Need help for a friend! (Male infertility)

A very good friend of mine was telling me about some of her DH's issues and said she wouldn't mind if I asked about it on here and hopes for some advice/success stories. Since male infertility is not my area, I really didn't have much to offer information-wise.

She first started realizing there was a problem when her DH's personality was changing. She wasn't sure if he needed antidepressants or what, but he was becoming extremely withdrawn and seemed to get very angry easily over random things that did not warrant getting upset over. They went to the doctor where they discovered he had very low testosterone. She said normal is around 1000, but his was 290. The prescribed him a testosterone gel and said he would probably need to use this for life. The plan was to recheck his level every 3 months and to keep a close eye on him because that medication has lots of side effects and could negatively effect the kidneys. At his next check, his level shot up to somewhere in the 500s. She noticed his mood had really improved too and they were really hopeful that things were looking up. Well, recently she noticed things got much worse very fast. They went to get his levels checked again and now his testosterone was 150 which was worse than where they started!! He continued on the gel so nothing there has changed. They have plans to see an endocrinologist (regular, not reproductive) to get some suggestions about how he should be treated.

They have not started TTC but would like to soon. Ultimately my friend is very concerned about her husband so most of all she wants to see him healthy - although she is concerned about the future with building a family and just wants to get some idea of what kind of a road she's in for and what she can be doing now to be proactive.

Thanks ladies!!

Need help for a friend! (Male infertility)

I cant say that I know personally about the story you are referring to but I can tell you about a story I do know.

A girl I know from my fertiliy clinic is married to a man that had to have his sperm surgically extracted. She did IVF & had 20 egg removed. When time to transfer, only ONE egg was good & produced a beautiful girl!!! I would think there was a problem with the fertilizing part. The point is though that with the clinics help, things can work & I am sure they will be successful too... It just sometimes is hard to get there.

Re: Need help for a friend! (Male infertility)

Re: Need help for a friend! (Male infertility)

I hope your friend's DH is able to get the help he needs.

My DH has low testosterone. He has been on anastrozole since September. If she is concerned about HIS fertility, it is important that he is not on synthetic testosterone as it will negatively effect his sperm count. Anastrozole is NOT testosterone. It decreases a person's estrogen level, which affects the testosterone level "naturally," which increase sperm production.

I am still not sure of our outcome ... we will know in 2 months.

Message edited 1/30/2013 8:17:40 PM.

Re: Need help for a friend! (Male infertility)

Depression and lethargy are symptoms of low T, but it's more important to figure out what is causing the low T. I'd strongly urge your friend's husband to see a urologist who specializes in male infertility. Testosterone gel should only be used in men with diagnosed low T who have certain causes. There are unknown long-term side effects of testosterone therapy, but there are other ways of bringing T levels up. Some studies also show that being on T supplements will hurt a man's chance of naturally conceiving. Plus, if your friend's husband has such low levels on the gel, then it's clearly not working for him. I'd also venture to guess that when they TTC that he will have problems with sperm count, so a urologist, rather than an endocrinologist, would help them with that, too.

As for the surgery to extract sperm (TESE, TESA, mTESA), it's a very painful, very expensive procedure that does not always work - IF your friend's husband is not producing sperm (or enough sperm, which they don't even know for a fact at this point, I assume). That is like 5 steps away from where they are now, and that surgery is usually the last step in a very long process. First there are other genetic and hormonal tests that should be run, as well as a physical exam.

If they are interested in TTC in the future, I'd urge them to see a MI urologist sooner than later. Sperm takes 3 months to be produced and then mature, so no matter what, with low T this will be a long journey for them. It's better to learn their options sooner than later and decide on potential treatment plans.

Hope this answers your/her questions!

Need help for a friend! (Male infertility)

NORMAL testosterone levels are between 160-740.
When taking artificial test such as the gel or injections it will supress his normal test levels thus causing his own body production to slow down or even shut down... which in turn can effect his sperm count. I would tell your friend to tell her hubby to get off that shit ASAP and see a UROLOGIST!

My hubby was on HcG (1,000 iu every other day and 50mg Clomid daily) this took care of test levels and sperm count...

Needless to say our MI issue is DNA Fragmentation ... which we found out before #3 IVF by doing the SCSA Analysis ...

Good luck to her!!!

Message edited 1/30/2013 8:28:03 PM.

Need help for a friend! (Male infertility)

This guy I was talking about was not able to produce sperm. As I stated in my first comment..I dont know about the story with low testerone. Maybe you can google

Re: Need help for a friend! (Male infertility)

Ladies, I can't think you enough for all the information. I knew I'd be able to count on this board for some good info to come back to her with!!

I know my friend was hoping to start ttc very soon (they've been married since 2007) but now her main priority is that her dh should be healthy and in a mentally good place because the side effects of the low testosterone are making him just not the man she knows he is.

I wish I could ask you all for specific dr recs but she lives in Ohio.

Thank you so much again, I'll be coming back to you ladies with more questions if they come up!

Re: Need help for a friend! (Male infertility)

Message edited 1/30/2013 10:11:05 PM.

Re: Need help for a friend! (Male infertility)

While TTCing, we found out DH had low testosterone (and b/c of that also low sperm count, low motility). Thank god we did b/c he was really scary sometimes! He had very similar symptoms... extreme fatigue and crazy mood swings.
Dr. B sent us to a urologist right away and he was put on clomid. It worked great for a bit, but then it plateaued. He switched to HCG injections and it worked much better (and also got us our twins).
PPs are correct, many of these treatments are not good for long term use and can also cause sterility. Since we're not TTCing right now, but may be in the future, our Dr. switched us to clomid and testosterone (steroid). DH will sometimes have some anger/aggression the day of his shot and be tired when it's time to take the next one, but it's waaaay better than before. Plus, he's aware of it now, so that helps too He will not be using any of the gels until we are definitely done having kids.
I agree with PPs that your friend's DH should see a urologist, specifically one that deals with MI. We love ours, but he does not take insurance Thankfully we only see him 1-2x a year now!

Re: Need help for a friend! (Male infertility)

a friend of mines DH had no sperm count due to a childhood cancer. His options was that surgery where they remove all living sperms from the male and freeze or save them. The surgery is VERY painful and not even 70% effective, at this point they after review of surgery, and finances they went with a sperm donor

Re: Need help for a friend! (Male infertility)

Tell your friend to STOP Androgel right away!!!!!

It stops sperm production in 99% of men!!!!! It takes about 3 months for new sperm to be formed so tell her to do it right away if she is planning to TTC....

He needs to go see a urologist that specializes in male infertility...he/she might put him on Clomid or HCG injections which work wonders on T levels and sperm production...


Androgen decline in the aging male (ADAM)

Editorial note: Recent description of the phenomenon of decreased strength, well-being and cognition that is associated with male aging has resulted in the term, ADAM. Contemporary studies delineating this phenomenon are provided below.
The study of androgen action and male reproductive dysfunction continues to expand significantly. Despite long-term discussion of similar syndromes in Europe, only recently has the definition of a disease state been associated with hormonal changes that occur in aging men. This syndrome, previously referred to as Andropause, has more recently been described as androgen decline in the aging male (ADAM; Morales et al., 2000.) The onset of ADAM is unpredictable and its manifestations are subtle and variable. It is associated with a decrease in testosterone, but also growth hormone, melatonin and dihydroepiandosterone. Clinical manifestations include fatigue, depression, decreased libido, erectile dysfunction as well as changes in cognition and mood. As the syndrome is better defined and understood, more specific treatment beyond androgen replacement is expected.

Message edited 1/31/2013 9:51:05 AM.

Need help for a friend! (Male infertility)

First i have to say that i'm so happy this post came about. We are 100% dealing with MI and I have been on this board for quite some time (had a different user name when i first joined) and this is the most i've heard on MI.
As someone stated normal Test are between 160-740>...that is not what the dr. told us...he said anything over 600. We went to a urologist and when my DH got tested he was at 96. (Two SA with no sperm) He was on clomid for 6 weeks and it did nothing. Dr. put him on 2,000 iu of HCG every other day...3 months later 3,000iu and another 3 months 5,000 iu...to our surprise at each stage his blood work increased. and now it's up to the high 200's. The urologist said they like to hit around 300 in order to do IVF (we were told this was our only option b/c of his sperm count and other blood results). he was on it for another 8 weeks and we started ivf. Next week is my first beta and he is still on it. The Urologist basically said that until i give birth he will be on it. We have sperm frozen just in case and out of 10 embies only one was good to use.
This is scary and all i can say is patience is key here!
My DH was on Androgel when he was yonger(when we were dating) and the dr. told him to go off of it for three months before we were trying to conceive and then to come back...so i'm assuming it's not good for making babies!
My suggestion is to do a lot of research on a urologist and go to the best one possible. Also they should know they are trying to conceive as that will change the plan.
Hope this makes sense and gl to your friend!

Message edited 1/31/2013 10:21:03 AM.

Re: Need help for a friend! (Male infertility)

Re: Need help for a friend! (Male infertility)

I've been meaning to come back to this post -- been such a crazy couple of days (cat issues ) Anyway........ I spoke to my friend and actually copy and pasted the messages on here to share with her all the words of wisdom you ladies had. I strongly urged her that she should stop the testosterone gel and see a urologist.

Ultimately.. my friend is the type to trust the doctors over me. Her general dr told her to see an endo so she's starting there and then says she will see. What can ya do..... I tried.... She had questions, I got them for her, and I just wish she had taken some of all our advice more seriously.

I guess we'll see what happens. She said she's not ttc yet (though wants to soon) so she just didn't think all this was necessary. I tried telling her how once she does decide to start in a few months, she will want to have the answers and not have to just get started at that point because she will get impatient VERY fast... but I guess we'll see.

Thanks again ladies!!