Male Fertility Assessment with Your Hormone Profile
Your hormone profile suggests reasonable fertility potential for natural conception, though your elevated SHBG may be reducing your bioavailable testosterone, which could impact fertility outcomes. Let me break down what each value means for your ability to conceive naturally.
Interpretation of Your Hormone Values
FSH and LH Levels
- Your FSH of 10.5 IU/L and LH of 7.7 IU/L are within normal ranges for male fertility 1
- FSH and LH work together to stimulate sperm production in the testes 1
- These values indicate your pituitary gland is appropriately signaling your testes to produce sperm
- Normal FSH levels (typically <10-12 IU/L) suggest adequate testicular function and spermatogenesis 2
Total Testosterone
- Your total testosterone of 40 nmol/L (approximately 1,154 ng/dL) is actually quite robust and well above the lower limit of normal (typically >10-12 nmol/L)
- This level supports normal spermatogenesis and sexual function
SHBG Consideration
- Your SHBG of 95 nmol/L is elevated (normal range typically 10-70 nmol/L) 2
- High SHBG binds more testosterone, potentially reducing the bioavailable (free) testosterone that's actually usable by your body
- This could theoretically impact fertility despite your high total testosterone 2
Likelihood of Natural Conception
Based on your hormone profile alone, natural conception is likely possible, but success depends critically on your actual semen parameters, which are not reflected in these blood tests.
Key Points About Fertility Prediction
- Hormone levels alone cannot definitively predict fertility - you need a semen analysis to assess actual sperm count, motility, and morphology 3
- Research shows that for subfertile couples, total progressive motile sperm count (TPMC) of ≥50 million provides the best predictive power for conception within 5 years, with median time to conception of 19 months 3
- Even values well above WHO reference ranges for sperm parameters are associated with better conception rates 3
What You Need Next
You must obtain a semen analysis to determine:
- Total sperm count
- Sperm concentration
- Progressive motility percentage
- Total progressive motile sperm count (TPMC)
These parameters are far more predictive of natural conception success than hormone levels 3.
Clinical Recommendations
Immediate Steps
- Schedule a semen analysis - this is the single most important test for male fertility assessment 3
- Consider calculating your free or bioavailable testosterone given your elevated SHBG 2
- Evaluate for any underlying conditions causing elevated SHBG (thyroid disorders, liver disease, medications)
Factors That Improve Natural Conception Success
- Female partner's age is the most critical factor - younger female age significantly improves conception rates 4
- Absence of fertility disorders in both partners 4
- Optimal timing of intercourse with ovulation 5
Expected Timeline
- In subfertile couples undergoing evaluation, median time to conception is approximately 22 months 3
- Pregnancy rate averages 1.9 per 100 acts of vaginal intercourse in couples without major fertility issues 6
- 65% of couples achieve conception within 5 years when male partner has adequate semen parameters 3
Important Caveats
- Your hormone profile suggests normal hypothalamic-pituitary-gonadal axis function, which is encouraging 1
- However, normal hormones do not guarantee normal sperm production - men with normal FSH/LH can still have oligospermia or azoospermia
- The elevated SHBG warrants investigation, as it may indicate an underlying condition affecting fertility 2
- Female partner factors account for approximately 40% of infertility cases, so her evaluation is equally important 2
Bottom line: Your hormones look reasonable for fertility, but you cannot assess your true conception potential without a semen analysis. Schedule this test promptly if you're actively trying to conceive 3.