At that time, I was working in a private hospital in Istanbul-Bağcılar. His father had been hospitalised with stomach bleeding and we were discharging him.
However, when I saw him for the first time, I asked him not to misunderstand me when I asked him if his private parts were small in volume, because he had no beard or moustache. The breasts were visible through the shirt and he was tall. In my opinion, this was at best a hippo. He coughed slightly and took his father out and closed the door. Ah! I thought the boy must have misunderstood. But it was not as I feared. He said, “Sir, how did you understand me? For how many years I couldn’t open this problem anywhere. Every night, my tears dried up from wetting the prayer rug, Allah brought you to me, I was almost alone with my fate. I wonder if today is the day when my prayers are accepted, he asked me with grateful eyes waiting for an answer. I advised her to do a hormone test tomorrow morning on an empty stomach.
The results were exactly as I predicted. FSH, LH, Testosterone together were very low.
As she was a teacher, she had to take additional leave. She was working in the East. I referred him to my teacher Refik Tanakol. At that time I could only guess, diagnose and refer to my teacher. After a very good treatment, everything changed and improved. Beard, moustache. Testicles and private parts all became normal. Even better, he said goodbye to being a bachelor and married the teacher he loved. He had a son spontaneously, that is, naturally with pregnancy. He dedicated the name of his son to my teacher and me. He bears both of our names. Now he is an important state bureaucrat. He is now a statesman who works hard in his region and leaves good works for the homeland and nation and raises young people.
He called me recently. He said, “Ours wants a sibling. So we got to work. The secret of success in patients with Hypophysial Hypogonadism is to spread HCG treatment for at least one year. Afterwards, the result comes with Menotropin. Since we have developed a detailed sperm precursor cell analysis system, we can get earlier results in treatment. We are ready to teach this to any embryologist who wants.
What I regret is this; I still hear unnecessary discourses such as if it does not come out in six months, I will leave this profession or if I could not do it, it means that you will never have a child. Another observation is that when you want to get married, we have not been able to break the habit of giving testosterone that messes up the system by saying that we will start HCG then. However, since the deficiency in this case is pituitary hormone production, it is necessary to give treatment with Gonadotropins belonging to this region. My sadness increases even more when I see those who micro TESE a case with pituitary hypogonadism. However, those who do this are called medical kickbacks in our country. In our country, it is becoming difficult to find a qualified endocrinologist like Refik Tanakol who has a proper approach to these cases. Approaches are rote and imitative. In other words, there is a logic that continues because our teacher was doing the mistakes made in the past. There is a rule in law, nakıs makisun aleyh does not happen. The meaning is that you cannot make the same mistake just because someone else is doing it. There is no point in continuing with the failed method anyway!
Another thing I regret is that endocrinologists refer cases to urologists without even treating them. They are grateful to them too. They operate without treatment, without foresight, with a rote logic, but unfortunately, after this stage, our treatment success decreases very much. International serious publications are now
They are now unanimous that gonadotropin treatment is essential for both hypo and azoospermia.
To the blind, of course.
