Just received a second-to-last semen analysis prior to M-tese scheduled for late October. I take this as a somewhat positive note, has anyone had a similar result in an SA, and if so what was your M-tese result? Thanks !

Numbers

Testicles 2.1 and 2.0 ML (very small)

Test 29.05

FSH 16.68

LH 6.4

Estradiol 136

No genetic issues

This has now been with 5 months of tamoxifen (30 mg every other day).

Hi Everyone, my husband ( 37 M) and I (33 F) have been trying for a baby only for 2 months and we recently got baseline tests done. My AMH is 1.03 and I had only 7 total antral follicles on day 2 scan. Our fertility doctor scared the heck out of us, she said our time is running out and told us to at least start with a medicated IUI.

My husband's Semen Analysis reports came and it is worrying us. He has only 3% normal morphology sperm (Teratozoospermia) and 38% progressive motility. But Rapid progressive type are 0%, all of them are slow progressive.

He is a non alcoholic, non smoker. He does not take hot baths and makes sure he does not keep laptop on his lap. He puts a pillow between his legs while sleeping. He however takes statins for cholesterol and does not get good sleep due to restless legs. He probably sleeps around 4-5 hours only. We are vegetarians.

Is there any way we can improve these numbers? Are these numbers bad? Should we be concerned about the future IUI sessions? If they don't work should we go for IVF or can we try naturally for a few months?

First time posting here. Wife and I have been trying for 16 months. After about 4 months I had a semen analysis. I was diagnosed with severe Oligozoospermia. Also was told I had a varicocele in my left testicle so had a surgery to remove that. 3 months post surgery and there was no change in the semen analysis results.

Next week I have a viability test to see if, although my count is low, there are any viable sperm that can be frozen to use for IVF. If this test has negative results, I seriously fear my wife and I will lose all hope. The next step after this will be an mTESE. Another surgery. Another day of my wife being there by my side but panicking and spiralling on the inside.

I feel sick to my stomach that I am the cause of us not being able to conceive. I found some notes in a diary my wife keeps saying how constantly down and depressed she is. And that she loves me more than anything but it is so hard for her to accept that she can’t have a baby due to no fault of her own. All we want is a healthy baby and I can’t provide that for her.

this is a continuation post to a how i just keep winning the lottery on everything going agains me .
parent post : https://www.reddit.com/r/maleinfertility/s/e1jNXL985A

Hi everyone,
I’m trying to understand a genetic finding from my infertility workup and would especially appreciate input from anyone with experience in male infertility, reproductive genetics, AMH mutations, or Persistent Müllerian Duct Syndrome (PMDS).

I have non-obstructive azoospermia (NOA) and previously had a testicular biopsy showing Sertoli-cell-only syndrome (SCOS) seminiferous tubules containing Sertoli cells but no germ cells identified in the sampled tissue.

My hormonal picture includes:
FSH: ~30 mIU/mL (elevated)
Testosterone: ~710 ng/dL
AMH: previously 1.46 and 2.18 ng/mL
Inhibin B: previously ~202 pg/mL

I recently had whole-exome sequencing. No established genetic cause for my NOA/SCOS was identified, but it found a heterozygous likely-pathogenic AMH variant:
AMH NM_000479.4:c.476dup
p.(Glu160Argfs*14)

This is a frameshift/predicted loss-of-function variant.
My understanding is that pathogenic AMH variants classically cause Persistent Müllerian Duct Syndrome type 1 (PMDS1), which is autosomal recessive. Since only one pathogenic AMH allele was identified, I would normally be considered a carrier rather than someone with PMDS.

What I’m trying to understand is whether there is any evidence that heterozygous AMH loss-of-function variants can affect adult Sertoli-cell function or spermatogenesis, even when they aren’t sufficient to cause classic PMDS.

In particular, I’m curious whether anyone has encountered:
Heterozygous AMH mutations in men with NOA or SCOS.
Evidence that partial AMH loss/haploinsufficiency affects germ-cell development or maintenance.

Men with AMH/AMHR2 abnormalities who had normal testosterone but severe spermatogenic failure.
Cases where WES initially found one AMH variant and later WGS/other testing identified a second variant.
Any evidence that AMH variants influence micro-TESE sperm retrieval.

I’m not assuming the AMH mutation caused my azoospermia. My genetics report itself categorized it as a gene possibly associated with my phenotype rather than an established explanation. I’m mainly trying to determine whether this is likely an incidental carrier finding or whether there is emerging evidence connecting heterozygous AMH loss-of-function to severe spermatogenic failure.

I am repeating AMH and inhibin B now and also undergoing additional genetic testing.
Would particularly appreciate papers, case reports, or experiences with a similar genotype/phenotype.

thanks

Hi everyone,

I (Male, 39) recently dug up my old medical reports from 2021 and am finally tackling this topic again after a 6-year break. I am planning to see an andrologist soon for follow-up tests and am considering undergoing a TESE (Testicular Sperm Extraction).

Back then, my findings were as follows:

*Diagnosis: Azoospermia.

* Hormones: FSH elevated at 15.21 U/I, Testosterone at the lower limit with 2.85 ng/ml.

* Testicular volume: Approx. 6 ml on both sides.

* Genetics: Chromosome analysis (46,XY) and AZF microdeletions completely normal.

Previous plan: I was prescribed Anastrozole (1 mg) back then, but I never really followed through with it consistently.

Now I am wondering how I should proceed and what my chances look like:

- What do you estimate my chances are? With an FSH of 15.21 and a testicular volume of 6 ml each, is a TESE still worth a shot after all these years? Are there any success stories with similar values?

- Direct TESE or medication first? Should I go straight for a TESE or try to optimize hormone levels first (e.g., using Anastrozole for a few months) to improve the chances of finding sperm in the testes?

- Lifestyle & Supplements: Do weight loss, exercise, or specific supplements (like CoQ10, Zinc, Selenium, etc.) actually help in a case like this, or is that more of a drop in the ocean given the underlying primary testicular insufficiency?

Looking forward to your input and experiences!

Hi everyone,
I recently had a semen analysis and I’m particularly concerned about the morphology result. I also want to mention our pregnancy history, because we have experienced several very early pregnancy losses, and I’m wondering whether there could be any connection with my semen analysis.
RESULTS
Volume
3.6 mL ≥ 1.4 mL
pH
7.2 ≥ 7.2
Days of abstinence
3 days - 2–5 days
Liquefaction
20 min -20–30 min
Appearance
Homogeneous -Homogeneous
Viscosity
Normal -Normal
Agglutination
Absent - Absent
Sperm concentration (sperm/mL)
56 million/mL ≥ 16 million/mL
Total sperm count (sperm/ejaculate)
201.6 million ≥ 39 million
Motility assessment possible
Yes -Yes
Progressive motility (PR)
43% ≥ 30%
Non-progressive motility (NP)
4%
—
Total motility (PR + NP)
47% ≥ 42%
Immotile (IM)
53%
—
Normal forms
1% ≥ 4% normal sperm forms
Abnormal forms
99%
—
Head defects
99%
—
Midpiece (neck) defects
0%
—
Tail defects
0%
—
Leukocytes
1.6 million/mL < 1 million/mL
Round cells
0 million/mL
—
Germ cells
0 million/mL
—

Regarding our pregnancy history:
● July last year: pregnancy loss at around 5 weeks.
● July this year: pregnancy loss at around 4 weeks.
● August this year: pregnancy loss at around 4 weeks.
So we have had three very early pregnancy losses.

And most importantly, do you think we still have a good chance of having a healthy pregnancy naturally despite the 1% morphology and our history of very early pregnancy losses?

Estradiol (E2): 24.3 pg/mL Reference range: 24.2–62.1 pg/mL

FSH (Follicle Stimulating Hormone): 30.4 mIU/mL Reference range: 1.5–12.4 mIU/mL

FT4 (Free Thyroxine): 1.23 ng/dL Reference range: 0.9–1.75 ng/dL

FT3 (Free Tri-Iodothyronine): 2.4 pg/mL Reference range: 2.0–4.2 pg/mL

LH (Luteinizing Hormone): 16.5 mIU/mL Reference range: 0.5–12.4 mIU/mL

Progesterone: 0.68 ng/mL Reference range: 0.21–2.1 ng/mL

Prolactin: 30.8 ng/mL Reference range: 2.52–13.23 ng/mL

Total Testosterone: 681 ng/dL Reference range: 171–789 ng/dL Status: Normal

Im seeing a urologist tomorrow, i just want to understand what the concerning markers are indictive of?

Context: Workout heavy lifting 4-5 times a week, sleep is a little disruptive prior to the blood test, work and life factors slightly underlying and stressful

No active symptoms i.e. low libido, fatigue, nipple discharge or anything

No active injuries or previous history of steroids

Any advice, suggestions or anything else would be much appreciated

Hey Guys, I wanted to introduce myself. Ive been reading your stories and questions for a few months and Ive even responded to some. I spend a lot of my professional life talking to men about fertility as a urologist.  But this is one area of medicine where I’ve also had the experience of sitting on the other side of the table. My wife and I went through IVF twice to have our children, so when I talk to men going through this process, I’m not speaking only as their doctor. I’m also speaking as a husband and father who remembers exactly what it felt like to be in it. I remember the injections, appointments, procedures, and waiting. I remember wondering how many eggs we would get, how many would fertilize, etc, etc.  I remember watching my wife carry most of the physical burden and doing my best to maximize my SA. I also really remember the failure we had and the loss of cycles. Believe me, being a urologist didn't somehow make IVF easy. Knowing the medicine didn't take away all the anxiety, disappointment or feelings. Ive been there with you.

That experience is a big part of why I’m here. I’m a urologist, but I’m also a member of this club of men who have gone through IVF, and it's a club most of us never expected or wanted to join. Male infertility and IVF can be incredibly isolating because so much of the process understandably revolves around what our wives and partners physically endure. As men, we often respond by trying to become the steady one, the person who stays positive, goes to work, tells everyone we're fine and keeps moving forward. Meanwhile, we also may be worried or have emotions.  I’ve felt some of those things too. So I'm here to answer questions when my experience as a urologist can help, but I'm equally here simply to support the guys going through it.  So, just saying hello and hope I can help a little on this journey. All the best guys, stay positive!!

I was having pain in my testicles...so i went to the urologist he suggested i should get a USG done..and also do a semen analysis I did that and usg shows varicocele grade 1 to 2 ....i showed that to my urologist he said it's not an issue...but my semen report is not good..he gave me medicine for that...the question that i am trying to ask is that does anyone here has this issue..? .and is surgery necessary for every varicocele? And will it affect my marriage in the future? Or it get ok on its own

My wife and I have been struggling with infertility issues for over 3 years now. After some testing, it turns out that I was the problem, low testosterone and low sperm count. I’m not even in my 30s yet. I never thought I would have issues like this, or that it would impact my life the way it has. Everyone of our siblings has children, almost all of our friends have children, all the social media we get is about being parents, even the bible groups at church for our ages are usually just new parents talking about being parents. The emotional toll it has taken on my wife and I cannot be understated. Over 36 months of hopeful waiting only to see another negative. We’ve taken to going out of town on Mother’s Day and Father’s Day the last 2 years, it’s just too hard. Don’t get me wrong, I love my nieces and nephews and I’m in no way upset at anyone for our struggles, it just is a bit too much to handle. On top of this I do not have a great support on my side of the family (they just don’t contact me other than once a month or so to say they miss us), and we’ve been living with her parents for the last 2.5 years as we are trying to save for a home. I feel like less than a man. I feel like a failure. Everyday. No matter what I’ve been doing. More than once a week I have to hold my wife as she cries and it has shattered my heart into pieces. I wasn’t very religious before I met my wife, but she made me a believer in Christ Jesus. I strive to remain positive and grateful for all that we do have and not dwell on what we haven’t gotten yet, but some days are worse than others. Like today.

Sorry for the rant, but I really don’t have anyone else to vent to. Have a good day.

I'm 30M and my wife is 28F. We've been trying to conceive since October 2025 and started fertility treatment in February 2026.

I've had 3 semen analyses this year, and I'm concerned because some of my parameters seem to be getting worse over time.

Semen Analysis #1 — February 2, 2026

Volume: 1.0 mL

Concentration: 120 million/mL

Total sperm: ~120 million

Active motility: 70%

Sluggish motility: 10%

Dead: 20%

Total motility: ~80%

Morphology: 20% abnormal → ~80% normal

Viscosity: Normal

Liquefaction: 25 minutes

Pus cells: 1–2

RBC: Nil

Bacteria: Nil

Immature germ cells: Nil

At this point my lifestyle was actually pretty bad. I was heavily using cannabis, eating a lot of junk food, drinking soft drinks and eating a lot of sweets. I wasn't exercising.

Semen Analysis #2 — August 2, 2026

After making major lifestyle changes starting June 3:

Quit cannabis and other smoking

Started going to the gym 5x/week

Started eating much better

Eating chicken/eggs regularly

Drinking much more water

Taking creatine + whey protein

The results were:

Volume: 1.0 mL

Concentration: 70 million/mL

Total sperm: ~70 million

Active forms: 25%

Sluggish forms: 35%

Inactive forms: 40%

Total motility: ~60%

Morphology: 70% normal / 30% abnormal

Viscosity: Viscous

Liquefaction: Prolonged — took >1 hour

Pus cells: 1–2

RBC: Nil

Epithelial cells: Nil

Spermatogenic cells: Present

pH: 7.5

This is where I became concerned because concentration dropped from 120 → 70 million/mL and motility from ~80% → ~60%, despite my lifestyle being significantly healthier.

The semen was also noticeably much thicker and took over an hour to liquefy.

IUI sample — August 31, 2026

I had an IUI performed.

Before sperm preparation:

Abstinence: 3 days

Volume: 1.0 mL

Concentration: 55 million/mL

Total sperm: ~55 million

Total motility: 30%

Progressive: 5%

Non-progressive: 25%

Morphology: 2%

Agglutination: Grade II

Aggregation: Grade II

Pus cells: 4–6

After density-gradient preparation:

Volume: 0.7 mL

Count: 30 million

Motility: 95%

Progressive: 85%

Non-progressive: 10%

Morphology: 2%

Agglutination: Nil

Aggregation: Nil

Pus cells: Nil

The huge improvement after washing is confusing to me. Raw progressive motility was only 5%, but after preparation it was 85%.

I'm 30 and honestly pretty worried that my fertility is deteriorating. I'd really appreciate input from anyone.

It wasn't until a few years after we got married that I was given a diagnosis of having a low sperm count and poor motility. Ever since then I've had a go at various medications and supplements, made some changes to my lifestyle and undergone several rounds of treatment, but the outcomes have been inconsistent.

The real difficulty, to be honest, hasn't merely come from the treatments, it's the continual questions from family and friends as to when we're having a baby. Since we've been married for five years, there's always this pressure at every family get-together....

Although people generally have good intentions, they don't know what it's like to receive those questions while you're already having difficulties all on your own.

How did you cope with the social pressure when dealing with male infertility and avoid feeling as if you were failing in your role as a husband?

This is the place for partner's perspectives today.

Hi everyone,

I (Male, 39) recently dug up my old medical reports from 2021 and am finally tackling this topic again after a 6-year break. I am planning to see an andrologist soon for follow-up tests and am considering undergoing a TESE (Testicular Sperm Extraction).

Back then, my findings were as follows:

* Diagnosis: Azoospermia.

* Hormones: FSH elevated at 15.21 U/I, Testosterone at the lower limit with 2.85 ng/ml.

* Testicular volume: Approx. 6 ml on both sides.

* Genetics: Chromosome analysis (46,XY) and AZF microdeletions completely normal.

Previous plan: I was prescribed Anastrozole (1 mg) back then, but I never really followed through with it consistently.

Now I am wondering how I should proceed and what my chances look like:

- What do you estimate my chances are? With an FSH of 15.21 and a testicular volume of 6 ml each, is a TESE still worth a shot after all these years? Are there any success stories with similar values?

- Direct TESE or medication first? Should I go straight for a TESE or try to optimize hormone levels first (e.g., using Anastrozole for a few months) to improve the chances of finding sperm in the testes?

- Lifestyle & Supplements: Do weight loss, exercise, or specific supplements (like CoQ10, Zinc, Selenium, etc.) actually help in a case like this, or is that more of a drop in the ocean given the underlying primary testicular insufficiency?

Looking forward to your input and experiences!

Hi everyone,

Getting married in the coming months and going to want to conceive. I’ve been on TRT for years, I’m 34.

I started HCG a few months ago. I did my first SA out of curiosity and it came back with 2.5 M/ml. Obviously far below ideal ranges. I also had virtually no motility.

I’ve heard some people say they’ve been able to conceive on TRT and HCG - I’m guessing that likely won’t be for me.

Anyone ever come off and switch to enclomiphene for better results? Did this to myself so while discouraged, only myself to blame here.

My wife (36F) and I (37M) have been trying for ~6 months. Her fertility tests (AMH, FSH, LH, etc.) are okay.

My testosterone/LH/FSH were poor in June, but after Clomid, CoQ10, L-carnitine, etc., my repeat bloodwork on Aug 25 showed significant improvement.

My June semen analysis at FlowLabs was also not great:

- Volume: 1.44 mL

- Concentration: 14.44M/mL

- Total sperm: 20.79M

- Progressive: 32.05%, Non progressive: 10.36, Immotile: 57.59, Total motile: 42.41

I'm already scheduled for a repeat semen analysis at FlowLabs on Sept 14.

Today, Trio recommended their semen analysis with DNA fragmentation testing for $350 out of pocket. They don't have my previous results yet.

From what I've read, ASRM doesn't recommend sperm DNA fragmentation testing as part of the initial infertility evaluation.

Would you pay the $350 now, or wait for my repeat standard semen analysis and decide based on those results? Is DNA fragmentation actually useful/necessary in my situation?

Would especially appreciate experiences from anyone who has dealt with Trio or DFI testing in Canada.

34 year old male healthy male looking for advice. Wife and I have been trying to get pregnant for 1.5 years now. I’ve had a grade 3 left Varicocele for as long as I can remember. No pain, maybe a slight ache here and there. Went to see a urologist, gotten all the tests necessary. Urologist told us I have azoospermia and having birth naturally is not possible. I addressed the Varicocele since I expected surgery. He states, that’s probably not the main cause of the azoospermia. He suggested getting microsurgery and a microTESE to begin the process of IVF. I really wanted the microsurgery or embo to see if the Varicocele can bring sperm back before even IVF. I was really optimistic on having natural birth but it seems like that might not be a possibility with my Semen analysis results being that terrible. If anyone has any experience about this please let me know. Would love an expert opinion. Should I get both surgeries? Or should I risk just getting the microsurgery to repair the varicocele and see what happens after?

Semen Analysis: volume - 5.3 Total count 0.53 Total concentration 0.1 %Motile - 0
FSH - 7.5
LH - 3.5
Prolactin - 10.2
Testosterone - 568
Karyotype - normal

Before marriage with masturbating it was fine. I tend to get erection and few drops of fluid don't know if it is ejaculate or pre ejaculate fluid followed by a sense of pleasure.

Once I got married I still get erection but it just ends here, I can't ejaculate nor reach orgasm, either by sexual intercourse or even masturbating. I tried to get semen analysis 3 times at lab and failed all of them. My wife got frustrated and left the home. I feel like my life is getting ruined and I don't know how to solve this. She said she won't return to home until I manage to perform a semen analysis which I keep failing.

My hormonal assay , pelvi abdominal and scrotal us came out fine. All hormonal assay is normal, scrotal us showed only bilateral varicocele which doctors said they have no role in this.

How to solve this issue ?

Hi everyone, I'm 29M and currently undergoing fertility evaluation. My wife has ADPKD, and because there is a risk of passing it to our child, we decided to go with IVF/ICSI + PGT-M.

Before moving forward with IVF, I had a semen analysis.

Semen analysis Volume: 2 mL Abstinence: 3 days Sperm concentration: 7.7 million/mL Motility: 0% Vitality: Not tested

A second manual examination reportedly found very few sperm, including occasional motile and non-motile sperm, but I'm not sure how reliable that examination was.

Hormone tests FSH: 2.7 mIU/mL LH: 5.39 mIU/mL Total testosterone: 521.5 ng/dL Prolactin: 11 ng/mL TSH: 2.03 µIU/mL

My Vitamin D was also 16 ng/mL.

Scrotal ultrasound with Doppler Right testicle: 4.5 × 2.8 × 2.1 cm Left testicle: 4.2 × 2.8 × 1.6 cm Normal testicular appearance Normal blood flow No varicocele Small 6 × 3 mm left epididymal cyst Minimal right hydrocele Spermatic cords reported as normal No obstruction reported

The radiologist also told me during the scan that there was nothing concerning and no obvious obstruction.

However, my doctor suspects an obstruction and has suggested TESA.

The radiologist told me there was nothing concerning and there is no obstruction and this case However, my gynec doctor suspects obstruction and has suggested TESA.

Would it be reasonable to repeat the semen analysis with vitality before doing TESA, and get a second opinion from an andrologist/ male-infertility specialist?

I'd appreciate experiences from anyone who has dealt with 0% motility, low sperm count, suspected obstruction or TESA.

Update: I have updated all units in reports

Hi All, I’m 34M trying for our 1st kid from past 8 months. Today I have my sample for semen analysis and the reports have come. Can anyone tell me if there is any problem in the report and any suggestions on fixing the problems.

34M | Semen Analysis | TTC

Abstinence: 4 days

SEMEN PARAMETERS
-------------------------
Volume: 4.5 mL
Liquefaction time: 20 minutes
Viscosity: Normal
Appearance: Grey opalescent
pH: 7.4
Epithelial cells: Present
Cell debris: Present
Leukocytes: 1–2/HPF

SPERM PARAMETERS
-------------------------
Sperm concentration: 9 million/mL
Total sperm count: 41 million
Total motility: 46%
Total progressive: 36%
Rapid progressive: 0%
Slow progressive: 36%
Non-progressive: 10%
Non-motile: 54%

MORPHOLOGY
-------------------------
Normal forms: 2%
Abnormal forms: 98%
Head defects: 52%
Neck & midpiece defects: 28%
Tail defects: 18%

Lab impression: Oligoteratozoospermia

I’m currently taking 40 mg of testosterone and 120 mg of Clomid per week. My wife and I are trying for a baby, and I asked my doctor for a semen analysis, but he doesn’t think I need one.

Has anyone been able to conceive while on a similar protocol? Should I push for the semen analysis anyway?

This is the place for partner's perspectives today.

Hey people, any expierence with DR Johnathan Ramsay from London. I go to visit him for FNA testicular mapping. Any good review from Lister hospital or general? Thanks.