Which Tests Follow a Semen Analysis? Hormone, Genetic and Ultrasound Checks in Male Infertility

The envelope from the lab is thinner than he expected. Two pages, a column of numbers, a few marked with a small flag. His partner reads it over his shoulder and neither of them knows whether a low count is a verdict or a starting point. The clinic phones the next morning and asks him to come back, not for another semen sample, but for a blood draw before ten o’clock.

That second appointment is where many men first hear the phrase male infertility hormone tests, along with a list that sounds intimidating on the phone: FSH, LH, testosterone, perhaps a genetic panel, perhaps an ultrasound. Each test answers a narrow, specific question. Together they turn a single number on a lab sheet into a story about how sperm are being made, whether they can get out, and whether anything in the wider body is interfering.

This article walks through that second stage in the order clinicians usually think about it, so the next phone call feels less like a summons and more like a plan.

Why a male fertility test starts with semen analysis but rarely ends there

A semen analysis measures how much fluid is produced, how many sperm it contains, how many are moving and what proportion look normally shaped. It is a snapshot, and a slightly blurry one. Counts swing with illness, fever, stress and even the length of time since the last ejaculation, which is why Mayo Clinic notes that laboratories usually ask for two to seven days of abstinence before a sample and often request a repeat test some weeks later before drawing conclusions.

Here is what the snapshot cannot tell you. It cannot say whether a low count comes from the testicles struggling to make sperm, from the brain sending too little of the hormonal signal that tells them to work, or from a physical blockage somewhere between the testicle and the outside world. Three completely different problems can produce the same disappointing number. The follow-up tests exist to separate them.

Mayo Clinic gives a useful anchor for the first number most people fixate on: a sperm concentration below about 15 million per milliliter is considered low. Below that line, and especially when very few or no sperm are seen, the odds rise that something measurable is happening upstream, and the case for hormone testing, genetic testing or imaging grows stronger.

One more reason the semen analysis is a beginning rather than an end: it is, in a sense, a health screen. Some causes of poor sperm production, including hormone-secreting tumors of the pituitary gland and testicular cancers, are conditions a man would want found regardless of whether he was trying to conceive. That is the quiet argument for taking the second appointment seriously, even when the first result was only mildly abnormal.

How the male infertility workup actually happens, step by step

The second visit usually opens with questions rather than needles. A clinician will ask about childhood surgeries such as undescended testicles or hernia repair, past infections including mumps after puberty, sexually transmitted infections, chemotherapy or radiation, anabolic steroid or testosterone use, heavy alcohol or cannabis use, work in hot environments, and any difficulty with erections or ejaculation. Each of these steers the testing that follows, which is why an honest history saves both time and blood draws.

Next comes a physical examination. The clinician checks the size and firmness of each testicle, feels for the vas deferens (the tube that carries sperm from the testicle toward the urethra) and looks for a varicocele, an enlarged cluster of veins in the scrotum that can warm the testicle. Small, soft testicles suggest a production problem; a missing vas deferens on one or both sides points toward a genetic or structural explanation. Examining a man standing up, and asking him to bear down, makes a varicocele easier to feel.

Only then are the laboratory tests chosen. Blood is drawn for hormones, ideally in the morning, because MedlinePlus explains that testosterone peaks early in the day and falls through the afternoon. If sperm are absent or severely reduced, a genetic panel is added to the same draw. Imaging is booked if the examination or the hormone pattern hints at a varicocele, an obstruction, or a mass.

The sequence matters because each layer narrows the next. A man with normal-sized testicles, normal hormones and no sperm in his sample has a very different set of likely explanations than a man with small testicles and a high FSH, and the tests that follow should look different too.

Which male infertility hormone tests come first, and what each one measures

Hormone testing in men with fertility concerns revolves around a feedback loop between the brain and the testicles. The hypothalamus signals the pituitary gland; the pituitary releases two messengers, follicle-stimulating hormone (FSH) and luteinizing hormone (LH); FSH tells the testicles to make sperm and LH tells them to make testosterone. Testosterone and a hormone called inhibin B then travel back to the brain and dial the signals down. When any part of the loop breaks, the numbers shift in a recognizable way.

Test	What it measures	Why it is ordered
FSH	Pituitary signal to sperm-producing cells	Distinguishes a testicular production problem from a signaling problem
LH	Pituitary signal to testosterone-producing cells	Read alongside testosterone to locate the fault
Total testosterone (morning)	Main male sex hormone	Low levels affect sperm production and libido
Prolactin	Pituitary hormone usually linked to lactation	High levels can suppress LH and testosterone; may signal a pituitary growth
Estradiol	Main estrogen, made partly from testosterone	Checked when body weight is high or breast tissue is enlarged
TSH	Thyroid-stimulating hormone	Thyroid disorders can disturb the reproductive axis

Not every man needs every row. Mayo Clinic describes hormone testing as a standard part of the evaluation, but clinicians typically begin with FSH and testosterone and add the others when the first results, the history or the examination raise a specific question. A single abnormal value is often repeated on a second morning before anyone acts on it, because testosterone in particular varies from day to day and falls after poor sleep, acute illness or a heavy meal.

What hormones are tested for male infertility tell you: reading the pattern, not the number

Clinicians rarely interpret one hormone in isolation. The information sits in the relationship between values, and three patterns account for most results.

The first is high FSH with a low or normal testosterone, often alongside small testicles. This suggests the testicles themselves are struggling to produce sperm, so the pituitary keeps shouting louder. Doctors call this primary testicular failure. Causes range from a past mumps infection or chemotherapy to genetic conditions such as Klinefelter syndrome, which is why this pattern is one of the strongest prompts for genetic testing.

The second is low FSH, low LH and low testosterone together. Here the testicles may be perfectly capable, but the brain is sending too little signal. This is called secondary or hypogonadotropic hypogonadism, and possible causes include a pituitary tumor, very high prolactin, prior anabolic steroid or testosterone use, severe illness, or a rare inherited condition present from birth. Because the underlying machinery is often intact, this pattern is, in clinical experience, one of the more treatable, though whether treatment applies is a decision for the prescribing team.

The third is normal FSH, LH and testosterone in a man with few or no sperm. Hormones are not the problem; the sperm are probably being made and not getting out. This shifts attention to obstruction, retrograde ejaculation, or a missing vas deferens, and toward imaging and genetic testing for cystic fibrosis gene variants.

An isolated high prolactin deserves a mention of its own. Mild elevations often trace back to stress, a recent blood draw scare or certain medicines, and are simply rechecked. Persistently high values may lead to imaging of the pituitary gland. The lesson across all three patterns is the same: a lab flag beside a number is a clue, not a diagnosis, and the treating team reads the whole panel together with the examination.

When is male infertility genetic testing recommended, and what does it look for?

Genetic testing is not offered to every man with a low count. It is generally reserved for those with severely reduced or absent sperm, for men with small testicles and high FSH, and for men whose vas deferens cannot be felt on examination. In those groups the yield is meaningful, and the results can change what treatment is even possible.

Three tests do most of the work. A karyotype (a picture of all the chromosomes in a blood sample) looks for extra or rearranged chromosomes. The most common finding is Klinefelter syndrome, in which a male carries an extra X chromosome. MedlinePlus reports that it affects about 1 in 500 to 1,000 newborn males, and many go undiagnosed until they are evaluated for infertility, because the outward signs can be subtle.

A Y-chromosome microdeletion test looks for missing segments in regions of the Y chromosome that govern sperm production. Some deletions are compatible with finding usable sperm in the testicle; others predict that none will be found. That distinction is exactly why the test matters before any surgical retrieval is discussed.

CFTR testing checks for variants in the gene responsible for cystic fibrosis. Men born without a vas deferens on both sides very often carry such variants, even when they have no lung or digestive symptoms, and their partners are usually offered testing too, because the result affects the risk for any future child.

Results take longer than routine bloodwork and are usually delivered in person, ideally with genetic counseling. A counselor explains what a finding means for the man’s own health, for the chances of retrieving sperm, and for children conceived with assisted reproduction. Mayo Clinic lists genetic testing among the standard additional tests precisely because it answers questions the semen analysis never can.

What a scrotal ultrasound for infertility looks for

A scrotal ultrasound is a painless scan using sound waves to picture the testicles and the tissue around them. It takes a few minutes, involves warm gel and a handheld probe, and needs no preparation. Clinicians order it when the examination is uncertain, when a lump is felt, or when they want to measure the testicles precisely, because testicular volume tracks closely with sperm-producing capacity.

The most frequent finding is a varicocele. Cleveland Clinic describes it as a swelling of the veins that drain the testicle, similar to a varicose vein in the leg, and estimates that it affects roughly 15 percent of adult men, with a considerably higher share among men evaluated for infertility. Pooling blood raises the temperature of the testicle by a degree or so, and sperm production is temperature-sensitive. Ultrasound with Doppler (a setting that shows the direction of blood flow) can confirm a varicocele and grade its size when a physical examination leaves doubt.

The scan also measures each testicle, checks the epididymis (the coiled tube where sperm mature) for cysts or signs of past inflammation, and looks for microlithiasis, tiny calcium deposits that are usually harmless but are noted for follow-up.

Less commonly, ultrasound reveals a mass. Testicular cancer is more common in men with fertility problems than in the general population, and an unexpected solid lesion is the single most important reason imaging is not skipped in men whose examination is not entirely normal. Most masses turn out to be benign, but the scan is how the distinction begins.

Not every man needs the scan. A man with a clearly normal examination, normal hormones and only mild changes in his semen analysis may reasonably be spared it, and the decision sits with the treating clinician.

Transrectal ultrasound, post-ejaculation urine and other checks for blockage

When the hormones are normal, the testicles are a normal size, and yet the sample contains very few or no sperm, the working question becomes: are the sperm being made but failing to exit? Two tests address it.

The first is a post-ejaculation urine test. A man empties his bladder, produces a semen sample, and then provides urine immediately afterward. If sperm appear in that urine, the diagnosis is retrograde ejaculation, in which semen travels backward into the bladder rather than forward. Diabetes, spinal injury, prostate or bladder surgery, and certain blood pressure or prostate medicines can cause it. The test is simple, non-invasive, and Mayo Clinic lists it among routine additional investigations for exactly this reason.

The second is a transrectal ultrasound, in which a slim probe is placed in the rectum to image the prostate, seminal vesicles and ejaculatory ducts from close range. It is brief and mildly uncomfortable rather than painful. Clinicians look for dilated seminal vesicles, cysts pressing on the ducts, or absent seminal vesicles, which would fit with the CFTR-related picture described earlier. A low semen volume with acidic fluid and no fructose (a sugar normally supplied by the seminal vesicles) is a classic clue that steers toward this scan.

Occasionally, when imaging and blood tests cannot settle whether sperm are being produced, a testicular biopsy is discussed. A small piece of tissue is removed under anesthesia and examined for developing sperm. It is done less often now that hormone patterns and genetic tests predict so much, and in modern practice it is usually combined with an attempt to retrieve sperm for future use rather than performed for diagnosis alone. Whether it is appropriate at all is a conversation for the treating team.

Who usually gets the full workup right away, and who is asked to wait

Fertility testing is unusual in that time itself is part of the diagnosis. Most couples are not evaluated at all until they have tried to conceive for about a year, since the NHS and Mayo Clinic both describe roughly 12 months of regular unprotected intercourse without pregnancy as the usual threshold for calling it infertility.

That waiting period shortens in specific circumstances. Clinicians usually move straight to evaluation, and often straight to the second-stage tests, when a man has a known risk factor: a history of undescended testicles, testicular surgery or torsion, chemotherapy or radiation, mumps after puberty, past use of anabolic steroids or prescribed testosterone, difficulty with erections or ejaculation, or a visible lump or swelling. The same applies when the female partner is over about 35, when her own evaluation is already under way, or when the couple has a known genetic condition in the family.

Who is asked to wait? A man whose first semen analysis is mildly abnormal, whose examination is normal and who has no risk factors is very often asked to repeat the semen analysis rather than proceed to blood tests and scans. Sperm take roughly two to three months to develop, so a result taken shortly after a fever, a period of heavy drinking or a course of certain antibiotics can look far worse than the man’s usual output. Mayo Clinic’s guidance to repeat the test before acting reflects this.

Hormone testing tends to be ordered earlier when the count is very low, when the man reports low libido or fatigue, or when the testicles are small. Genetic testing and imaging follow the same logic: the more severe or specific the initial findings, the sooner they are added. The order is not rigid, and a thoughtful clinician tailors it to the person in front of them.

What are the top 3 causes of male infertility, and which test points to each?

Ask three specialists for the three biggest causes and you will hear slightly different lists, but the categories overlap heavily and map neatly onto the tests in this article.

The first is impaired sperm production within the testicle. Varicocele is the most common correctable contributor here; Cleveland Clinic notes it is found in a large share of men evaluated for infertility. Other production problems include past infection, heat exposure, chemotherapy, and genetic conditions such as Klinefelter syndrome and Y-chromosome microdeletions. The tests that expose this category are the physical examination, scrotal ultrasound, and the FSH and testosterone pattern.

The second is hormonal signaling failure. Here the problem originates above the testicles: a pituitary tumor, a high prolactin, thyroid disease, or the suppressive effect of external testosterone and anabolic steroids, which switch off the brain’s own LH and FSH and can bring sperm production close to zero. Mayo Clinic specifically lists these among causes. The hormone panel is the test that finds this group, and it is the group where the numbers most often change what a clinician recommends.

The third is obstruction or transport failure. Sperm are made but cannot leave: a missing or blocked vas deferens, scarring from infection or surgery, or retrograde ejaculation. Normal hormones with absent sperm, a low semen volume, a post-ejaculation urine test and transrectal ultrasound are the pointers here.

A fourth category sits behind all three: unexplained infertility, where every test returns normal and the semen analysis is still poor. Mayo Clinic acknowledges that in a substantial share of men the exact cause is never identified. That is frustrating, but it does not close the door on treatment. It simply means the treating team works from the sperm they have rather than from a diagnosis.

What the following weeks usually look like: results, repeats and referrals

The rhythm of the second stage is slower than most people expect, and knowing the typical shape helps.

Routine hormone results are usually back within a few days. If a value is borderline, a repeat morning draw is commonly scheduled a week or two later, because MedlinePlus notes testosterone can vary considerably from one day to the next. A repeat semen analysis, when requested, is typically spaced several weeks from the first so that a new cohort of sperm has had time to develop. Mayo Clinic describes this repeat as standard, not a sign that something went wrong.

Ultrasound is often done on the same day as a follow-up visit or within a couple of weeks. Results are usually available immediately or shortly after, and a normal scan closes off several possibilities at once.

Genetic testing is the slow lane. A karyotype involves growing cells in the laboratory, and results for karyotype, Y-microdeletion and CFTR panels commonly take several weeks. Clinics usually arrange a dedicated appointment to discuss them, and a genetic counselor may join.

Somewhere in this window a referral often happens. A primary care clinician or gynecologist who ordered the first tests may hand the man to a urologist with training in reproductive medicine, particularly if the hormones are abnormal, sperm are absent, or a varicocele or mass has been found. The couple is frequently seen together by a fertility specialist at the same time, because the woman’s evaluation runs in parallel and the eventual plan depends on both sets of results.

The realistic timeline from the first abnormal semen analysis to a completed second-stage workup is therefore measured in weeks to a few months, not days. That is not delay for its own sake; it is the pace at which the body produces the evidence.

Male infertility hormone tests and medicines: what a result changes, and what it does not

People often assume a low testosterone reading means testosterone will be prescribed. In a man trying to conceive, the opposite is usually true. Testosterone given from outside signals the brain that levels are already high, so it suppresses LH and FSH and can shut down sperm production almost completely. Mayo Clinic lists testosterone use among causes of male infertility for this reason. A man on testosterone who wants children should raise this with the prescribing clinician rather than stopping or continuing on his own.

When the pattern shows the brain is under-signaling, clinicians may discuss medicines that restore the signal rather than replace the hormone. Two classes come up. Gonadotropins are injectable versions of the pituitary messengers that stimulate the testicles directly. Selective estrogen receptor modulators, a class of oral medicines, block estrogen’s feedback at the brain so the pituitary releases more LH and FSH of its own. A third class, aromatase inhibitors, lowers the conversion of testosterone to estradiol and is sometimes considered when estradiol is disproportionately high. Because sperm take two to three months to develop, any effect on a semen analysis is judged over months rather than weeks, and clinicians repeat the semen test to see whether it is working.

Evidence for these approaches is strongest when a defined hormonal deficiency has been shown; in men with normal hormones the benefit is uncertain, and mainstream guidance describes such use as unproven rather than established. A high prolactin may lead to medicines that lower it, and thyroid disease is treated in its own right.

None of this is a menu. Whether any medicine is appropriate, which one, and for how long are decisions for the prescribing clinician, informed by the whole picture, including the partner’s evaluation.

What people often get wrong about male fertility testing

The first misconception is that a low testosterone number is the diagnosis. In most men with fertility problems, testosterone is within the normal range, and a mildly low reading on a single afternoon sample says little. Clinicians repeat it in the morning and read it alongside LH before drawing any conclusion.

The second is that a normal semen analysis means everything is fine. It means the sperm looked reasonable that day. It does not test sperm DNA integrity, nor does it guarantee function, which is why couples with normal results on both sides can still be labeled unexplained.

The third is that testosterone or supplements marketed for fertility will raise a low count. As described above, prescribed testosterone typically lowers sperm production. Over-the-counter products are generally unproven, and any that secretly contain hormones can do harm. Mayo Clinic advises discussing any supplement with a clinician before use.

The fourth is that genetic testing is only about the man’s own health. Its greatest practical value is often in predicting whether sperm can be found and in informing partners about risks to a future child, which is why counseling accompanies it.

The fifth is that infertility is mostly a female problem. Mayo Clinic notes that nearly 1 in 7 couples is infertile and that a male factor plays at least a partial role in up to half of them. Testing the man early is not an afterthought; it is half the investigation.

The last is that a varicocele found on ultrasound must be repaired. Many are small and incidental. Whether repair is likely to help depends on its size, the semen findings, the partner’s situation and the couple’s timeline, and the urologist weighs those together rather than acting on the scan alone.

Questions to ask your care team before and after the tests

A fertility consultation moves fast and covers ground most people have never heard of. Writing questions down beforehand, and bringing a partner or a friend to take notes, changes the experience. These are the ones that tend to matter most.

• Which of my semen analysis results are abnormal, and how far outside the reference range are they?
• Do you want a repeat semen analysis before ordering more tests, and if so, how far apart?
• Which hormone tests are you ordering, and what pattern would change your thinking?
• Should my blood be drawn in the morning, and do I need to fast or stop anything beforehand?
• Do my results suggest a production problem, a signaling problem or a blockage?
• Am I someone who should have genetic testing, and will a genetic counselor explain the results?
• If a genetic finding is present, what does it mean for my own health and for a future child?
• Did my examination or ultrasound show a varicocele, and how large is it?
• Is there anything on the scan that needs follow-up for reasons unrelated to fertility?
• Are any of my current medicines or supplements likely to be affecting sperm or hormones?
• How should my partner’s evaluation and mine be combined into one plan?
• What are the realistic options if every test comes back normal?
• Who do I contact with questions between appointments, and how long should results take?

Asking a clinician to explain what a result would change, rather than simply what it is, tends to produce the clearest answers. A test whose outcome would not alter the plan is a test worth questioning; a test whose outcome would open or close a treatment path is one worth doing promptly. Good teams welcome that framing, because it keeps the workup focused on decisions rather than on data for its own sake.

When to call your doctor

Most of this workup is unhurried, and results that arrive slowly are not a cause for alarm. A few situations are different and warrant a call rather than waiting for the next scheduled visit.

Contact your clinician promptly if you notice a new lump, hardness or change in the size or shape of a testicle, or a heavy, dragging feeling in the scrotum that has appeared recently. Testicular masses are usually painless, which is precisely why they are easy to dismiss. The same applies to breast enlargement or tenderness in a man, or to a persistent headache with changes in vision, which can accompany a pituitary growth in someone with a high prolactin or low LH and FSH.

Seek same-day or emergency care for sudden, severe testicular pain, particularly with nausea or swelling. Testicular torsion, in which the testicle twists and cuts off its blood supply, is a surgical emergency in which hours matter. Fever with scrotal pain and swelling, painful urination with discharge, or blood in semen that does not settle also need timely assessment.

Call as well if you have started, stopped or changed any hormone, steroid or supplement since your tests were ordered, because it can make results uninterpretable. Report new erectile difficulty, loss of libido, marked fatigue or hot flushes, since these can accompany significant hormonal shifts.

Finally, a word on the emotional side. Infertility evaluation carries a documented psychological load, and low mood, anxiety or strain in the relationship are common and worth raising. Many fertility services include counseling, and a primary care clinician can help arrange support. None of these calls is an overreaction. The purpose of the second-stage workup is to find what matters, and a man who speaks up about a change in his body is helping that process rather than interrupting it.

Frequently asked questions

What hormones are tested for male infertility?

The usual first set is follicle-stimulating hormone (FSH), luteinizing hormone (LH) and total testosterone, drawn in the morning. Prolactin is added when testosterone or LH is low, estradiol when body weight is high or breast tissue is enlarged, and thyroid-stimulating hormone when thyroid disease is suspected. Clinicians read these as a pattern rather than individually, and borderline results are often repeated on a second morning before any decision is made.

How to test if a male is infertile?

Testing begins with a semen analysis, ideally repeated after several weeks, together with a medical history and a physical examination of the testicles and scrotum. Depending on those findings, blood tests for FSH, LH and testosterone follow, then genetic tests or ultrasound where indicated. No single test labels a man infertile; the diagnosis emerges from the combination, and Mayo Clinic notes that in some men no cause is ever identified.

What is a male fertility test at the doctor like?

Expect a conversation about health history, a brief examination performed standing and lying down, and a semen sample produced in a private room or at home if the clinic allows it. Blood is drawn on a morning visit for hormone tests. Ultrasound, if needed, is a short, painless scan. Genetic testing uses the same blood draw but results take several weeks and are usually explained in a dedicated appointment.

When is male infertility genetic testing recommended?

It is generally offered when sperm are absent or severely reduced, when testicles are small and FSH is high, or when the vas deferens cannot be felt. The three common tests are a karyotype, a Y-chromosome microdeletion screen and CFTR gene testing. Results guide whether sperm retrieval is likely to succeed and whether a future child could inherit a condition, which is why genetic counseling usually accompanies them.

What does a scrotal ultrasound for infertility show?

It measures testicular volume, which tracks with sperm-producing capacity, and looks for a varicocele, cysts or inflammation in the epididymis, and any solid mass. Doppler settings show blood flow and confirm a varicocele when the examination is uncertain. The scan takes a few minutes and needs no preparation. It is not required for every man; clinicians order it when the examination, hormones or semen findings raise a specific question.

What are the top 3 causes of male infertility?

Most specialists group causes into impaired sperm production in the testicle (varicocele, infection, heat, chemotherapy, genetic conditions), hormonal signaling failure from the pituitary or hypothalamus (including suppression by external testosterone or steroids), and obstruction or transport problems such as a blocked or missing vas deferens or retrograde ejaculation. A substantial share remains unexplained after full testing, according to Mayo Clinic.

Does a low testosterone level mean I am infertile?

Not on its own. Many men with fertility problems have normal testosterone, and many with a mildly low reading on one afternoon sample have normal sperm. MedlinePlus notes testosterone is highest in the morning, so a repeat morning test is standard. Clinicians interpret it alongside LH and FSH; the combination shows whether the testicle or the brain’s signal is the issue, and only then does it influence a plan.

Why did my doctor order a post-ejaculation urine test?

It checks for retrograde ejaculation, in which semen flows backward into the bladder instead of forward. If sperm are found in urine collected immediately after ejaculation, that explains a low or absent semen volume. Diabetes, spinal injury, prostate or bladder surgery and some medicines can cause it. The test is painless and non-invasive, and Mayo Clinic lists it among routine additional tests when the semen volume is low.

How long does the whole male infertility workup take?

Routine hormone results return within days, a repeat semen analysis is usually spaced several weeks from the first so new sperm have developed, and genetic results commonly take several weeks. Ultrasound is often same-day. Altogether the second stage typically spans weeks to a few months, and Mayo Clinic describes repeating the semen analysis as a normal part of the process rather than a sign of trouble.

Should I stop testosterone or supplements before my fertility tests?

Do not stop or start anything without speaking to the clinician who prescribed it or who is running the evaluation. Prescribed testosterone and anabolic steroids suppress sperm production and distort hormone results, and some supplements contain undeclared hormones. Tell your care team exactly what you take so they can time the tests and interpret them correctly; the decision about any change rests with them.

References

• MedlinePlus: Semen analysis
• MedlinePlus: Testosterone levels test
• MedlinePlus Genetics: Klinefelter syndrome
• Cleveland Clinic: Varicocele

This article is for general information only and is not a substitute for professional medical advice. Please consult a qualified doctor about your individual situation.