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Infertility,hypothyroidism,low Semen Count.

Posted on Sun, 20 May 2012

Question: Hi doctor i am 30year old male, having fertility problem since last 2 years.
Test report of Blood test done for FSH,LH ,Proclatin ,testosterone done in nov 2009 is as below
FSH - 12.43 mIU/mL Reference range 1.7-12.0 mIU/mL
L.H.- 2.4 mIU/mL Reference range 1.1-7.0 mIU/mL
Proclatin serum -9.58 ng/mL Reference range 3.46-19.40 ng/mL
Testosterone -285.4 ng/dl. Reference range 166-877 ng/dl
The test report for the semen was showing NIL sperms .
After repeated 2-3 semen test in a period of 6 months & consulting urologist the result was same .
i visited to mumbai(india) for treatment & the doctor suggeted to do the test again .however in the test for FSH,LH,Testosterone,TSH was aslo done by LAB
the report is as below
FSH 13.69 mIU/mL reference range 1.4 to 18.1 mIU/mL
TSh 65.05 microIU/mL
and so i was deteded Hypothyroid & consulted endocronologit for treatment & started taking Eltroxin 100 mcg . The doctor also prescibed calcium 500 ,Folic acid tablets, vitamic C 500 & repeat test for semen & thyroid after two months .The results of test results after two months are as below

Time of Collection 12 : 00 Abstenance Period 5 DAYS
General Examination Chemical Examination
Volume 3 ml PH 7.6
Colour Greyish White
Occult Blood ABSENT
Viscocity NORMAL Fructose POSITIVE
Liquification 30 min
Microscopic Finding
Sperm Count 50-100sperms/ml
Clumping ABSENT
Motility 50 % ,Cellular Debris ABSENT
Total Amo.Part Debris ABSENT
Grade I 50 % Agglutination ABSENT
Grade II 10 % Abnormalities In
Grade III 30 % Head 25 %
Grade IV 10 % Neck 15 %
Morphology Tail 20 %
Normal 40 %
Abnormal 60 %
Wet Amount
Pus Cells 4-5 / hpf
RBS ABSENT
Epithelical Cells 2-3 / hpf
Gram Stain NO ORGANISAMS SEEN

FSH- 19 mIU/mL
Testosterone-400 ng/dl
The level of T3,T4 & TSH are now normal .

my main concern is now semen count and morphology .
there are dead soerms in my semen & count is too low (but much better than NIL )
Kindly see my semen test report & suggest the reason of problem & how it can be cured.

Answered by Dr. Pragnesh Vachharajani (37 minutes later)

Dear XXXXXXX

Thanks for your query.

The good part about your problem is that you got a diagnosis.In many of the couples who are affected infertility the diagnosis always a mystery with every test coming normal.

First of all I think with thyroid now under control you sperm count should improve.There are many reason for low sperm count.The common set of reasons are
1.Hormonal deficiency
2.Drugs
3.Alcohol,smoking
4.Stress in today`s era,strenuous exercise
5.Local problems like varicocele,infection etc.
6.Trauma
7.Recent history of viral infection like mumps etc.
8.And some local surgical problems.

Since you have already visited a urologist he must have look for surgical reasons.

You should continue the drugs as advised,take good nutritious diet.Keep regular follow up with your doctor.

Do consume foods XXXXXXX in Zinc and selenium. They are known to help in sperm production.

In mean time you can keep trying naturally.In some cases where sperm count is low,the doctor may advise some assisted technique like Intrauterine insemination(semen is directly put inside) or later on In-vitro fertilization(I.V.F.).

Please follow this for some months and I hope thing should be fine.Stress is a big factor for infertility,so please try to avoid it.Age is still on your side,as you are still young and I see bright chances for you.

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

All the best and regards.

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

Follow up: Dr. Pragnesh Vachharajani (24 hours later)

i want to know whether there is any abnormality in semen test report except sperm count and morphology .is ther any indication of infetion?
My testicular examination was normal and ultrasound was also normal.
is there any test to further determine the root cause and where it can be done .
i am non alcoholic ,non smoker any does not have any bad habits .hypothyroid has caused fatigue in my body and i want to get same activeness as 10 years back . what exercise can be recommended & kindly advice what diet i should take for Zinc ,selenium and other required elements ?

Answered by Dr. Pragnesh Vachharajani (9 hours later)

Hi XXXXXXX

Good to see you back.

There is no abnormality in sperm report except the sperm count.Presence of pus cells to this extent does not need any treatment, there is no significant infection.

Most of the tests done are normal for local examination related to low sperm count.Wait before going for further test.Ultrasound ans semen analysis are good enough to find a cause.At this point of time, I would not recommend any further tests.

It is good that you are not having any addiction.Please take following in your diet that will help to increase sperm count as well as your weakness.

1.Beans,nuts,whole grains,dairy products are XXXXXXX in zinc
2.Have more of tomatoes,water melon,papaya
3.Fruits like strawberry,orange,grape fruits

This are indicative things,this will help in natural way increasing the number of sperms.Your doctor may prescribe the tablets having this vitamins and minerals.

You can also try relaxation technique like yoga,which will help to control stress.In nut shell,healthy natural diet consisting of variety of fruits,vegetables will definitely help.Avoid junk food .Watch for your weight,it should be normal.

Do regular exercise like walking.

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

Regards.

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