Dear Soroush,
Thanks for the interest and reply.
Thats for sure that he has some hormonal imbalances and azoospermia as well.
his Testicular FNAC reports read as follows.........
"Smears from both testis show similar morphology. The smears show predominantly Sertoli cells and Leydig cells. Few spermatogonia are seen...............
Impression:- Few dead sperms are seen in the right side only.ICSI sugessted."
And rest of the hormonal reports are.....
Prolactin 9.9 ng/ml Normal 4 - 12 ng/ml
TSH 1.9 mIU/ml 0.4 - 6 mIU/ml
Testosterone 1.2 ng/ml 2 - 6.9 ng/ml
FSH 1.4 mIU/ml < 22 mIU/ml
LH 1.8 mIU/ml 2 - 15 mIU/ml
His USG Scrotum with colour doppler reads as .....
Normal testis and epididymis. Bilateral mild Hydrocele.
For him to have an erection while awake has been a very rare phenomena. Occasionally he gets some scanty ejaculation while sleep only.......and thats like once a month.He feels no sensation as pleasure with an erection.
For now i have prescribed him a dose of LYCOPODIUM 200 and placebo for two weeks.
There bieng no question of a sperm count or sperm analysis since there is no ejaculation.
A very strange case indeed.
Regarding him having sex with his wife, he says there is no desire and / or pleasure but he still manages to let his wife feel OK but thats once a month maybe perhaps owing to his inability to have a sustained erection. But now the wife wants a child.
Any insights......?
Thanks and warm regards.
Vivek
Message 11
From: "Finrod"
finrod@webstar.co.uk
Date: Mon Apr 10, 2006 1:23am(PDT)
Subject: Re: Azoospermia
Dear Vivek
I do not think this is a case of Azoospermia. Pls see
http://www.malefertility.co.uk/azoospermia.html
"Azoospermia is the complete absence of sperm in the semen and as such
means
that a man will be completely infertile. The diagnosis of azoospermia
is
sometimes still made even though as many as 500,000 sperm per ml of
semen
may have been seen because it is extremely unlikely that the man will
be
able to father a child naturally with this number of sperm. Its
incredible
to realise that millions are needed for any chance of natural
conception!"
It is normal that a 'normal' man should ejaculate at least once in a
while
(this depends on age - for a 35 year old, I would expect approx every
two
weeks) even without sexual stimulation and usually in his sleep. He
should
also achieve an refection from time to time, with or without sexual
stimulation. This happens even to men who have had a vasectomy and is
independent of sperm count as such.
The fact that you say this man has not ejaculated nor experienced any
orgasm
is indicative of perhaps a hormonal problem.
It is interesting that he has married.
Can he achieve an refection?
Does he have sex with his wife?
So lots of questions for you to ask delicately.
Good luck
Soroush