Likelihood of Sperm Production with Your Hormone Profile
You are likely producing sperm, though possibly at reduced levels, and your FSH of 10.5 IU/L suggests some degree of testicular dysfunction that warrants close monitoring and a semen analysis to confirm actual sperm production. 1, 2
Interpretation of Your Hormone Values
Your hormone profile shows a mixed picture that doesn't fit neatly into complete testicular failure:
FSH 10.5 IU/L is moderately elevated above the typical threshold of 7.6 IU/L used to distinguish obstructive from non-obstructive causes, suggesting some impairment in spermatogenesis, but this level is not high enough to predict complete absence of sperm 1, 2
Your total testosterone of 40 nmol/L (approximately 1154 ng/dL) is actually elevated, not low, which is inconsistent with primary testicular failure—men with true testicular failure typically have low testosterone with elevated LH and FSH 1, 3
LH 7.7 IU/L is at the upper end of normal or mildly elevated, which combined with your high testosterone suggests your Leydig cells (testosterone-producing cells) are functioning well 3
SHBG 95 nmol/L is elevated, which can increase total testosterone measurements while free testosterone may be more limited, though your total testosterone is high enough that this is less concerning 4
What This Pattern Suggests
This constellation of findings indicates "compensated hypospermatogenesis"—a condition where FSH is elevated as the pituitary tries to compensate for reduced sperm production, but testosterone production remains intact:
FSH levels are negatively correlated with spermatogonia numbers, meaning your elevated FSH of 10.5 suggests reduced but not absent sperm production 1, 5
Men with FSH levels in your range (10-12 IU/L) can still produce sperm, though often at reduced concentrations—up to 50% of men with non-obstructive azoospermia and elevated FSH have retrievable sperm 1, 2
Your normal testosterone and only moderately elevated FSH make complete azoospermia less likely than in men with very high FSH (>15-20 IU/L) and low testosterone 1, 3
Critical Next Steps
You must obtain a semen analysis to determine your actual sperm production—hormone levels alone cannot definitively predict fertility status:
At least one comprehensive semen analysis evaluating concentration (normal >16 million/mL), total count (normal >39 million), motility (normal >40%), and morphology (normal >4%) is essential 2, 5
Physical examination of testicular size and consistency would provide additional prognostic information—normal-sized testes with FSH of 10.5 suggest better outcomes than atrophic testes 2, 5
Consider genetic testing if sperm concentration is <5 million/mL, including karyotype and Y-chromosome microdeletion analysis, as recommended for men with elevated FSH and severe oligospermia 1, 2
Important Warnings and Monitoring
Men with elevated FSH and initially normal semen parameters are at risk for progressive decline in sperm production over time:
Recent evidence shows that men with FSH >7.6 IU/L and normal baseline semen analysis experienced subsequent decline in sperm parameters, with higher rates of developing oligospermia compared to men with normal FSH 6
If you are considering future fertility, sperm cryopreservation should be discussed now rather than waiting, as men with spermatogenic failure can experience further deterioration over 15 years 4, 6
Absolutely avoid testosterone supplementation or anabolic steroids, as exogenous testosterone will suppress your remaining sperm production through negative feedback on the pituitary gland 1, 2, 5
Common Pitfalls to Avoid
Don't assume you're infertile based on FSH alone—men with maturation arrest can have normal FSH despite severe dysfunction, and conversely, men with elevated FSH can have adequate sperm for conception 1, 5
Your elevated total testosterone may be misleading due to high SHBG—calculated free testosterone would provide a more accurate assessment of bioavailable testosterone 4
FSH levels show natural variation, and a single measurement should be interpreted in context with semen analysis and physical examination findings 2