This is a story of a patient that needs to be shared. It speaks to how essential it is for all men with abnormal semen parameters to have a dedicated male fertility evaluation.
Marc and his wife have been trying to conceive for well over a year. They went to a prominent local fertility center for evaluation, which included a semen analysis. His sperm count was extremely low, almost zero. The reproductive endocrinologist, instead of simply proceeding to in-vitro fertilization, referred him to me for examination and evaluation.
He had no symptoms, and was otherwise in good health. On examination one of his testicles was very enlarged, and firm, which can be an indication of a testicular mass.
Ultrasound confirmed that the whole testicle had indeed been taken over by a mass, and his blood work showed a very high tumor marker. His CT scan showed that he had a large mass of lymph nodes, diagnostic for metastatic cancer.
His testicle was surgically removed and he promptly started chemotherapy. His chance of survival and cure is strong, despite his testicular cancer having spread, and simply put, his semen analysis and reproductive endocrinologist saved his life.
While this is a rare case, it is important to see a specialized fertility specialist, who can help determine if there is a root cause of infertility. Read more about an infertility evaluation.