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Could zero sperm count be related to blood in urine?
djburt posted:

Over a year ago, a regular physical urine analysis showed blood in my urine, so the doctor prescribed a course of antibiotics and asked me to repeat the test in one month. I never took the antibiotics, repeated the test, and never heard back so I assumed it was ok.

Just recently I had another physical and there was again blood in my urine. Between these two visits, my wife and I had been trying to get pregnant and finally found that I had zero sperm in my semen. The infertility urologist concluded without any further testing that the only way for us to have a biological child was through in vitro. Though it was extremely sad news for us, we've had lots of support and are now in the process of embryo adoption - an option we are very much at peace with.

But I can't help wonder if these two things are related - they are after all right next to each other down there, and I understand that sometimes things like enlarged prostate glands can cause blood in urine and can also block the vas deferens. I have an appointment with my infertility urologist set up for Monday, but in the meantime, I hoped to pose this question here.

I'm 35 years old, otherwise healthy, and no symptoms except that I can't get my wife preggo. Thanks very much for any help.

amyaalc responded:
Blood seen in the urine can happen from time to time and most often a sign infection. If this untreated infection was bad enough to disrupt your sperm production and cause damage to the testicles is hard to say. I just don't understand why you didn't take the antibiotics and make sure to take care of the situation when it appeared a year ago??? Your doctor will not babysit you. They will leave it up to you to schedule that follow-up. It's not that they thought it was okay to skip the follow-up but rather they just don't have the office staffing to call back patients to remind them of needed checks. Did your urologist give you any diagnosis to why you are not producing sperm? Did you have blood work to check your hormone levels? It is hard to say what is going on but working with your urologist to figure out why you are not producing is key and to see your option for sperm retrieval for use with IVF.

Common assessments for men with no sperm in ejaculate: 1)Fructose assay on ejaculate to check if you have a blockage making it impossible for sperm to pass into the ejaculate. 2) At least 2 semen analyses 3) Blood work to check free and total testosterone, prolactin, estradiol, FSH, LH and TSH 4)testicular ultrasound 5)testicular biopsy to assess if the your testicles have any sperm production 6)DNA testing to see if you carry a genetic cause for being sterile

We would love to hear how you next appointment goes and what you find out.

Amy Perkins, MS, TS (ABB)
Laboratory Supervisor
Arizona Andrology Laboratory & Cryobank
International Center for Vasectomy Reversal

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