Prolistem - New Azoospermia Treatment

Can hormone levels show whether Prolistem is working?

In men with non-obstructive azoos***mia, hormones such as FSH, LH, and testosterone help us understand testicular function but they do not determine success or failure by themselves.

Men with elevated FSH may experience fluctuations during the Prolistem program, a temporary increase followed by a decrease can indicate some activity and recovery.

Men whose hormone levels are normal may show little or no change in their blood tests, even though blood hormones cannot directly reveal what is happening within small areas of the te**es.

The outcomes that matter most are whether s***m appear in a carefully examined semen sample or can be retrieved through microTESE.

Even before microTESE, FSH cannot reliably predict whether s***m will be found. High FSH does not eliminate the possibility of finding small areas of s***m production.

Hormones provide useful clues but they do not tell the whole story.

S***m production does not begin with s***m. It begins with the cells that make s***m possible.

The s***m-production journey involves:

• S***matogonial stem cells that begin the process
• Sertoli cells that support developing s***m
• Leydig cells that help maintain the hormonal environment
• Cellular energy and antioxidant protection throughout development

Prolistem Plus is a three-month nutritional program designed for men with oligos***mia. Its comprehensive formula supports the biological processes involved in s***m production, from the early cellular environment to mature s***m.

Support s***m production from A to Z. Discover Prolistem Plus.

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Individual results vary. Prolistem Plus does not guarantee improvement or pregnancy.

Azoos***mia? Your fertility journey may still have another step.

Every case is different. Prolistem is a six-month program designed to support the testicular environment in selected men with non-obstructive azoos***mia before surgical s***m retrieval.

Want to know whether Prolistem may be suitable for your case? Contact us for an honest conversation about your diagnosis, realistic chances and available options.

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Talk to us today and discover your next step.

Results vary, and s***m production or retrieval cannot be guaranteed.

Oligos***mia and Azoos***mia: Different Problems Need Different Strategies

Oligos***mia means that s***m are present in the semen, but their concentration is lower than expected. Think of the te**es as a factory: production is working, but not at full capacity.

Depending on the underlying cause, medical care, lifestyle changes and targeted nutritional support may help improve semen parameters. Prolistem Plus is a three-month program designed to support s***m concentration, motility and viability in men with oligos***mia.

Azoos***mia is completely different.

It means that no s***m are detected in the ej*****te. This may result from a blockage or from severely impaired s***m production.

In non-obstructive azoos***mia caused by primary testicular failure, the factory is not simply working slowly. Its production system is severely damaged. However, small isolated areas inside the te**es may still produce a few s***m.

This is why the same strategy used for oligos***mia cannot automatically be applied to azoos***mia.

Prolistem for Azoos***mia is a separate six-month program designed specifically to support the testicular environment in selected men with non-obstructive azoos***mia before surgical s***m retrieval.

Neither program can guarantee results. The first and most important step is understanding your exact diagnosis and choosing the appropriate strategy.

Low s***m count and zero s***m count are not the same problem. They should not be managed in the same way.

Azoos***mia Is Not a Dead End

The latest clinical study presented at ESHRE 2026 evaluated men with non-obstructive azoos***mia who had already undergone at least two unsuccessful microTESE procedures, with some having experienced three previous failures.

After using Prolistem, the overall success rate was approximately 34%, with s***m either appearing in the semen or being successfully retrieved through microTESE.

These were extremely challenging cases that had previously been considered to have very limited options.

Prolistem cannot guarantee success, but these results show that even after repeated failed procedures, another opportunity may still remain.

Why Are FSH Levels Important in Azoos***mia?

FSH is an important hormone that helps doctors understand how well the te**es are producing s***m.

1) Elevated FSH indicate non-obstructive azoos***mia (NOA).
When azoos***mia is confirmed, elevated FSH, together with testicular size, medical history, and other findings, usually suggests impaired s***m production rather than a blockage.

2) Higher FSH often reflects more severe testicular damage.
In general, a higher level may indicate greater impairment of s***m production. These patients may need more time to respond to treatment.

3) FSH may provide indirect information about the remaining germ cells.
Very high FSH can be associated with fewer s***matogonia or more extensive damage inside the te**es. However, FSH cannot directly measure the number of s***m stem cells.

4) FSH cannot determine whether microTESE will succeed or fail.
Even men with very high FSH may still have small, active areas inside the te**es that produce s***m. FSH alone cannot reliably predict whether s***m will be found.

5)High FSH is usually not the cause of azoos***mia.
It is generally the body’s response to impaired s***m production. When the te**es are not responding adequately, the brain releases more FSH in an attempt to stimulate them.

The key message:
High FSH may indicate more severe testicular impairment, but it does not mean that the chance of finding s***m is zero.

This information reflects the current male-infertility guidance of the American Urological Association/American Society for Reproductive Medicine (AUA/ASRM) and the European Association of Urology (EAU).

References:
• AUA/ASRM Male Infertility Guideline
• EAU Male Infertility Guideline

Can Prolistem Create New S***m Stem Cells?

The short and honest answer is no.

Prolistem is not a stem-cell treatment, and it should not be described as creating new stem cells or germ cells when those cells are completely absent.

S***m production begins with s***matogonial stem cells already present inside the te**es. Prolistem’s goal is to support the testicular environment and give the remaining stem cells or developing germ cells an opportunity to continue the s***m-production cycle.

But there is an important point to understand.

A biopsy examines only a small piece of testicular tissue. If no germ cells are seen in that sample, it does not always prove that they are absent throughout both te**es. In non-obstructive azoos***mia, s***m production can be focal, meaning that a few small areas may still contain germ cells even when most of the testicular tissue does not.

This is why some men with very poor biopsy findings or high hormone levels may still have rare areas of s***m production.

However, if germ cells are truly absent throughout both te**es, Prolistem would not be expected to create them or restore s***m production. Certain genetic conditions, especially complete deletions involving specific regions of the Y chromosome, may also indicate an extremely poor or absent chance of finding s***m.

Our message must remain clear:

Prolistem does not create cells that do not exist. It is designed to support the cells that may still remain and give them another opportunity to continue s***m production before surgery.

It does not guarantee that s***m will appear in the semen or be found during surgery. Every patient must be evaluated individually using his medical history, hormone levels, genetic results and previous biopsy findings.

Prolistem is about creating a better opportunity, not making an unrealistic promise.

We have been asked many times about the ROSI technique, so I would like to clarify a few important scientific points.

ROSI, Round S***matid Injection is used when no mature s***m can be found and an immature round s***matid is injected directly into the egg.

During ICSI, piercing the egg with a needle or using electrical or chemical stimulation may sometimes activate the egg and cause it to begin dividing. However, cell division alone does not confirm normal fertilization and does not mean that a healthy embryo has been created. Even an egg without any male reproductive cell can sometimes divide through parthenogenetic activation, but such development is not equivalent to normal fertilization and cannot normally result in a healthy live birth.

It is also incorrect to say that injecting “any round cell” can achieve fertilization. A true round s***matid contains a haploid paternal genome, while many other round cells found in testicular tissue are somatic cells, immune cells, or earlier germ cells. Correctly identifying a round s***matid is difficult and represents one of the major limitations of ROSI.

Round s***matids also lack the natural egg-activating capacity of mature s***m. Therefore, ROSI usually requires additional artificial oocyte activation. Published research confirms that healthy children have been born after ROSI, so the technique should not be described as impossible. Nevertheless, its overall efficiency remains very low. A systematic review reported approximately 38.7% fertilization but only 3.7% pregnancy.

More developed cells such as elongating or elongated s***matids are closer to mature s***m and have generally produced better results than round s***matids.

Therefore, ROSI may represent a final experimental option for carefully selected patients, but it should not be presented as an established treatment or as an alternative with a high success rate. Finding mature s***m remains the preferred and biologically strongest option whenever possible.

From Two Unsuccessful Biopsies to S***m in the Semen

This is an encouraging Prolistem patient story.

According to the patient’s medical history, he had non-obstructive azoos***mia and underwent two previous testicular biopsies, but no s***m were found.

His histopathology report described:

• Testicular atrophy
• Almost no germ cells
• Mild hyalinization of the seminiferous tubules
• No inflammation or malignancy

His ultrasound showed te**es with normal volume and appearance, together with moderate bilateral varicocele and hydrocele. His reproductive hormone levels were reported to be within the normal range.

After three months of using Prolistem, a semen analysis detected five s***m for the first time.

Two weeks later, the analysis was repeated and another three s***m were detected in the semen.

The number is small, but in non-obstructive azoos***mia, every s***m matters. Finding s***m in two separate semen samples suggests that some areas inside the te**es may still have limited s***m-producing activity.

This case also demonstrates why repeated semen analysis is essential. When s***m are found, the laboratory should be prepared to freeze any viable s***m immediately because they may not appear in every sample.

This does not represent normal s***m production, and an individual result cannot guarantee the same outcome for every patient. However, for a man with two previous unsuccessful biopsies and almost no germ cells documented in his tissue, finding s***m in the semen represents a meaningful new opportunity.

Prolistem does not promise results. It aims to create another opportunity before the next surgical procedure.

Prolistem for Women: Designed to Restore Hormonal Balance

Prolistem for Women is a specialized supplement designed for women with PMOS (Polyendocrine Metabolic Ovarian Syndrome), formerly known as PCOS.

Its unique formula targets the hormonal pathways involved in testosterone regulation. By helping reduce excess testosterone and restore hormonal balance, Prolistem for Women may help:

• Regulate the menstrual cycle
• Support healthy ovulation and egg maturation
• Reduce symptoms associated with PMOS
• Improve reproductive health
• Support women who are trying to become pregnant

Whether your goal is to manage PMOS symptoms or support your fertility journey, Prolistem for Women targets one of the main hormonal factors behind the condition, not only its symptoms.

Balance your hormones. Regulate your cycle. Support your fertility journey.