Help with a medical mystery-It's never good when the doc says "Hmm, that's rare"

Hello there,

My husband is 37 and has been dealing with low T for 2 years now. His numbers generally stay in the "under 300" realm. He has tried the testosterone injection (had a negative reaction), testosterone patches (made NO difference) and Androgel (which only raised T by about 30). Nothing has worked. He then stopped all TRT so that we could start trying to conceive our 2nd child.

Fast forward to now. We are over a year in and still no baby. He had a semen analysis which showed VERY low sperm count (under 1mil) and poor motility. After the urologist did more tests, it appears his FSH is normal but his LH is low. The urologist said "Hmm, that's rare. Usually LH and FSH are high with low T"...

We are now awaiting an appointment with an endocrinologist, but I am obviously a bit impatient. Can anyone shed some light on this? What could it be? Does anyone know some possible treatment options? Will we ever get my poor husband back to "normal" with sperm and testosterone?

Many thanks from a desperate wife

It depends on what "type" of hypogonadism he has. Primary hypogonadism means the testicles are not functioning correctly. Secondary hypogonadism means there is a problem usually with the pituitary gland. Low LH and FSH are the indicator for secondary hypogonadism. I have not heard of low LH only (I am not a doctor), but I would guess this is why the doctor made that statement. I have secondary and both my FSH and LH levels are extremely low. Basically the endocrine system is a big loop, each part sending signals to the next part. If one of these parts is busted (not working correctly) it throws off the whole system.

The drug HCG mimics FSH and LH and signals the testes to produce more T and more sperm. Plus it will make your hubby super horny (side effect) like he is 16 years old again. My guess is the doc will give him HCG. HCG is also prescribed as a fertility drug for men. So if the doc doesn't mention it...ask him! If he is against it, find another doc.

For more info:
https://en.wikipedia.org/wiki/Luteinizing_hormone
Read the last paragraph!