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Dr. Andrew Rynne

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Semen analysis showed poor motility. Any advice?

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Dr. V. Kumaravel

Endocrinologist

Practicing since :2001

Answered : 297 Questions

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Posted on Wed, 26 Dec 2012 in Thyroid Problem and Hormonal Problems
Question: Doctor,

I did semen analysis and it was reported as poor motility. After consulting a urologist, I did a harmonal profile. The Urologist says everything is alright, But I suspect low testosterone with slightly elevated prolactin levels. I also think that this is the reason for the low motility and above average sperm count. I have uploaded the report.

I am 32 years old. I used to have a super sex drive. However my libido has decreased drastically and the refractory period is increasing too.

Please advise after looking at the report


doctor
Answered by Dr. V. Kumaravel 20 hours later
Hello: welcome to healthcare magic. We appreciate your concern.

I do understand that you are a 32 year old male, concerned about your abnormal semen analysis. Your hormones are perfectly fine and I would say you prolactin and testosterone are also normal for your age.

I would like to know the reason why a semen analysis was done for you and I again we can draw conclusion from one result. Again it is very important to know your testicular volume and other gonadal status to guide you further.

Hoping to hear from you soon

Regards

Dr. Kumaravel
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. V. Kumaravel 21 hours later
Doctor

I have been marrried for 11 months. we consulted a gynaecologist when my wife had painful periods. Since we had started trying for a baby, we asked the doctor for a fertility evaluation. My semen analysis was abnormal (Motility - 10% as per MACLEOD's grading - NOT AS PER WHO - Report attached)

I consulted a urologist at Chennai. He however said that the report is normal (On the basis that MACLEODS GRADE IV, III & II are equivalent to WHO's progressive forward motility i.e my motitlity was actually 55% and not 10%) and simply said we have to keep trying.

On my request, he did further investigations and a harmonal profile (report attached) and doppler study of testes (report attached) was done. He again said everything was normal. But after going through various articles on the internet, I believe that my testosterone is low & prolactin is elevated, I requested him for medicines. He refused and asked me to consult an endocrinologist.

Further Background that may help in diagnosis
______________________________________________

I am a vegetarian. I am in a deskjob and my working hours stretch for 13 to 14 hours. I weigh 86 Kilos and I am 181 cms tall. I believe that my libido has decreased drastically over a course of 2 years and I find that I am putting on weight around the waist and thighs. Previously this was not the case. Even though my libido has decreased, there is no effect on erections or duration of sex. Also I could have sex atleast 2 times in a single day. Now I am not able to do so. I can have sex only every other day and also semen seems to be less in volume. All this I believe is a symptom of low testosterone.

Please help me doctor.
doctor
Answered by Dr. V. Kumaravel 28 hours later
Hello

Thanks for your detailed history that you had provided. I could totally understand your concern regarding your fertility and sexual functions.

Your testosterone and prolactin are normal for your sex and age and I would not prefer for any hormonal intervention. Treating with testosterone may certainly improve your sexual performance, but will further decrease your sperm count and may not be advisable ad fertility is an important concern for you.

Looking at your semen analysis, no conclusion can be drawn from a single report and you could repeat a semen analysis and still if the motility is low, we could try some drugs that can improve your motility and count after a clinical examination. I feel you testosterone and prolactin may not be an issue in your case.

Hope this answers your query. Do let me know if you have more concerns.

Regards

Above answer was peer-reviewed by : Dr. Shanthi.E
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