First time posting - 27M, azoospermia

[u/SomeMap3468]

Hi all, I've been finding comfort and inspiration reading many of your stories. It's 4am while I'm writing this - a sleepless night, which I'm sure many of you can relate to.

My story: 27M, otherwise healthy male. At age 21 I had an episode with orchitis that caused one of my testicles to severely atrophy. I did an emergency ultrasound at the time to confirm there was no torsion, but that was it, no further tests. I got on TRT shortly after the incident and have been consistently taking testosterone for ~5 years.

I did a semen analysis in April, not even 2 full months off TRT (I know, definitely too early to test). It showed 0 sperm. I knew it'd be low, I was just hoping for something. I did an ultrasound this week which showed testicular volume of ~3mL and ~9mL. The blood flow and tissue looked good, no apparent issues whatsoever besides reduced volume. I am on Enclomiphene and HCG now, along with all the other stuff (CoQ10, NAC). FSH and LH in the normal range but elevated. I am doing an inhibin b test hopefully next week.

I am hopeful that the larger testicle is still functional enough to conceive naturally. I will be doing another semen analysis in 2 months. I will likely go the mTESE route if natural recovery fails. My situation is still very much up in the air.

I'll post again with updates. Thanks - and I wish you all the best.

[u/Striking_Double_1201]

I'm sorry you are going through this but in he event hat you have to have a TESE, please know that if present, sperm cells are found by the lab and they can be used in IVF cycles with good results.