Q: I am 32 years old male, having infertility issues. My testicular size is very small and also I am noticing a gradual increase in the size of my breasts. Since last 10 years, I am using testosterone amp 250 mg and bromocriptine tablet. I have visited a large number of doctors and they told me that it is impossible to provide a definitive treatment for my problem. Please help.

A:With infertility, small testes and breast enlargement, you are clearly suffering from testicular insufficiency. First, we need to confirm that with an examination, and certain tests like serum testosterone, FSH and LH levels needs to be carried out. Second question that needs to be answered is the cause, whether it is due to a genetic abnormality or secondary to a disease process later in life. It is likely that in your case we may reach a diagnosis of primary testicular failure, with no sperms or testosterone producing cells in your testis. Only then, we would be ready to answer your questions. The answer to your problem of infertility would then lie in adoption. The answer to lack of secondary sexual characters and breast enlargement lies in adequate testosterone replacement, obviously inadequate at present. You need to get in touch with an endocrinologist for dosage regulations.