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What does this semen analysis indicate?

Answered by
Dr. Vishal Garala


Practicing since :2009

Answered : 1714 Questions

Posted on Mon, 25 Aug 2014 in Testicle Problems
Question: My semen analysis readings are as below:
Liquification time : 40 minutes
Total ML : 4
Reaction: Alkaline
Total sperm count : nil million/ml
PUS cells : 4-5 / hpf
Epithelial cells: 1 -2 /hpf

I had hernia operation on both sides & undescended testes removed from the left side.

Please advice me what to do... does undescended testes & hernia operation a cause for zero sperm count... Please advice
Answered by Dr. Vishal Garala 26 minutes later
Brief Answer:
Your report suggest azoospermia.

Detailed Answer:

I went through your report and I feel it's azoospermia. pH, pus cell and epithelial cells are within the normal limit. Your semen liquification time is slightly higher than normal. You have not mentioned about fructose test here. Was this done?

Azospermia has two possible causes:
1. Due to obstruction in pathway of its production?
2. Is absent production.

Undescended testis and previous hernia surgery may cause obstruction which may present with similar features. To differentiate it fructose test is required.
- If test is negative that means it is obstruction.
- If test is positive that means absent production.

Hope this answered your question. If still you have query than feel free to ask.

Above answer was peer-reviewed by : Dr. Prasad
Follow up: Dr. Vishal Garala 26 hours later
fructose test has not been done. can fructose test result alone answer whether its obstructive or not. It Is that if fructose test is positive then the obstructive azospermia is completely ruled-out?

can obstructive azospermia cured? if cured can be have baby in a normal way?

Can low levels of FSH & LH lead to zero sperm count? can hCG & other injection increase the sperm count?

Is there a possibility that a ejaculation can have no sperm count & ejaculation after some days can have sperm in it? I have tested it only once.

I hear that non-obstructive azospermia cannot be cured and the only option is taking sperm from testis if available by Testicular Biopsy and do ICSI and IVF. Will this be successful? is this treatment available in XXXXXXX & how much will be cost for it?

Answered by Dr. Vishal Garala 1 hour later
Brief Answer:
Hi thanks for revert back.

Detailed Answer:
Hi dear.
Very good to see you again.
I understand your concern.

Fructose positive means presence of fructose in semen.

It comes from prostatic fluid. Its absent in a case of obstruction. Thus if fructose absent in semen that suggest obstruction in the pathway of semen production.

Obstruction can be treated with surgical operation. Results are depend upon site and type of obstruction.

It is difficult to say that by removing that obstruction will improve your sperm count.

Uro surgeon will best guide you regarding its chances of getting improvement in azoospermia.

Testosterone is the main hormone which are useful in spermatogenesis.

FSH and LH in low levels does affect sperm count. Injection of hcg is not useful to increase sperm count.

If have a query then go for repeat test. It is very difficult to treat non obstruction azoospermia. Results are not good. But there are other method to reproduce like ICSI and IVF.

ICSI and IVF is the method to be pregnant .

It is costly. IVF cost is very from doctor to doctor. It can cost around 2 to 5 lacs.
Yes it is available in any metro town like XXXXXXX

Consult good gynecologist.

Thank you.
Hope you will get best.
Above answer was peer-reviewed by : Dr. Ashwin Bhandari

The User accepted the expert's answer

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