Your Fertility Status: Reassuring Parameters with Minimal Concern
You do not have testicular atrophy, and your current fertility parameters are reassuring—your sperm count, motility, and testicular volume all fall within normal ranges, indicating you are currently fertile. 1, 2
Understanding Your Test Results
Your parameters place you well within the fertile range:
Testicular volume of 10ml bilaterally is at the lower end of normal but does not constitute atrophy. Testicular atrophy is typically defined as volumes significantly below 12ml with associated dysfunction, and your normal sperm production confirms adequate testicular function. 1, 3
Sperm concentration of 100 million/ml far exceeds the WHO lower reference limit of 16 million/ml, placing you in the normal fertile range. 2
Total sperm count of 330 million per ejaculate (100 million/ml × 3.3ml) is excellent and well above the WHO reference of 39 million total. 2
60% motility meets normal standards for progressive motility. 4
Total motile sperm count (TMSC) of approximately 198 million vastly exceeds the 10 million threshold associated with good natural conception rates. 1
Interpreting Your Hormone Levels
Your FSH of 9.9 IU/L (upper normal range) warrants attention but does not predict infertility:
FSH levels between 7.6-12 IU/L indicate mild compensatory elevation by the pituitary, suggesting the testes require slightly more stimulation to maintain normal sperm production—which they are successfully doing. 1, 2
The key distinction: FSH >7.6 IU/L predicts problems primarily when accompanied by testicular atrophy AND reduced/absent sperm production. You have neither. 1
Your LH of 7.2 IU/L and testosterone of 37.2 nmol/L (approximately 1073 ng/dL) are both normal, indicating your Leydig cells are functioning well and you do not have primary testicular failure. 1
FSH alone cannot predict fertility status—up to 50% of men with non-obstructive azoospermia and elevated FSH still have retrievable sperm, and you already have excellent sperm counts. 1, 2
Risk of Future Fertility Loss
Your risk of progression to infertility is low but not zero:
Testicular volume of 10ml bilaterally represents reduced testicular reserve compared to the ideal 15-25ml range, meaning you have less "buffer" against future insults. 1, 5
The mildly elevated FSH suggests your testes are working harder to maintain current production, which could theoretically decline over time. 2, 5
However, your robust sperm production (100 million/ml with 60% motility) indicates your seminiferous tubules are currently functioning well despite the compensatory FSH elevation. 5, 3
Critical Actions to Protect Your Fertility
Never use testosterone or anabolic steroids if you desire current or future fertility—these completely suppress FSH and LH through negative feedback, causing azoospermia that can take months to years to recover, if at all. 4, 1, 2
Optimize modifiable factors:
- Maintain healthy body weight (BMI <25), as obesity impairs male fertility 1
- Avoid smoking and excessive alcohol 4
- Minimize heat exposure to the testes (avoid hot tubs, saunas, laptop on lap) 1
- Limit environmental toxin exposures 1
Consider sperm cryopreservation if you anticipate delaying fatherhood beyond age 40-45, as this provides insurance against age-related decline. Banking 2-3 ejaculates now, while parameters are excellent, is reasonable given your reduced testicular reserve. 1
Monitoring Recommendations
Repeat semen analysis in 12-24 months to establish whether your parameters remain stable or show any declining trend. Single analyses can be misleading due to natural variability. 1, 2
Physical examination by a urologist or reproductive specialist to assess for varicocele (dilated veins in the scrotum), which can progressively damage the testes and is present in 15% of men. If a palpable varicocele is found with your borderline testicular volume, repair may be beneficial. 1, 6, 7
Recheck FSH, LH, and testosterone at the same time as repeat semen analysis to track any hormonal changes. 1, 2
When to Seek Fertility Assistance
If you're actively trying to conceive: With your current parameters, natural conception should occur in >90% of couples within 12 months of regular unprotected intercourse, assuming normal female fertility. 1
Seek evaluation if no pregnancy after 12 months of trying, or after 6 months if female partner is over age 35. 1
If future semen analysis shows decline to sperm concentration <20 million/ml or TMSC <20 million, consider genetic testing (karyotype and Y-chromosome microdeletion analysis) and more aggressive fertility preservation strategies. 4, 1
Common Pitfalls to Avoid
Do not interpret your FSH in isolation—the combination of mildly elevated FSH with normal testicular volume, normal sperm production, and normal testosterone indicates compensated testicular function, not testicular failure. 1, 2
Do not assume you need treatment—empiric hormonal therapies (SERMs, aromatase inhibitors, FSH injections) have limited benefits that are outweighed by assisted reproductive technology if natural conception fails. Your current parameters predict excellent natural fertility. 4, 1
Do not delay fatherhood unnecessarily if it's important to you—while your current fertility is good, reduced testicular reserve means you have less margin for age-related decline than men with larger testes. 1, 5