A previously healthy 25-year-old man presented to the urology clinic with concerns of low energy and an interest in testosterone replacement therapy. He reported no symptoms of low libido, erectile dysfunction, or ejaculatory dysfunction. His medical history was significant only for attention-deficit/hyperactivity disorder for which he was prescribed dextroamphetamine/amphetamine. Although he was not currently trying to conceive, he was interested in future fertility. On physical examination, he was 178 cm tall and weighed 82 kg (body mass index, 25.8), was well developed, had no visual field defects, and had no gynecomastia. He had bilateral descended atrophic testes that were each 4 mL in volume (reference volume, 20 mL). His epididymides and spermatic cord structures were present and normal bilaterally.
James A. Kashanian, Robert E. Brannigan. Gonadotropin Interpretation in a 25-Year-Old Man. JAMA. 2016;315(9):936–937. doi:10.1001/jama.2015.18157