoospermia . Urological doctor suggests control spermiogram and visit with XXXXXXX . Before first spermiogram i was in so much stress i literally have not sleep for a month . But now i managed to calm down and live my life like before . I sometimes felt an ache on left side of scrotum and frequent urination , but after i calmed down everything dissapear no more pain and urination . I would just like to know whether elevated fsh at 11 could not possibly sugest deletirious effect on spermatogenesis caused by 15 years of untreated varicocele . Doctor said i have it for at least that long :( . I try to stay positive with everything . What would u suggest to do next ? If there is deffect in seminal vessels , wouldnot that be obvious on uktrasound ? U gave me hope that it can be obstruction azoospermia what is better option i presume . Thank u for your reply
As regards me i am non smoker never drink alcohol , regularly workout 5 times a week , playing football and ice hockey 4 times a week .
My wife has done some testing in gynecologist . She seems very much allright .
Regarding my results . It is all written in slovak lamguage . Does it mind . ? Should i send it anyway .
There is only written . Varicocele sin L , and syndrome star by night plus azoospermia . Urological doctor suggests control spermiogram and visit with XXXXXXX . Before first spermiogram i was in so much stress i literally have not sleep for a month . But now i managed to calm down and live my life like before . I sometimes felt an ache on left side of scrotum and frequent urination , but after i calmed down everything dissapear no more pain and urination . I would just like to know whether elevated fsh at 11 could not possibly sugest deletirious effect on spermatogenesis caused by 15 years of untreated varicocele . Doctor said i have it for at least that long :( . I try to stay positive with everything . What would u suggest to do next ? If there is deffect in seminal vessels , wouldnot that be obvious on uktrasound ? U gave me hope that it can be obstruction azoospermia what is better option i presume . Thank u for your reply
Brief Answer:
follow up .
Detailed Answer:
Hi
Thanks for the details.
* FSH level of 1.5 to 12.5 is considered as normal, so your level of FSH is not
high.
* Next step for you in my recommendation is
@ Semen analysis via concentrated pellet technology, where the expert find out
hidden sperms if any,
@ MRI of seminal vesicles, ejaculatory duct, epididymis to evaluate further in
depth.
@ Testicular biopsy according to the result of MRI.
* Lastly, if there is sperm produced in testis normally, there are all modern
methods of conceiving available after sperm retrieval, so do not panic at this
stage rather focus to find out the reason.
Wishing you fine health.
Regards.
follow up .
Detailed Answer:
Hi
Thanks for the details.
* FSH level of 1.5 to 12.5 is considered as normal, so your level of FSH is not
high.
* Next step for you in my recommendation is
@ Semen analysis via concentrated pellet technology, where the expert find out
hidden sperms if any,
@ MRI of seminal vesicles, ejaculatory duct, epididymis to evaluate further in
depth.
@ Testicular biopsy according to the result of MRI.
* Lastly, if there is sperm produced in testis normally, there are all modern
methods of conceiving available after sperm retrieval, so do not panic at this
stage rather focus to find out the reason.
Wishing you fine health.
Regards.
Above answer was peer-reviewed by :
Dr. Kampana
Thanks for quick reply again . Ok i will go and check another local urologost and see what he advice me to do .
By indergoing mri investigation do u think there can be something cancerous behind this ? Even when all of urologists definetely cancelled this options and told me i am for sure 100percent cancer free .
What do you think ?
U did not mention anything about varicocele dont u think yhis could be an issue why this all is happening ?
This is my really last question .
Thank you i advance
By indergoing mri investigation do u think there can be something cancerous behind this ? Even when all of urologists definetely cancelled this options and told me i am for sure 100percent cancer free .
What do you think ?
U did not mention anything about varicocele dont u think yhis could be an issue why this all is happening ?
This is my really last question .
Thank you i advance
Brief Answer:
follow up .
Detailed Answer:
Hi
* Varicocele is found in 5% of men with non obstructive azoospermia, its absolute
impact on azoospermia status is unknown.
* Varicocele repair does induce spermatogenesis and increase sperm retrieval rate
in some of the cases, the value in every case is controversial.
* As your case is under evaluation phase at this stage, I had not commented on
definite surgical repair of varicocele.
* So far as cancer is concerned, MRI is not for that purpose, but for evaluation of
micro blockages, fibrosis & other information.
Welcome for further doubts.
Do not consider any question as last, feel free to ask.
Regards.
follow up .
Detailed Answer:
Hi
* Varicocele is found in 5% of men with non obstructive azoospermia, its absolute
impact on azoospermia status is unknown.
* Varicocele repair does induce spermatogenesis and increase sperm retrieval rate
in some of the cases, the value in every case is controversial.
* As your case is under evaluation phase at this stage, I had not commented on
definite surgical repair of varicocele.
* So far as cancer is concerned, MRI is not for that purpose, but for evaluation of
micro blockages, fibrosis & other information.
Welcome for further doubts.
Do not consider any question as last, feel free to ask.
Regards.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Answered by
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