I’m 28M, my FSH was 51 while everything else was perfectly normal. No microdeletions, etc. The doctors even bragged on how insanely healthy I was when my bloodwork came back. Am I bitter? Yes. Am I jealous of others? Yes. I’m trying to stop comparing and accept it’s probably for the best.

My wife has epilepsy, so any pregnancy would have been high risk anyway. We had serious discussions about donor routes and even had one picked out but ultimately decided we shouldn’t volunteer for seizures if we didn’t have to. We were going to foster/adopt even before this journey, so I guess we’re starting that earlier than we thought.

I’m desperately trying to not grow bitter about my circumstances, because I’ve maintained a healthy lifestyle just to get hit with a SCOS diagnosis. My wife and I are very open with each other and she’s made it very clear that I’m all she ever needs and with the hardships I’ve had growing up that I’d be very beneficial for empathizing with troubled kids.

Apologies for the vent, I just needed to get this out there. Best of luck to anyone struggling with this, just don’t forget to lean on one another, and don’t handle it on your own.

Comedic relief, I told my wife she’s gotta realize I’m now a one of one, so she’s got a rare catch.

Hey guys so a week ago today I went in for labs and a semen analysis. This will be my third analysis since December both prior ones were at zero sperm. Started clomid about a month ago. Anyway when should I expect to get the results for the microdeletion test and the semen analysis ?? It’s been 7 days and the wait is killing me !

All,

As I am digging more into male factor infertility, one aspect that has continued to run through my mind after I was diagnosed with NOA is the environmental and toxicity factors that could be causing it. In your journeys, has anyone here had similar thoughts or experiences that have lead them to believe this could be the reason for their diagnosis. With someone factors like micro plastics, phthalates, bpa and I am sure a bunch of other stuff that’s harmful id love to know if anyone else has gone down this path.

Hi all

Long time no post been trying to come to terms with failed mTese. (1 sperm found not useable)

mTese was done in Nov 25.

Ive had 3 blood tests since including yesterday.

Testosterone has held pretty flat which is a good thing as thats one of the main side effects. LH now has mean 13 across the 3 vs 10 mean in the pre surgery blood tests.

Fsh has gone higher so like mean 39 as opposed to mean 33.

The trend on LH and FSH is clear as i ensured I have enough data points.

The LH makes sense to me in that if they cut out some Leydig cells during the op then my LH is working as hard to keep my Testosterone levels stable.

What I am considering is why the jump to 39 FSH.

Pre surgery I never posted 39 (my highest over 8 bloodtests was 36 with mean of 33). Post surgery it is 40 39 39.

Any conjectures or signposts to potentially missed spermatogenesis?

Hi all,

Like the title says, I’m curious to know if there is anyone with AZFc that has success in having natural pregnancy or through IUI. Knowing that the condition is not reversible, any tips or advice to optimize the sperm numbers?

Hi everyone,
I am a 34-year-old male looking for opinions and experiences regarding my fertility situation.
My wife and I have been trying to conceive for almost 3 years. We underwent one ICSI cycle. Seven oocytes were fertilized, but only two good-quality embryos developed. Both embryos were transferred, but unfortunately the cycle failed and we have never achieved a pregnancy.
I would like to share my complete medical history and test results.
Medical history
Previous large left varicocele.
Microsurgical varicocelectomy performed in January 2024.
Latest scrotal Doppler ultrasound
Right testicular volume: 14 mL
Left testicular volume: 9 mL
Mild left testicular hypotrophy, reported as a sequela of the previous varicocele.
Residual veins measuring approximately 2.5 mm, without reflux.
The radiologist concluded that there is no recurrent varicocele.
Small bilateral hydroceles.
Prostate volume: 29 mL.
Ultrasound findings suggestive of chronic prostatitis sequelae.
Hormonal profile

FSH: 4.87 mIU/mL (Normal)
LH: 4.83 mIU/mL (Normal)
Total Testosterone: 6.48 ng/mL (Normal)
Prolactin: 15.11 ng/mL (Normal)
Estradiol: 54.06 pg/mL (Elevated)
TSH: Normal
Free T3: Normal
Free T4: Elevated
Anti-TPO antibodies: Positive
Vitamin D: Low (below reference range)

Semen analysis
Abstinence period: 3 days
Macroscopic examination
Appearance: Opalescent
Volume: 4.4 mL (normal)
Liquefaction time: 30 minutes (normal)
Viscosity: Normal
pH: 8 (normal)
Microscopic examination
Sperm concentration and count
Sperm concentration: 23 million/mL (normal according to WHO 2021 reference)
Total sperm count per ejaculate: 101.2 million (normal according to WHO 2021 reference)
Motility (1 hour)
Category A (rapid progressive): 1%
Category B (slow progressive): 12%
Category C (non-progressive movement): 7%
Category D (immotile): 79%
Progressive motility (A+B): 13% (reduced)
Total motility (A+B+C): 20% (reduced)
Motility (4 hours)
Category A: 0%
Category B: 8%
Category C: 5%
Category D: 87%
Other semen parameters
Vitality (live sperm): 38% (reduced)
Normal morphology (typical forms): 8% (reduced according to my laboratory reference)
Multiple anomaly index (MAI/IAM): 1.32 (normal)
Leukocytes (peroxidase positive): 0.04 million/mL (normal)
Round cells: 0.96 million/mL (normal)
Sperm agglutination: Absent
Aggregates: Absent
DNA Fragmentation Test: 8% (Normal)

Conclusion from the laboratory: Reduced sperm motility and reduced sperm vitality.
Suspected seminal dysbiosis
Despite a negative semen culture, my fertility specialist suspects seminal dysbiosis (an imbalance of the seminal microbiome).
I completed a 21-day course of antibiotics and I am now considering probiotics to help restore the microbiome.
My questions
Could the left testicular hypotrophy (9 mL) still affect fertility despite successful varicocele repair?
Could chronic prostatitis sequelae or seminal dysbiosis contribute to reduced sperm motility and vitality?
Has anyone experienced seminal dysbiosis despite a negative semen culture?
Can improving the seminal microbiome improve sperm motility and vitality?
Based on these results, do you think natural conception is still possible, or is another ICSI cycle more realistic?
Thank you very much for taking the time to read my post. I would really appreciate any advice, medical opinions, or personal experiences.

Hey thought I'd provide a quick update on this post seeing as I've been asked a couple of times.

I ended up having privately funded microTESE surgery with outstanding results - six vials were collected. Really really very lucky as the odds were against us.

You go into the surgery not knowing whether they'll be able to find anything, or whether anything found would be viable.

They do a test immediately in the same room to see whether a sample would survive freezing and thawing - my guys aren't going to enter the sperm olympics but there was enough to say they would be viable for ICSI.

The surgeon diagnosed the cause being Sertoli Cell-Only Syndrome (SCOS), likely caused by testicular trauma, so from the mumps.

Still waiting for things to fall into place from the actual IVF side, but a positive outcome for me none-the-less.

Hi everyone, following up on my previous post, I wanted to share a bit more of my story in hopes that it might help someone here.

Although I was initially diagnosed with azoospermia (zero sperm count) at a local clinic, the follow-up tests at the university hospital showed around 300,000 sperm. However, the sperm morphology and motility were still very poor.

I vividly remember my first day at the university hospital. The doctor asked me to pull down my pants, examined my testicles, and then looked at something on his desk that resembled a wooden rosary or a string of beads. Each bead had a number on it indicating size (I later found out it’s called an orchidometer). It seems that smaller testicular volume can often correlate with lower sperm count.

I was diagnosed with a varicocele and had surgery shortly after. Prepping for the surgery meant shaving that entire area, which was honestly quite an awkward and challenging experience in itself...

Since I see a lot of people here hesitating about varicocele surgery, here are a few honest takeaways from my experience:

1. If you have the time and flexibility, I’d recommend getting the surgery.
2. Don’t expect immediate results. It usually takes at least 6 months to a year to see any real improvement in sperm parameters (which is why I mentioned having time on your side).
3. Definitely pay attention to your diet. A famous urologist in South Korea strongly recommended cherry tomatoes and walnuts for sperm health. I ate them regularly, and I personally feel they made a positive difference.
4. Take fertility supplements. Regular multivitamins are good, but looking into male fertility-specific vitamin blends (like CoQ10, antioxidants, etc.) is definitely worth it.

To be completely honest about my case, I was fortunate enough that it wasn't total azoospermia. They were able to find viable sperm under a micro-dissection/microscope after ejaculation, which was a huge relief.

Also, while medical guidelines often suggest an ejaculation interval of 3–4 days for optimal sperm quality, in my personal case—since my total count was so low—I felt that an interval of around 5–6 days gave me a better volume to work with.

I’ll probably talk more about this later, but as men, our primary role in this process is producing and retrieving the best possible sperm. After that, everything else takes place inside our partner's body.

(Unless it's like that old Arnold Schwarzenegger movie Junior, which is theoretically impossible in real life!)

So while we should all do our absolute best to produce healthy sperm, I think it’s equally important that we show deep care, empathy, and attention to what our partners have to go through in their bodies afterwards.

Hang in there, brothers. Feel free to ask anything!

I’m posting from my wife’s account because my own account has many people I know, and I haven’t told any of my family or friends about my azoospermia. I hope the moderators understand.
Anyway, I was diagnosed with azoospermia last December. My wife and I have been trying to conceive for two years and a few months now; in October, it will be three years of trying.
The month before last, my wife’s period was late and she started experiencing what seemed like every possible pregnancy symptom. Out of curiosity, she took a home pregnancy test and found out she was pregnant, but it turned out to be a chemical pregnancy.
Then, the following month (last month), the same thing happened again: her period was delayed, she took a home pregnancy test it was negative, then she did bloodwork and the β-hCG was 21 mIU/mL
and she had another chemical pregnancy.
All I can say is… WTF

I just had a failed micro tese yesterday. I was diagnosed with noa azoospermia about 9 months ago. My wife is currently having her eggs retrieved and frozen due to not finding any sperm. Is donor sperm or adoption our only options? I hate for this to be the end of the road. My wife and I recently read about infertile men using Accutane (isotretinoin) and having success with sperm production through ejaculate but would still need to use the IVF process. Just looking for any input from anyone who is currently experiencing a similar situation or has gone through this. Thanks

No problems on the genetic testing
FSH 33.6
LH 5.8
Estradiol <25
Testosterone normal

Hey all!

I’ll keep this brief as I just have a quick question after meeting with a couple urologists. I’m 27M. Total sperm count is 7 million ml with 25 % motility.

Doctors are pushing towards IVF but I just wanted to see if anyone has had experience with getting sub clinical varicocele operated on. I have some revealed when they did an ultrasound but doctors don’t seem too concerned.

Only thing is, my blood work is completely normal, I’m very healthy, and doctors don’t see anything wrong with me.

Doctors really want to start IVF but I can’t get the varicocele out of my head, as my grandfather had the exact same thing in the early 1970’s. Back then they just operated on the sub clinical varicocele as a last ditch effort, and they were pregnant with my mom the very next month.

I’ve told the doctors there is a family history of it and maybe worth exploring but have been shut down on it and steered towards IVF.

I just want to know if anyone has had experience with Sub clinical varicoceles and would love any advice! TIA!

Hey all, 36 year old hopefully soon to be Dad here. My wife and I have been on our pregnancy journey for approximately 18 months. I just had my first SA on Monday and the results were less than spectacular. I had some factors with the test that I’m wondering if, they threw off the test significantly. My results were volume 1.0ml, 5.7 million/ml concentration, 42.1% motility, 24 motile sperm, 33 non motile sperm, tmsc 2.4 million. Not great numbers but the reason I question is for two reasons. Number 1, my appointment was at 1:30 pm this past Monday, my last ejaculation prior to that was 7:30pm on Saturday. Call it a newbie mistake but the scheduling secretary said if it was Saturday I would be set for the appointment Monday. But that wasn’t a full 48 hours 🤦‍♂️ Reason number 2, during the SA, my logistics skills weren’t that great as far as collecting and I missed the first part of the ejaculate and didn’t make it into the cup. Made it onto the perfectly sanitary couch and myself 🤦‍♂️. I’ve been taking bird and be power pack with coq10 for 3 months, I regularly workout, water intake hasn’t been great but not horrible, diet has been 80/20 as far as good whole food. My question is how big of a factor were these 2 issues? For context I have a repeat SA this Thursday. Hoping for better numbers 🤞

We had an mtese done about 2 weeks ago. The mtese was initially unsuccessful but we got a call a couple hours later saying they found three sperm. Tissue is being sent to pathology and we have a follow up appointment to discuss if IVF will be possible but the wait is killing us. I wish I had time to understand more and ask more questions so I wanted to see if anyone else experienced anything similar. I believe they said they were going to continue looking, has anyone elses doctors found more sperm days after their mtese? Did anyone have success when such few sperm were found? We are worried about surviving the freezing. Looking for anyone elses experiences!

Hi everyone,

My wife and I have been trying to conceive for almost 3 years, and I recently had a repeat semen analysis that has completely shocked me.
First semen analysis (22 May 2026):
Abstinence: 3 days
Volume: 2.5 mL
Concentration: 54.8 million/mL
Total sperm count: 137 million
Total motility: 63%
Progressive motility: 49%
Morphology: 4%
At the same time, my total testosterone was 167 ng/dL (below the normal range), so my doctor advised further evaluation.

Repeat semen analysis (21 July 2026):
Abstinence: 3 days
Volume: 3.0 mL
Concentration: 8.0 million/mL
Total sperm count: 24 million
Total motility: 19%
Progressive motility: 17%
Morphology: 6%

What confuses me is how dramatically my sperm count and motility deteriorated in only two months. The abstinence period was the same for both tests, and both samples were collected at the same laboratory.
The only things I can think of are:

I’ve been in Pakistan during extremely hot weather for the past couple of months.

I wasn’t fully erect while producing the second sample (although I believe I collected the full sample).

I haven’t had any testosterone treatment or anabolic steroids.

I’m currently waiting for my repeat hormone results and am planning to see a fertility specialist/urologist as soon as possible.

To be honest, I’m just heartbroken. After three years of trying to conceive, seeing these results has made me feel pretty hopeless.

Has anyone experienced such a dramatic drop in semen parameters over a short period? If so, was there an identifiable cause, and did your numbers recover?
I’d really appreciate hearing your experiences or any advice while I wait to see the specialist.

sperm report parameters

Abstinence - 2 days

- *Volume*: 1.5 ml

- *pH*: 7.5

- *Viscosity*: Normal

- *Liquefaction Time*: 15 minutes

- *Sperm Concentration - 35 million/ml

- *Total Sperm Count*: 52.5 million

- *Progressive Motility*: 15%

- *Non-Progressive Motility*: 14%

- *Total Motility*: 29%

- *Morphology - Normal Forms*: 2%

- *Vitality*: 60%

- *WBC / Pus Cells*: 0-1 /hpf

- *RBC*: Absent

- *Impression*: Astheno Teratozoospermia with ROS

Also I have Varicocele grade 2 and 3 in my testicle.

Can someone tell me if I can conceive naturally with my wife pls?

This is the place for partner's perspectives today.

I posted here awhile back when I found out I had azoospermia. Admittedly, I deleted the post since then. For backstory, been trying for about a year, I’m 31, super low volume, obviously no results considering my diagnosis.

Flash forward a few months and turns out I carry Cystic Fibrosis. Would love anybody’s insight on their experience. I am wondering if my attention should shift to the CF results, but my understanding is you can have a mild/asymptomatic case where it can just really affect fertility. My assumption is that’s where I sit.

Had a scrotal sonography done.

The report stated "the veins enlarge up to 7.7 mm during straining (Valsalva) and measure 5 mm at rest."

Is this a significant size of varicocele?

Hi everyone,

I recently received my first semen analysis results and I’m feeling a bit overwhelmed. I’m hoping to get some insight from anyone who has started with similar numbers or has advice on what my next steps should be.

Here are my results (2-5 days abstinence):

The Basics:

• Volume: 2.6 ml (Normal: 1.5 - 4.0 ml)
• pH: 8.1 (Normal: >=7.2)
• Liquefaction: Complete
• Viscosity: Mild
• Agglutination: None

The Count & Motility:

• Concentration: 1 M/ml (Normal: 15 - 250 M/ml)
• Motility: 28% (Normal: >=40%)
• Progressive Motility: 21% (Normal: >=32%)
• Forward Progression: 2 (Normal: >=2)
• Total Motile: 0.73 M (Normal: >=20 M)

Other Markers:

• Morphology: TFTC (Lab noted: Concentration was too low to perform a morphology or viability assessment)
• Round Cells: 0.05 M/ml (Normal: <2 M/ml)

Obviously, the total motile count being under 1 million is the biggest concern here. From what I’ve been reading, it seems like natural conception or IUI is off the table, and IVF with ICSI will likely be our path forward.

I’m already looking into dietary and lifestyle changes to try and improve my overall sperm health, but I plan on booking an appointment with a reproductive urologist ASAP.

A few questions for the community:

Has anyone started with a count this low and seen significant improvements through lifestyle changes, supplements, or treating a varicocele?

For those who went straight to IVF/ICSI with numbers like these, how was your experience and success rate?

What specific bloodwork or tests should I ask the reproductive urologist to run at my first appointment?

Drs give low hopes on fertility in my specific situation. Any hopes and how to deal with the psycological aspect? High hopes to be a father one day.
Thanks!

over the last 10 years I realized that I’ve had a tendency to hold my piss.. I have a natural instinct to just hold it and constrict my bladder with this learned pattern.. I also never wanted to make a mess when I was a teen when I’d jack off so naturally I found myself doing the same habits.. when I was with my ex I developed phimosis and this turned into more of an insecurity and scared of judgment that I couldn’t piss standing up.. I just now put the pieces together as to why I’ve dealt with this for so long. has anyone had a similar experience and if so did something like this ever occur to you to change habits and did it get better?

I can explain in better detail in dm or here but I think I might’ve actually cracked the code as to why I’m exp this and can undo the damage done

Hi **everyone**,

​I was diagnosed with a 4mm microprolactinoma after finding elevated prolactin levels around 60 ng/mL. I’ve been taking Cabergoline (0.25 mg weekly) from Jan 2026 for about 6 months, and my prolactin levels have now normalized from Feb first week.

​My Journey So Far:

​**January Baseline**: My initial semen analysis came back as OAT (Oligoasthenoteratozoospermia), with a baseline count of just 3.1 million/mL along with reduced motility and morphology.

​**Recent Test:** My latest results show my count has tripled up to 9.4 million/mL, showing that my body is responding well to bringing prolactin down.

​**Current Regimen**: I'm taking CoQ10, Vitamin C, Vitamin E, and daily Tadalafil to support microcirculation and recovery.

​**For those who have treated hyperprolactinemia or secondary hypogonadism:**

​**Fertility Recovery:** For those who started with an OAT diagnosis linked to high prolactin, how long after prolactin normalized did your count, motility, and morphology continue to climb?

​**Physical Traits:** As testosterone levels rebounded post-prolactin, when did you start seeing noticeable gains in muscle mass, body hair, or voice depth/resonance?

​**Success Stories:** Has anyone with a similar starting OAT profile achieved natural conception after long-term prolactin control?

​Would love to hear your timelines and experiences. Thanks!

Well after 3 semen analysis it’s confirmed that there is no sperm found in my sample.
All blood work has come back as normal and well within range so the doctor has suggested PESA to try retrieve sperm directly.

For those that have gone this route, please help with the below:

1. Did you get positive results from your PESA?
2. How painful was it? I’m stressing about this
3. What was recovery like?
4. Any other input is appreciated

Thank you