Sir my age is 25. Height 5 ft 11 inch. Weight 82 kg. Unmarried.from 2 years I was having problem of numbness and tinging in whole body, bone and muscle pain, muscular weakness in whole body, chest enlargement and belly fat enlargement, frequent urination, high blood pressure 150/100. Many doctors advised me many medicine but no one worked for me. I was also noticing a huge reduction in my testis size. All my test were clear except serum testosterone was low every time i.e 241 ng/dl (in hypogonadal range. All problems are increasing with time. Few days ago I met to an urologist who is M.CH in urology. He understand my problem of low sr testosterone and asked mw to get test done like semen analysis, FSH and LH and ultrasound of scrotum. So I had all my test on 17/7/2017, FSH was 6.26mIU/mL (range 0.67 to 11. 7mIU/mL), LH was 1.29mIU/mL (range 1.9 to 12mIU/mL) and serum testosterone was 249 ng/dl (range 240 to 820), semen analysis shows azoospermia (volume-3.5 ml, sperm - nil, colour - greyish white, viscosity- normal. Then he saw the test and asked me to again do that test for confirm analysis, ultrasound shows left testis volume 8 cc and right 9 cc. So on 24/7/2017 I again had those test report, it shows FSH was 11. 07mIU/mL (reference 0.67 to 11.7),LH was 2.29mIU/mL (reference 1.9 to 12) and serum testosterone was 306 ng/dl. Transrectal ultrasound shows normal study. Prostate size 13. 4 cc.Then doctor take me to checkup room. And see my testis saying that these are small in size but not flabby, he said vas deferens is observable means it is there, epdidimis also there. Then he said he suspect it as case of NON-OBSTRUCTIVE AZOOSPERMIA. Then at last he asked me to get FNAC of testis and said then he will plan further. But I did not get fnac done because I am scared of the pain. So I want to ask you that if had a case of testicular failure, will I be able to marry in future and able to do proper sex. As I heard testosterone are very essential for erection. And if there will be hormonal failure will I be able to enjoy sex life or I will live alone?
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In case of testicular failure, you can have erection and have sex and can have happy married life.
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Before proceeding any further I would say stick to the urologist who is treating you! He has done a terrific work up and reached the diagnosis! If you are having nocturnal erections you would be able to perform the coital act but wouldn't father a child! Don't waste your time and money else keep busting the good urologist who is treating you.
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I can see that you are under the care of a very good Urologist and you must continue to consult him for the testicular issue. Now let me give you the Endocrinology (hormonal) perspective with respect to your "Low Testosterone" level. In a case such as yours, I would undertake a comprehensive evaluation of all associated hormones and metabolic parameters and treat the insufficiencies, if any. All this along with positive lifestyle changes. In many cases we are able to increase Testo levels without actually having to give exogenous Testosterone. If the above does not result in achieving satisfactory levels of Testosterone, I would consider Testosterone replacement Therapy (TRT) not so much for the sexual benefit but for ensuring good health at multiple levels in the long term. My preferred method of TRT is through use of transdermal cream. Whether you will be able to father a child or not is a completely different issue which will have to be addressed separately.
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