Referral and Further Tests
So, I saw the GP again today. Managed to get an appointment through a sneaky route, bypassing the (dumb?) system of making an appointment on the day.
The next steps now include me providing another semen sample (I have been abstaining from sex and masturbation for a week, and my God has it been difficult!), and a blood test to check my hormonal levels. (This PDF by the American Society for Reproductive Medicine explains quite nicely the diagnostic tests for male infertility.) Apparently hormone (endocrine) evaluation should be performed if there is 1) a low sperm concentration (so for me, read none!); 2) impaired sexual function (I do have a problem ejaculating during intercourse, but otherwise I get really good wood); 3) other signs of endocrine disease. Basically my follicle stimulating hormone (FSH), testosterone, luteinising hormone (LH) and prolactin levels will be checked.
FSH and LH are important hormones for females (they're important for ovulation, and changes in their concentration in the blood makes them the main reason for the lovely monthly lady problems...) but as they're produced by the pituitary gland, they also have an effect on the male bits. LH acts on specialised cells in the testes to stimulate the production of testosterone, and FSH acts on other cells in the testes to stimulate the production of sperm. So my lay deduction from this is that if I have an endocrine problem, it would probably be related to FSH.
My GP also conducted a physical examination. To add to my woes, she thinks I have an undescended right testicle, and a small left testicle. If I'm honest, I actually think I do have two balls, but they're a bit small. This is also a possible contributing factor to azoospermia! Hoorah! Any more ways to help dent my masculinity?
Anyhow, my GP is referring me to the local Reproductive Medicine unit. My medical insurance covers investigations and tests, but if we (the wife and I) wish to pursue fertility treatment this will not be covered. So fingers crossed we get to see a specialist soon and start to figure out a way to deal with this.
I think counselling would be useful at some point too.
The next steps now include me providing another semen sample (I have been abstaining from sex and masturbation for a week, and my God has it been difficult!), and a blood test to check my hormonal levels. (This PDF by the American Society for Reproductive Medicine explains quite nicely the diagnostic tests for male infertility.) Apparently hormone (endocrine) evaluation should be performed if there is 1) a low sperm concentration (so for me, read none!); 2) impaired sexual function (I do have a problem ejaculating during intercourse, but otherwise I get really good wood); 3) other signs of endocrine disease. Basically my follicle stimulating hormone (FSH), testosterone, luteinising hormone (LH) and prolactin levels will be checked.
FSH and LH are important hormones for females (they're important for ovulation, and changes in their concentration in the blood makes them the main reason for the lovely monthly lady problems...) but as they're produced by the pituitary gland, they also have an effect on the male bits. LH acts on specialised cells in the testes to stimulate the production of testosterone, and FSH acts on other cells in the testes to stimulate the production of sperm. So my lay deduction from this is that if I have an endocrine problem, it would probably be related to FSH.
My GP also conducted a physical examination. To add to my woes, she thinks I have an undescended right testicle, and a small left testicle. If I'm honest, I actually think I do have two balls, but they're a bit small. This is also a possible contributing factor to azoospermia! Hoorah! Any more ways to help dent my masculinity?
Anyhow, my GP is referring me to the local Reproductive Medicine unit. My medical insurance covers investigations and tests, but if we (the wife and I) wish to pursue fertility treatment this will not be covered. So fingers crossed we get to see a specialist soon and start to figure out a way to deal with this.
I think counselling would be useful at some point too.
posted by Benchimus at
6/08/2006 02:41:00 pm
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