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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Hi, I'm trying for a family but my recent semen

Hi,
I'm trying for a family but my recent semen analysis reports show no spermatazoa for two separate semen analysis tests. what are the chances these results are incorrect on two separate attempts?
I have been told that the possibilities of the above could be due to obstructive or non-obstructive scenarios. If diagnosed as non-obstructive, would you able to suggest what available procedures exist to extract the sperm samples and associated costs (approx.) to carry out the same. I have been asked to do a testosterone , FSH test.
What other tests would you recommend?
My partner is 29 years old, her tests are confirmed clinically as normal. what are the chances of a natural pregnancy?
Fri, 11 May 2018
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Hi, I have attched the conversation i had with a doctor below...can you please go through it and give your opinion. senthil.psgct: Hi, I m 27 and not able to ejaculate whenever i masturbate, but i m having wet sleep Doctor: Hi Doctor: I am Dr. Jagdish senthil.psgct: Hi Doctor Doctor: Are yo married? senthil.psgct: no Doctor: Do you used to ejaculate normally before? senthil.psgct: i never tried to masturbate Doctor: Are you masturbating now/ senthil.psgct: yeah, when i try now im not able to ejaculate Doctor: How many times you masturabated ? senthil.psgct: probably 9 or 10 different times over last 2 years Doctor: so any time did u have ejaculation senthil.psgct: never senthil.psgct: i was having a very small drop sometimes Doctor: usually the normal quantity of ejaculated fluid ismax 1 teas sponn 5ml senthil.psgct: no not that much Doctor: but u r wetting the cloths in sleep senthil.psgct: i might be getting that quantity in sleep Doctor: is that right? senthil.psgct: yeah Doctor: plz hold senthil.psgct: ok Doctor: The first thing you should due if you are concerned is to have a semen analysis performed. Doctor: f at that time the volume is determined to be low, than you must first determined that the specimen was obtained properly(48-72hrs abstinence) and retrograde ejaculation has been ruled out. Doctor: *if senthil.psgct: what is that...how and where to do that? Doctor: I will tell u Doctor: Low volume may represent a rare decreased in androgen levels. Doctor: If you go to lab ask for semen analysis Doctor: they will give a kit and ask you to collect semen in th bottle ok Doctor: Do u follow me? senthil.psgct: oh...k...how do i get the semen? Doctor: Any amount is ok Doctor: one drop is also fine senthil.psgct: see im not able to ejaculate when i masturbate and thats my problem Doctor: ok Doctor: Low volume may represent a rare decreased in androgen levels. Doctor: So please get the serum testosterone levels senthil.psgct: through semen analysis? Doctor: No Doctor: it is a blood test senthil.psgct: ok Doctor: If the harmone is low , the semen is not prodcueed senthil.psgct: if thats the case, then it shud not be produced in sleep also rite? Doctor: There are other causes no ejaculation Doctor: ok senthil.psgct: u there? Doctor: obstruction of the ejaculatory ducts, Vas Deferens, or epididymus cause no ejaculate Doctor: For that u need ultrasound of prostate,Vasography senthil.psgct: but doctor im ejaculating in sleep so obstuction of duct is ruled ou senthil.psgct: u there? Doctor: Plz be patient Doctor: if the chat is not complete Iwill call u senthil.psgct: ok..hope u have my number Doctor: 0000& senthil.psgct: no...its 0000..last digit has typo err Doctor: the point is u r ejaculating in sleep and not ejaculating in masturbation Doctor: ok senthil.psgct: yes Doctor: So but the investigations are same Doctor: Why are you not ejaculating Doctor: Defintely u r prodicuing semen senthil.psgct: yes Doctor: The semen is produced in prostate and mixed with sperms from testicles Doctor: It comes from deep in prostate thru urethra senthil.psgct: i see Doctor: in between uyerthra and testiclea there are tubes which carry semen senthil.psgct: oh.. Doctor: When there is an obstruction of the ducts it will go back to bladder Doctor: or it may n ot come forward] senthil.psgct: i see senthil.psgct: why is this obstruction not happening in sleep Doctor: So u need Ultrasound of the proistate to see whether there is obstrctuion of the ducts going thru the prostate and to see if there is swelling of the prostate which might be blocking Doctor: I dont know Doctor: There is no explanation for all Doctor: Vasography is they inject dye thru the penis and look whether the floe is normal or obstructed senthil.psgct: i see... senthil.psgct: may i know whats ur qualification? Doctor: MBBS with 2 yr family medicine in USA Doctor: I recommend you consult the urologist . He will do the ultrasound of the Prostate and assist in vasography senthil.psgct: ok.. Doctor: May I ask u few Q Doctor: Do you have any medical problems ? senthil.psgct: yes senthil.psgct: no Doctor: Do you take any medicines ? senthil.psgct: im perfectly fit...don take any medicines Doctor: ok Doctor: DO you have any stress ? senthil.psgct: no Doctor: Ok Doctor: So I do not see any other causes of no ejaculation from history Doctor: Do you have any diifuclty urination senthil.psgct: nope Doctor: So probably there is back flow of semen or might be obstruction

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