Question

A 30 y male was delivered to andrology department for medical evaluation due to ineffective sexual competency. His physical examination and interview with the specialized physician revealed some other symptoms that were related to wounds that won’t heal, unexplained weight loss, hair loss, lack of alertness and sometimes diarrhea. These symptoms were seen in the last 6 months only and nothing seen before. Semen analysis and other tests were prescribed and the results were: Semen analysis Days of abstinence: 3 days Time of collection: 9:30 am Time of receipt: 9:45 am Liquifaction time: 30 min Volume: 4ml Viscosity: normal pH: 8.5 Sperm concentration: 12 million/ml Sperm motility: marked decreased motility Morphology: more than 50% normal forms Spermatids and WBCs: less than 1 million/ml Other tests Fructose level was in normal range Viability testing showed that most sperm are viable Low serum testosterone Discuss these results, what is the expected case, mention any confirmatory tests if required?

Answer 1

I think the patient is suffering from hypogonadism it is a condition which occur due to failure of gonads .In this patients condition the wound won't heal Testosterone is a necessary androgen for maintaining lean mass and wound healing. A deficiency leads to catabolism and impaired healing. The use of large doses exogenously increases net protein synthesis, but a direct effect on wound healing has not yet been demonstrated.The symptoms like hair loss, wieght loss are indicator of this

Low level of serum testosterone and low count of sperms is also a clear indicator of hypogonadism.

For the confirmatory test of hypogonadism these can be done Initial laboratory testing should include early morning (8:00–10:00 AM) measurement of serum testosterone, prolactin, FSH, and LH levels.This is because For the diagnosis of primary hypogonadism, FSH measurement is particularly important because FSH has a longer half life, is more sensitive, and demonstrates less variability than LH.