u/maxksa18

Hi guys I just got diagnosed unfortunately with azoospermia and how I discovered that there is no sperm in my semen is just a funny story i did empo one year ago for grade 3-4 Bilateral varicoceles (more then 10 years) so one day i noticed that my libido is gone and completely ED thats when everything started i went to the doctor and did some bloodwork and semen analysis , my testicles the right 3.16x1.39x2.32 , left 2.58x1.10x1.38

Blood work :

Estradiol(E2) 44.55 pg/mL 25 - 84
Follicle Stimulating
6.50 mIU/mL 1.4 - 12.6
Hormone (FSH)
Lutenizing Hormone (LH) 7.71 mIU/ml 0.5 - 12.4
Prolactin 12.2 ng/mL 2.5 - 13.2
Prostatic Specific Antigen
(PSA) Total
1.17 ng/mL 0 - 4
Testosterone (Free) 25.14 pg/mL 12.3 - 46.6
Testosterone (Total) 3.82 ng/mL 1.71 - 7.89

Semen analysis

https://ibb.co/FL8ZdXrW

[url]=https://ibb.co/FL8ZdXrW][img]https://i.ibb.co/Jwr6Sq1d/IMG-1472.jpg[/img][/url]

Unfortunately couldn’t find karyotype test in my country so my doctor prescribed me 3 months ago clomid 50 and hcg 5000 and ai , my question is

1- are these immature germ cells means anything?
2- can we find its NOA or OA without any biopsy or surgical procedure?
3- does anyone has any success without Mtese?
4- i heard some stuff about dr peru and dr ramaswamy should I contact with them? Are they offering online consultation or i should travel?

I really can use some guidance right now this news just destroyed me completely