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Should male hormones be taken for low sperm count?

Q: I am 31 years old working in Saudi Arabia and got married 2 years ago. My wife also came here 9 months ago. After 6 months both of us had a medical checkup and it was found that my sperm count is low (22 million) and motility is 65 %. The doctor advised me to take Proviron 25 mg for 3 months for low sperm count. After 3 months the semen analysis revealed almost the same sperm count. Now the doctor has asked me take Andriol 40 mg (Testosterone) tab 3 times a day. I am totally confused and am wondering whether to take this medicine now or should I take a vacation and get a checkup in India and then start medication. Please advise me on this.

A:The use of male hormones such as mesterolone (Proviron) or testosterone is justified only if there is proven androgen (male hormone) deficiency. They are useless as a treatment of impaired spermatogenesis (production of sperms) unless there is associated hypogonadism (impairment of male gonads). In the absence of hypogonadism, such hormones inhibit pituitary gonadotrophin secretion and consequently depress sperm production. Generally, if fertility is desired, the usual treatment is with gonadotrophins (such as human chorionic gonadotrophin sold under the brand names of Corion and Profasi in India) which will stimulate sperm production as well as male hormone production. As per clinical studies, a sperm count of less than 20 million/ml with a motility of less than 40% is associated with an increased risk of infertility (but not essentially leads to infertility).

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