Patient: Description of condition (time of onset, main symptoms, hospital visited, etc.): Hello, Dr. Lee. I am currently tested for azoospermia, I will show you the report and ask for your guidance, I will go to you if necessary. FSH 3.9 PRL 20.2 TESTO 11.7 Peripheral chromosome 46, XY AZF test is Y chromosome not seen missing. Left testis 44×27×20mm Volume is 16.6 ml Right 41×31×22mm Volume is 19.5 ml. Bilateral epididymal heads are normal in size with uniform internal echogenicity. An echogenic area with a diameter of 1.9m and a round shape is seen in the left epididymal head. The border was clear, smooth and neat, and the wall capsule was thin. The prostate gland was 45×30×40mm in size, and an echogenic plaque was seen in the prostate gland with a size of about 1.5mm. The vas deferens was not dilated bilaterally, and the pelvic segment of the vas deferens was visible bilaterally. The right spermatophore: 30×10mm, left spermatophore size 34×12mm. Bilateral spermatophore size and morphology were normal, internal echogenicity was uniform, spermatic cord size and morphology were normal, no varicocele was seen. The sperm discharge volume was normal in acidity and alkalinity. Fructose characterization: positive. At present, it is said that all other things are normal, only after centrifugation round cells are 30-40/HP, white blood cells are 0.1×10 of six times ml, because of this to give a little medicine, selenium and zinc supplement, and one is to remove the poison. I don’t know what to do next, but I haven’t had a testicular puncture. Dr. Li, I am eager to get your help, no matter what it takes, to do a testicular puncture? Or should I take some medicine first? The first thing you need to do is to take a shot to treat your testicles. Patient: Dr. Li: Hello! What is your preliminary view of my problem? The actual fact is that you will be able to get a lot more than just a few of these. My lover is on vacation right now, so should I let her go to you first or should I go directly to get an injection? Also, can you tell me what other tests I need? Thank you so much. I’ve read all your replies and I admire your personality, really! Hospital Men: If obstruction is ruled out, injections (3-6 months) can produce sperm in the semen of half of the patients. However, there is no guarantee of 100% efficacy. Even if the injection is fruitless, it has a great promotion effect on spermatogenesis, which is beneficial for subsequent puncture for sperm retrieval. Your FSH results are quite good, suggesting that the testes have some spermatogenic potential. Patient: Thank you, then I’ll try the injection first, but my family is not in Beijing and I can’t stay there to receive treatment all the time, do you think I should go for the injection regularly or take it back and do it myself? Hospital masculology: The injection needs to be brought back to your local area for treatment use. It is not possible to stay in Beijing all the time for the injections, there is no need for that. Patient: Thank you, Dr. Li. I think there are two other issues that I urgently need you to address. One. I’m going to go next week, but my lover, who is on vacation, has to go and show you the labs first and then let me go (I’ve been in a bit of a hurry lately), but I think I’d better go together, because I’d really like to see you. Can I come back the same day? Two. I’ve been to Shanghai Renji and Ruijin, and they prescribed me “Spermogenic Tablets” (25 boxes) and “New Rare” and “Clearing and Detoxifying Pills” (one month’s supply). Should I stop or continue these medications before the injection? Thank you very much. Patient: Oh. Sorry, one more question, do you think I still need a seminal plasma biochemistry test? Hospital Male: You have already done the seminal plasma fructose, there is no need to check other seminal plasma biochemistry. I don’t think it makes much sense for you to decide whether or not to continue using those medications that were originally of low therapeutic value. Patient: Dr. Li: Hello! Could you please 1. Where did you give the last three-month injection? The buttocks or the arms? I forgot to ask you. 2. I asked a friend to get the results of the last examination at your hospital, so you can tell me FSH 3.08 MLU/ML (2.97-6.82) LH 2.49 MLU/ML (1.18-3.54) PRL 10.6 NG/ML ( Hospital masculology: the examination results support treatment with injections. Of course it is a buttock (spanking). Patient: Dr. Li: How are you doing? Beijing a few days apart, feel most deeply is your dedication, but you should pay more attention to their own body, work up without water and eat this is the iron man can not stand, I hope you cherish their own body, at the same time will give us more gospel. My husband has already started the injections, we will insist on three months, last time in a hurry did not check the cell shedding science I wait for the next time when you go directly with a list to check again. Can I? Hospital Male: Yes. Patient: Dr. Li: Hello! My husband has been taking the injection for almost two months now, but he doesn’t feel anything special, but his libido is stronger, I don’t know if this is a good sign or not. In another month, (his testosterone is low), should I have a blood test? Thank you. Hospital Men: It is also a normal reaction, there is no need to test the blood, you can check the semen at the time of treatment. Patient: Dr. Li: Hello! Thank you for your hard work! I’ve been away for almost three months, and I’m going to be tested in a while, so I’m trembling in my heart. I would like to know: what does low testosterone mean? Does it mean that there is a sperm production function? What should we eat for food therapy? Or what should we pay attention to? I’ve been on the medication for a while and my head is obviously getting bigger, it’s hard to feel bad, but I’ll do whatever it takes to get well! Thank you! Hospital masculology: Patients who can have the opportunity to play, of course, there is a chance, even if there are no results in March, do not be discouraged, the course of treatment is 3-6 months. Those who have been ineffective for six months, only then give up the injection and choose to have an epididymal puncture, there is also a chance. What do you mean by “significantly larger head” design? Are you tired of the injections? Or do you have the side effect of head swelling? Patient: Dr. Lee: Hello! I mean that the shape of my head is bigger, one circle bigger than before. You haven’t answered my question about testosterone yet oh, what else should I do? Whatever I do, as long as I can be cured, I am willing to do it, not to mention the injections. Beijing Union Medical College Hospital male science Li Hongjun: low testosterone, if you exclude the laboratory error, suggesting that male characteristics are not strong, will also affect the testes sperm production, you can use drugs to cure, or injections will also be effective. Your head is big? It is difficult to understand ah. If the drug has this effect, it is simply too bizarre. In that case, you should stop taking the medication. Patient: Dr. Li:Hello! The testosterone index of the last examination in your hospital is as follows: T 2.34 (3.80-7.77) FSH 3.08 ( 2.97-6.82) LH 2.49 (1.18-3.54) PRL 10.6 E2 27.82 Now the testosterone is low, but everything else is within the index. I think my male characteristics are normal, hey, how can this happen? Hospital masculology: It is because your FSH is not high that you decided to treat with medication, and the predicted efficacy of the drug is more efficient. Patient: Dr. Li: Hello! My lover has been taking the injections for 3 months now, and tomorrow he and I will go for lab tests to see how it works. But I want to take another 3 months of shots no matter what the results are, what do you think? I can tell you the results tomorrow Oh, I’m nervous! Hospital Maleology: Okay, don’t be nervous, a normal mind helps recovery. No matter what the result is, you have to work down the road. Patient: Hello Dr. Lee!!! We are a couple kowtowing to you at the computer, thank you so much! After three months of your injection and oral treatment, today’s semen examination results: after centrifugation all specimens see two good active sperm, no dead sperm. The spermatocytes are followed by a grass head. The doctor said it means more, I do not know what it means. I don’t know what it means. But I’m already very happy, if you were there, I would like to hug you! Now I ask you: 1. do I continue to use the medication, is it increase or decrease the dosage? 2. If I continue, should I go to Beijing or should my friend in Beijing pick up the medication and mail it to me? (Because I’ve been a little busy lately, but if you let me go, I’ll “go for it”!) Hospital masculinity: Accept your thanks with a sense of security, because you are successful. And one of those patients who had the same injection as you will have no sperm out, no results, he may scold me, or complain about me. After all, the success rate is 50-60%. You can continue with the medication and keep the same dose for now. If you want to see me, come to the hospital and discuss it in person. Or your friend can come instead of you, both are fine.