Endocrine Abstracts

A 45-year-old Caucasian man with BMI of 34 presented with a few years’ history of low libido and premature ejaculation. He had azoospermia in the past for infertility investigation 4 years ago with his previous relationship. His LH and FSH were high at 18 U/l(2-13 U/l) and 10 U/l(2-9 U/l) while his 9 amtestosterone level was 19.2 nmol/l(10-38 nmol/l) along with normal prolactin and TSH. The testicular examination is unremarkable. His repeat semen analysis shows azoospermia and ultrasound testes is normal. There is no history of chemotherapy, radiotherapy, mumps infection, or testicular injury. His chromosomal analysis is in process. He is not planning to father a child in the future. This case demonstrates Sertoli cell injury and brings the challenges of how to investigate the causes if chromosomal analysis is normal and how to manage low libido with normal testosterone.