The endocrine assessment of a man with fertility problems or a low sperm count includes measurements of serum total testosterone, LH, and FSH and other tests as clinically indicated. Serum total testosterone should be measured on a blood sample obtained between 8 and 10 AM.
The results may indicate a number of different diagnoses such as:
- Primary (hypergonadotropic) hypogonadism (affecting both spermatogenesis and Leydig cell function).
- Primary (hypergonadotropic) hypogonadism (seminiferous tubule damage without Leydig cell dysfunction).
- Secondary (hypogonadotropic) hypogonadism.
- Partial androgen resistance.
Medical therapies to increase circulating gonadotropin concentrations
Therapies to increase circulating gonadotropins (and maximally stimulate spermatogenesis) include clomiphene citrate, aromatase inhibitors and recombinant human follicle-stimulating hormone (rhFSH).