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Can I father a child?

Q: I am a 43 years old married man suffering from type 2 diabetes. I have been diagnosed with azoospermia. Recently, I consulted the doctor, who asked me to undergo a blood test. The blood test reported follicle stimulating hormone (FSH) - 11.40 mIU/ml, luteinising hormone (LH) - 6.6 mIU/ml, total testosterone - 419.1 ng/dl and prolactin - 4.7 ng/dl. Based on these reports, is it possible for me to father a child?

A:I assume your semen parameters are abnormal in that they show no sperm and this test has been repeated. No sperm in the semen analysis could be either from obstruction or from decreased production. The urologist/andrologist should examine you for urogenital abnormalities. Impaired spermatogenesis and decreased sperm production is often associated with elevated FSH concentration (you have slightly elevated levels). If there is an issue with obstruction or an absence of vas deferens (usually found on examination), then you may need a surgical procedure to correct the problem. Depending on the age of your wife, you may need to have a testis biopsy or a microdissection testicular sperm extraction procedure to get sperm. Your wife may need to undergo artificial reproduction or IVF in order for you to have a baby.

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