**Post micro-TESE, waiting on pathology**

34M, NOA. Normal karyotype, no Y microdeletions, total testicular volume around 11.7 cc.

**Hormones at baseline (March 2026, before any treatment):**
- Total T: 314 ng/dL
- FSH: 35.5 (high, range 1.4 to 18.1)
- LH: 18.01 (high, range 1.5 to 9.3)
- Estradiol: 63

**Protocol (all of it running right up to surgery day):**
- Anastrozole 1 mg daily, started March 23 — about 7 months
- hCG 2000 IU three times a week, started early April — about 6.5 months
- rFSH 75 IU three times a week, started July 20 — exactly 3 months

I pushed for the rFSH myself. The hCG had suppressed my own FSH to almost nothing, and I didn't feel I had run a complete hormonal trial without addressing the FSH side before agreeing to surgery.

**Hormones on protocol (June 2026):**
- Total T: 548 ng/dL
- FSH: 0.9 to 1.2 (suppressed by the hCG, not an improvement in my own production)
- LH: 0.19 to 0.55 (same, suppressed by hCG)
- Estradiol: around 49, which my urologist wanted held in the 40 to 60 range

So testosterone responded well, but the low FSH and LH after treatment are just the hCG shutting down my own pituitary signal. My baseline FSH of 35.5 is the number that mattered, and it pointed to testicular level failure from the start.

**Sperm searches:** Semen analysis July 7, zero. Extended sperm search at Maze September 17, two specimens, both centrifuged, AI assisted search, zero recovered.

**Micro-TESE today:** Overall, today went really well. My medical team was amazing from start to finish. The anesthesiologist, the nurses, and my urologist all took good care of me and made me feel at ease.

They took samples from both the left and right testicles. It sucks that the doctor couldn't see any sperm during the surgery, but the tissue is going to the lab to be broken down and checked more thoroughly. We're hoping something turns up in pathology. I'm still hopeful.

At the same time, I don't feel bad. This has been a long time coming, and whatever the result is, I'll accept my fate. I'm also still coming off the anesthesia, so I think the emotions just haven't hit me yet.

**Recovery so far:** The pain feels like a kick in the stomach. They have me alternating ibuprofen 600 mg and Tylenol 325 mg, plus ice and rest.

My fiancée has been by my side the whole way. She's my best friend and my partner in crime, and I couldn't do this without her.

To anyone else going through this, you're not alone. I'll update when pathology comes back.

Hello, I had a varicocele surgery mainly to try and fix my infertility and low sperm counts.

As I recover now post surgery, I am looking to do everything in my control to help improve! Keeping a healthy diet and working out when I’m allowed to. On top of that my Dr recommended taking a supplement like Conception XR if I wanted to. Although he said there’s no strong proof it works, but it can’t hurt to take.

Looking into it it seems pretty expensive compared to other supplements and the ingredients don’t seem like anything unique, just high concentrations of Vitamin C, D, E, folate, zinc, and selenium.

Was wondering if people used this and found success or if there are good alternatives I should look into?

Thank you!

Been trying a few months and no results yet. Here's my results. Thoughts on if I should be concerned?

Time of Analysis
09:41

Container Type
Sterile Cup

Collection Method
Masturbation

Viscosity
Normal

Normal
Color
Clear

Agglutination
N/A

Cells
+3

Volume
4.1

mL
1.5-7.6
Concentration
11.3 (L)
mill/mL
15.0-259.0
Total Count
46.3
10/15/26 4:37 PM
Vol X Conc

Million
39.0-298.0

Motility
55.0

%
40.0-81.0
Grade of Motility
1.5 (A)

>2.5
Total Motile Count
25.5
10/15/26 4:38 PM
Total Count X %Motility

Kruger Strict Morphology
3 (A)
%
>4

Hi All,

I am 32M

Below are my params

Sperm concentration: 34 million/mL

Total sperm count: 119 million

Progressive motility: 15%

Normal morphology: 2%

Sperm DNA Fragmentation Index (DFI): 27% (SCSA method)

High DNA Stainability (HDS): 5%

FSH: 2.37

LH: 3.55

Prolactin: 17.11

Grade 1 varicocele right side

Right epididymal head measures 0.8x0.7cm and appears normal in size with regular contours and homogenous echogenicity with a cyst measuring 2x1.9mm noted within

Grade 3 varicocele left side

E/o multiple dilated venous channels measuring approx. 2.5 to 2.8mm, 2.7 to 2.9mm and 2.7 to 3.0mm in the cord, lateral and basal aspects of left testis and showing reflux on Valsalva.

Initially I was thinking of going for micro surgery varicocele but my family insisting on going for IVF/ICSI directly (my wife is ready). I read somewhere like urologists are recommending this to make money and in somecases i heard like the parameters did not improve post surgery.

I am confused now what should I do now ? If you gone through the same situation what you did and why ? Please share your experiences.

This is the place for partner's perspectives today.

I'm a 70-year-old man who recently purchased two LabCorp at-home sperm tests.

I followed the instructions carefully on both occasions, including allowing the semen to liquefy for 30 minutes and swirling the sample around the collection cup to contact the testing chemicals.

Neither test produced any visible result at all. No positive line, no negative line, nothing.

My semen volume was relatively low (under 1 mL), but I was able to complete the collection process.

Has anyone experienced this with the LabCorp home kit? I'm particularly interested in whether this indicates a defective or invalid test, insufficient sample volume, or something else.

I'm not asking anyone to diagnose infertility. I'm just trying to figure out why two tests produced absolutely no readable result. 

Personally, I think im infertile as rarely does much if any any ejaculate come out.

TY

Hello everyone,
I’m looking for feedback or similar experiences regarding my long-term TRT protocol and persistent symptoms.
Background & Diagnosis:
Cause: Primary hypogonadism following severe orchitis 9 years ago.

Initial Labs (Pre-TRT): Total Testosterone was extremely low (~3 ng/dL), with elevated LH and FSH, and mild-to-moderate testicular atrophy.

Current Protocol: 200 mg Testosterone Cypionate per week (split into 100 mg every 3.5 days).

Current Bloodwork:
Total Testosterone: Near the upper limit of the normal range.

Estradiol (E
2

E2 ) & General Labs: All within optimal ranges.

Progesterone: Undetectable / Below detection limits.

(Note: I have not tested Pregnenolone or DHEA-S levels yet).

Current Symptoms:
Sexual: Low/flat libido, severe penile desensitization, delayed ejaculation/anorgasmia (often taking over an hour to achieve climax).

Cognitive/Mood: Recent memory issues, brain fog, and elevated anxiety.

My Questions: Since my Leydig cells are damaged due to the previous orchitis (as evidenced by high LH/FSH prior to TRT), I’m wondering about the best strategy to address the shutdown of upstream neurosteroids, especially given my undetectable progesterone level:
HCG: Given that I have primary hypogonadism, is HCG still worth trying to stimulate Leydig cells or adrenal pathways, or is its effect likely to be minimal in my case?

Pregnenolone + DHEA: Given that my progesterone is completely shut down, would supplementing directly with Micronized Pregnenolone (e.g., 25 mg/day) and Micronized DHEA (e.g., 10-15 mg/day) be the most reliable way to restore the upstream neurosteroid cascade (allopregnanolone/progesterone) without relying on damaged Leydig cells?

Has anyone with primary hypogonadism and undetectable progesterone resolved delayed ejaculation, penile numbness, or brain fog using either of these approaches?
Thanks in advance for your insights!

This is the place for partner's perspectives today.

Here are the results from my latest semen analysis. Wife and I have been trying to conceive for 12 months. I was diagnosed with stage 3 vericocele by a urologist but he doesn’t think I need the surgery. The morphology is very low though.

What do you all think? Any experience with the surgery and morphology improving?

28 years old and healthy

Sample details
Color: Pale yellow; viscosity: normal
Volume: 6.4 mL
Concentration: 40.5 million/mL (average of 42 and 39)
Total motility: 85.5% progressive (average of 86% and 85%)
Progression: 2+
pH: 8.2
Agglutination: none
Round cells: <1.0 million/mL
Morphology (normal forms 3%)
Normal forms: 3%
Tapering heads: 14%
Amorphous heads: 83%
Midpiece defects, macroheads, microheads, tail defects, and immature forms: 0% each

Hi all (posting from my wife’s account because I don’t have reddit)

I’m sorry we’re all in this boat, but I’m new to this and wanted some insight from people who’ve been here before. My genetic test results just got back and they are normal, no microdeletions or genetic abnormalities.

My hormone panel was also normal (US):

FSH: 5.5
LH: 4.9
Test: 363
Prolactin: 12.1
Estrogen: 10

This seems like obstruction with these results, right? Urologist appointment with scans isn’t for two more weeks but I don’t want to be shocked when I go in. I know Sertoli only or even maturation arrest is a possibility, but a less likely one given an (alleged) pregnancy accident in college.

If your stats were similar to mine, what was your diagnosis? Did you move onto TESE/TESA right away or did they do further testing? Did they suggest micro-TESE anyway? I would really rather have them collect my sperm via TESA/TESE.

Thank you guys in advance

Hello all , I’m after advice , I’m really struggling with the fact that a sperm donor might be our only option , has anyone gone down this route ? If so did you have the thoughts of ‘ maybe I won’t be excited of the we’re pregnant , getting the nursery ready together , having that special connection with the baby that’s biologically not yours ? How did you cope with all these thoughts ? I have something called double strand dna damage , don’t think its ever possible to have children naturally, we have done 3 rounds of IVF first round 2 fertilised 2 embryos 1 blast didn’t stick
Second round 1 fertilised 1 embroyo got put in early didn’t stick third round 0 fertilised , all 3 rounds we have a high number of eggs over 20 ,
It’s getting between the relationship because my partner desperately wants children but I can’t give her that and this seems like the only option , she doesn’t really want to adopt because there’s nothing wrong on her side and she wants to experience giving birth which I totally understand , just wondering how other people in my situation if any got through it or didn’t . There’s no one to really open up to in my life because I don’t know of anyone going through it or have gone through the same thing.
Thank you for taking the time to read

This is the place for partner's perspectives today.

I am now a patient of Dr. Turek after struggling with infertility for 2.5 years. We did FNA mapping and they did not find any sperm, but I did get a diagnosis of early maturation arrest. We are starting the isotretinoin clinical trial. I guess I am just looking for experiences/advice. Curious about ESSM at MAZE and if we should do that instead of a standard semen analysis at a lab. All baseline labs were normal except for testosterone was a little low at 204. History of medication (clinic, HCG FSH), and failed TESE a year ago

Your semen analysis results are below.
-Total volume is_3.2_ mL, we like to see this equal to or greater than 1.4mL
-Sperm concentration (number of million sperm
per milliliter) is_2.5_ million/mL, we like to see this equal or greater than 16 million/mL
-Total motility is _55%, we like to see this equal or greater than 42%. This percentage shows the sperm that is moving.
-Morphology/Normal Form (shape) is_3%, we like to see this equal or greater than 4%.
-Total Motile is _4.4 million, we like to see this equal to or greater than 20 million.
-Total Progressive Motile Sperm is_3.8_
million, we like to see this equal to or greater than 8-10 million to be considered adequate for IUI (intrauterine insemination). This number encompasses semen volume, sperm
r- entration, and sperm that is swimming forward

Hi everyone, I’m having my first TESA (not TESE) next month on the same day as my wife’s egg retrieval and I’d really appreciate hearing from anyone who has been through this.
I have almost 0% sperm motility although my sperm concentration and count are relatively good. The main reason for the TESA is the lack of motility and we’re planning to use the sperm for ICSI.
I have a few questions:
1. Recovery and driving
*How painful was the procedure once the local anaesthetic or sedation wore off?
*Did you experience swelling, bruising, or significant pain afterwards?
*Were you able to walk normally and move around, or did you need to rest for the rest of the day?
*Most importantly, were you able to drive afterwards? Would driving around 4 hours after the procedure be realistic, or is it better to arrange someone to drive you home?
2. What should I expect?
*How long did the procedure take?
*How many days did the discomfort last?
*Were you able to return to normal activities the following day?
3. Two sperm collections before TESA
This is something I’m particularly curious about. My clinic has planned the following schedule for my wife’s egg retrieval day:
6:00 AM: First sperm collection at home and bring with us to the clinic. The clinic gave me a special liquid called culture medium to use with the sample.
9:30 AM: A second sperm collection at the clinic. In my case they have often been able to obtain better-quality samples from the second collection.
Around 12:00 PM: TESA.
My question is: After two ejaculations on the same morning, is it still realistic to retrieve sperm through TESA? Could the two previous collections affect the number or quality of sperm available in the testicles or does TESA retrieve sperm independently of the ejaculated samples?
I understand that the testicular sperm may also be immotile and that the laboratory needs to assess their viability. I’m just wondering whether anyone with almost 0% motility has had a similar protocol and what their experience was.
Any advice, personal experiences, or things you wish you had known before your first TESA would be greatly appreciated.
Thank you! 🙏

How/Where are you all getting your HCG? I'm prescribed 10k bottle to take 2500iu 2x a week. That means I'll need two bottles a month. It's so expensive and most of the pharmacies I have been to act dumb about ordering it. I finally got CVS to order it but it requires a PA. Hopefully it goes through and I get some insurance coverage. Any recommendations on where to get my prescription filled in U.S. ? I tried looking for online pharmacies but I'm still not sure.

Hi everyone, I'm 29 years old male and been married for 2 years. We've been trying for over a year to conceive but nothing happened so we went to get ourselves tested. My wife is in very good condition but we discovered that my sperm is pretty bad. These are the results from January 2026:

Volume: 3.5ml
Concentration: 5mln
Total Count: 17.5mln
Progressive: 13%
Nonprogressive: 5%
Immotile: 82%
Normal forms: 1.5%

FSH: 12.64 mIU/ml
LH: 2.88 mIU/ml
Estradiol: <10
Free Testosterone: 8.95pg/ml

Other info: The urologist did a physical exam and he didn't find any varicocele, but he told me that my testicles were very small. I did an ultrasound and they were around 7ml volume. I also did genetic testing, everything was normal and I had no Y deletions either. My family doesn't have fertility issues either. This is the first time that I did a SA so not sure how it was before.

After these tests we saw a urologist and he prescribed some supplements to take for 3 months to see if there's any improvement. Unfortunately, after 1-2 months of taking the supplements I started getting fevers and I was diagnosed with Brucellosis (bacterial infection). I had to take 3 different antibiotics, one IV for 14 days and two tablets for 12 weeks.

When the infection was no longer active in June, we were interested to see how's the state of my sperm and we did another SA. It came back with literally zero sperm. We were kind of upset but it kind of made sense given the continuous on and off fevers that I was having for an entire month until we figured out what was happening.

My antibiotics treatment finished on August 14 and on October 14 (2 months after antibiotics), I went for another SA to see what's happening. I was upset to see that it has become worse. Here are the new results:

Volume: 1.5ml
Concentration: 2mln
Total Count: 3mln
Progressive: 20%
Nonprogressive: 0%
Immotile: 80%
Normal forms: 0%

Note: Abstinence here was 2 days whereas 3 days in the first SA. Not sure how much this matters.

I've spoken to my urologist and we're leaning towards IVF since chances of natural conception seem to be extremely low. The issue is that he told me that the 0% morphology is terrible for IVF and needs to be improved first. That's the part that I'm mainly worried about. I'm also worried about the possibility that my testicles are failing. I understand that brucellosis probably did some damage and it might not have fully recovered in 2 months.

I'm back to taking supplements (coq10, zinc, selenium, the usual stuff) and trying to improve my lifestyle (no heat, no alcohol, more exercise) for 1-2 months, as instructed by my urologist.

I'd like to know what other people think of my situation and whether there's good hope that I'll be able to have a child since I'm kind of feeling down at the moment. I guess I just want to chat with people about it since no one in my private life knows about this.

Thanks to anyone who took the time to read through!

Hello, this may sound funny but does anyone else feel like after the procedure, it's hard to keep the little guy hard? Please let me know if you've experienced this lol

This is the place for partner's perspectives today.

Sucks to be making this post, but I'm 30M and was diagnosed with non-obstructive azoospermia after about a year of workup. Honestly, I’m completely at a loss. This looks like an emotional and expensive road, and I don’t have unlimited funds, so I’m trying to be strategic about where to put money first.

I’m currently looking into Columbia’s STAR program. Should I also be looking at Maze’s ESSM, or is it basically the same idea? Has anyone done one before moving to surgery?

Hormones (Apr 10, 2026)

• FSH: 26.2 mIU/mL
• LH: 11.85 mIU/mL
• Total testosterone: 243 ng/dL (lab ref 197-670)
• Prolactin: 8.9 ng/mL
• Free testosterone: 6.66 ng/dL (Aug 2025)

Genetics

• Karyotype: 46,XY
• Y-chromosome microdeletion (AZF) test: negative

Other

• No medications, no steroids or testosterone, nonsmoker, 1-2 drinks a month, exercise regularly
• No risk factors found on history or exam
• Partner has no known fertility issues

My urologist said micro-TESE success is about 40-60% overall, and probably under 50% for me because of the FSH, though some studies say otherwise.

What I’m looking for:

1. Has anyone with FSH in the 20s found sperm with micro-TESE?
2. Experiences with STAR or ESSM, and whether you did that before surgery?
3. Surgeons or clinics you’d recommend in the Mountain West (Utah, Colorado, Washington), and what you paid out of pocket?
4. Anything you wish you’d done or asked earlier?

Thanks for reading. Any advice or just hearing from people who’ve been through it would mean a lot.

Has anyone gotten there inhibin b tested? I got all sorts of labs done and I was diagnosed with non obstructive azoospermia 4 years ago but recently did some new labs. Inhibin b was undetectable (less than 4) FSH was elevated at 28.1 and LH was elevated at 15.7. All this gave me an answer as well of Sertoli Cell Dysfunction. I had recently seen a doctor, absolutely amazing, who created a high frequency ultrasound to determine if any sperm germ cells could be present. However in my case, there were some signs of possible sperm, but those areas unfortunately were scarring when the biopsy was sent off. It showed 60% of the tubules contained Sertoli cells and 40% were scarred. Now with that only being a single biopsy, it may not represent the entire testicle but because of how severe the scarring is, I was given the 5% chance of finding sperm if I will proceed with the mTESTE. He mentioned if I would be interested in trying a reboot protocol that involves taking testosterone plus HCG for several weeks to lower FSH production. Once FSH has been suppressed for a couple weeks, we would re-introduce HCG and FSH to see if the testicles can be stimulated. This would be done to try to salavage any of those Sertoli cells to get some of them to be functional. If there is a rise in the inhibin B, then a MicroTeste could be the next step with a 5% chance of finding sperm. Also, if anyone has gotten the MicroTeste done, were you told to be on testosterone for the rest of your life? We are both just at a loss at this point and we are hoping to get any sort of answers from any men or couples who have had similar results to ours. This community has helped me not feel alone, but I am just tired.

I originally posted my story on here to give everyone some hope, but now I’m in desperate need of some hope myself. I think I posted the link to the original post above.

Unfortunately, the two embryos we implanted resulted in a very early chemical pregnancy.

Since then, we did another IVF cycle and were lucky enough to retrieve 11 eggs. Unfortunately, when they thawed my frozen vial of tissue there weren’t nearly as many viable sperm as they thought (originally estimated to be approximately 200). After thaw, there were only 3 viable sperm (2 nonmotile and 1 motile) that they injected into 3 eggs.

Today, we were told that only 1 (one of the nonmotile sperm) successfully fertilized the egg. The other two are still being watched, but chances are fertilization didn’t work. We are waiting to hear back in a few days whether or not development continued.

I consider myself extremely lucky that they found sperm to begin with. I know how many of you hope for that miracle only to be met with negative results. However, it is a classic case of not seeing the forest for the trees. Finding sperm is just the first most basic step in this process and there are so many pitfalls that follow once you get past that initial hurdle.
I guess I am also sharing this as a cautionary tale that this journey isn’t over until you are holding a baby in your arms.

I don’t mean to sound so negative or ungrateful. I’m really not. I know what a miracle it was to find sperm at all. But, I could really use some positive stories where 1 lonely embryo worked and lead to a live birth against all odds for someone with NOA SCOS.

We do still have more eggs and I can do another surgery, but after getting knocked down so many times in the last few months I’m finding it really hard to find hope in this situation. Thanks for listening and sharing your own stories and hardships. I wish I had better news to update you with, but unfortunately this is the reality we are all forced to deal with.

I'm going to try to make a long story short, but in essence:

Started showing low testosterone symptoms in summer of '25, went to the doctor and got officially diagnosed with low T, and was put on Clomid 50mg EOD. Prior to starting the Clomid, FSH was 14, now it's in the 40's. T levels are good, E's are fine but could be better, but now I'm azoospermic. I've had 2 SA's in a 5mo span after we realized my wife wasn't getting pregnant anymore. In 2025 she had 3 pregnancies, all resulting in early miscarriage. She also had another miscarriage in 2023, but that one lasted longer, up until (I believe) 20 weeks.

Yesterday I had my first consultation with a reproductive urologist, and she basically told me that:

1. My typical urologist is an idiot for not doing a SA prior to starting Clomid
2. My high initial FSH indicated that something was already wrong
3. It's likely that I was either already azoospermic or severely compromised before starting Clomid

This is extremely concerning, for obvious reasons, but also because not much has changed in the 3 years that me and my wife have been together. The only thing that I can immediately think of is my weight gain. In 2023 I was 200-205lbs and around 25-26% body fat (I was in the gym a lot), but now I'm 226 and ~31% body fat after putting in some effort to lose weight. I peaked at nearly 240lbs and 37% BF

Can anyone provide any insight on their own experiences with something similar? I'm trying very hard not to spiral, and I know that getting back in the gym wouldn't hurt, but I also know that it's probably pure copium to think that something like this can be fixed just by lifting again.

I was diagnosed with varicocel grade 1 with no reflux on my right testicule, I'm going to the gym 3 -4 times a week .

Should i stop definitely the gym , or are there some precautions or exercises i should avoid?

I need help, please