What should I do with elevated Follicle-Stimulating Hormone (FSH) and low Testosterone levels, and abnormal Sperm parameters, including low concentration, motility, and morphology?

Your Hormone and Semen Parameters Are Reassuring and Do Not Require Intervention

Based on your results, you do not need to take any action at this time. Your FSH is within the normal range, your testosterone is adequate, and your semen parameters meet WHO criteria for normal fertility potential.

Why Your Results Are Normal

FSH Level (10.2 IU/L)

• Your FSH of 10.2 IU/L falls within the normal laboratory reference range of 1-12.4 IU/L 1
• While some research suggests FSH >7.6 IU/L may be associated with mild testicular dysfunction, this threshold is lower than most clinical laboratory ranges and your level is still within normal limits 1, 2
• FSH levels alone cannot definitively predict fertility status—up to 50% of men with non-obstructive azoospermia and elevated FSH still have retrievable sperm, so your borderline-normal FSH with actual sperm present is reassuring 1

LH Level (7.0 IU/L)

• Your LH of 7.0 IU/L is within the normal range of 1-8.6 IU/L and argues against primary testicular failure 1
• Normal LH indicates your pituitary is providing appropriate signals to your testes for testosterone and sperm production 1

Testosterone (36 nmol/L)

• Your testosterone of 36 nmol/L (approximately 1038 ng/dL) is in the high-normal to elevated range, making primary testicular failure extremely unlikely 1
• This level is well above the threshold for hypogonadism and supports normal spermatogenesis 1

Semen Parameters

• Your sperm concentration of 62 million/mL significantly exceeds the WHO lower reference limit of 16 million/mL, indicating normal sperm production 3
• Your motility of 50% is at the borderline-normal threshold but acceptable 3
• Your morphology of 6% exceeds the WHO reference limit of 4%, which is normal 3
• Your semen volume of 3.2 mL is normal 1

Testicular Volume

• Your testicular volumes of 13 mL and 10 mL are within the lower range of normal but do not indicate severe testicular atrophy 1
• Men with non-obstructive azoospermia typically present with much smaller testicular volumes and testicular atrophy, which you do not have 1

Important Caveats

Natural Variability

• Semen parameters exhibit significant intra-individual variation, and a single analysis may not reflect your true baseline 4
• If you are actively trying to conceive and have concerns, consider a repeat semen analysis in 2-3 months to confirm stability of parameters 3, 5

What to Avoid

• Never use exogenous testosterone if you desire fertility in the future—it will completely suppress FSH and LH through negative feedback, causing azoospermia that can take months to years to recover 1, 5, 6
• Avoid excessive heat exposure to the testicles, smoking, and maintain healthy body weight 3

When to Seek Further Evaluation

• If you and your partner have been trying to conceive for >12 months without success (or >6 months if female partner is >35 years old), both partners should undergo fertility evaluation 7
• If repeat semen analysis shows declining trends in concentration, motility, or morphology 1
• If you develop symptoms of testosterone deficiency despite your current normal level 1

Bottom Line

Your hormone profile and semen parameters are within normal limits and do not require medical intervention 1, 3. Your FSH is at the upper end of normal but paired with normal testosterone, normal LH, and most importantly, normal sperm concentration well above WHO thresholds 1, 3. Continue healthy lifestyle practices and proceed with natural conception attempts if desired 3, 7.