FSH test slightly increased, low semen analysis is hypogonadism?

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Hello doctor. I'm ready to start a family. Recently, I had a testicular ultrasound after 3 years of varicocele surgery and got the results: left testicle 38x18x26, right testicle 40x18x27. With such a size, is my testicles shrinking? Because I find it too small compared to the standard size that I can refer to. In addition, I also found that my Testosterone index was 19.53 but my FSH was elevated at 8.29, plus the results of the semen analysis were severely weak, could it be that I have testicular failure, so it leads to the pituitary gland to produce more FSH to stimulate sperm? Complete sperm production? Is there any test or test that can help me determine the cause of low sperm count and treat it for better results? Will the FSH index increase day by day? I would like to thank the doctor.
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Hello. In my case, testicular size is relatively normal (4x3x2cm), Testosterone is normal, FSH is slightly increased, semen is low, a history of varicocele surgery is not enough, so I don't meet the diagnostic criteria. hypogonadism.
My main problem is low semen volume which may be caused by testicles. You should go to an orthopedic specialist to do more in-depth tests to re-evaluate and advise on specialist treatment.
Thank you for your question to Vinmec Health System. Best regards.
Resident Doctor Trinh Ngoc Anh - Endocrinologist - General Internal Medicine Department - Vinmec Times City International General Hospital