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Unable To Conceive, Viral Fever, Semen Test, Hormonal Test, Testosterone Levels Abnormal. Treatment ?

Posted on Thu, 7 Jun 2012

Question: Sir,

I am married for 4 yrs. and trying to have baby for 2 yrs.
I had semen analysis two times before and result was as below:

counts 1 million/ml
motality: 40 %

In july this year I was suffering from Viral fever ,
I gave sample 32 days later and result was as below:

Counts : occasionally seen
Motality :NIL

after this on 46th day I had gone through semen test and hormonal test with results as below:

date:09/09/2011
Blood Test
serum for testosterone(CLIA): 141.20 ng/dl
T3 : normal
T4 normal
TSH: 6.19
serum for Prolactin (CLIA) :25.6 ng/ml
serum for FSH (CLIA) :12.08 mIU/ml
serum for LH (CLIA):4.56 mIU/ml
serum for V.D.R.L : Direct non-reactive
indirect non-reactive
serum for HIV1+2 antibody(ELISA) both negative
serum for Anti Chamydia antibody (IgM)(ELISA)-Negative
serum for HBsAg(Australia Antigen)(ELISA)-Non reactive

Semen test
Vol-2.75 ml
Counts -Ocassionally seen
Motility-OK
Grade-I and II and Grade III sperm seen

My weight is 85 Kg , height is : 170 cm
Sir, Please guide me about my TSH and testosterone levels
Thanking you

Answered by Dr. V. Kumaravel (3 hours later)

Hello

Thanks for your query.

I do understand that you had been worked up for infertility and found to have some abnormality in your semen test and testosterone levels.

Your TSH 6.19 is high and this signifies that you have subclinical hypothyroidism. If you have neck swelling or positive anti TPO(Thyroid peroxidase ) antibody in your blood or any other clinical features of thyroid dysfunction, you would require treatment with thyroxine tablet.

Your testosterone is 141ng/dl is also low. You would require further clinical examination to assess your secondary sexual characters, testicular size and sexual functions to decide on exact abnormality and treatment if any.

Hope this answers your query.I will be available for follow up.

Regards.

Above answer was peer-reviewed by : Dr. Radhika

Follow up: Dr. V. Kumaravel (5 hours later)

Sir,

thanks for reply
I have no problem(swelling etc..) in my neck.
Also I had gone through physical examination of my testis by a surgeon and no problem (no varicocele, size normal etc) was found. My sexual desire and penis erection are all normal.

Please prescribe me medicine I have to follow.

Answered by Dr. V. Kumaravel (14 hours later)

Hello
Thanks for your feedback.

For your thyroid, get your Anti TPO antibody blood test done. If it is high then you can start on thyroxine medicine. If not, no thyroid medication will be required for now and you can check your Thyroid functions after 2 months with Serum TSH level.

For your low testosterone level, if your secondary sexual characters ( Testicle size etc) and sexual functions are normal , treatment may not be indicated. If any of these are concern you would have to take testosterone tablets or injection. But one thing that has to be remembered with testosterone injection is that it may not improve your sperm count.

For your absent/decreased sperm count, unless you know the cause, you may not be able to treat. If there is no cause found, an appropriate IVF can be planned with the help of Infertility Specialist.

I feel you would require some more tests and counselling in discussion with your physician to decide on required medication.

Best wishes

Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar