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How Low Testosterone and Fertility Are Connected



Low testosterone and fertility — it’s a conundrum that’s baffled scientists for years.

Given a passing thought, it probably seems to most of us that testosterone — the substance that makes us men — would certainly contribute to our most manly of duties:

Making babies.

testosterone and fertility

And to a large extent, it’s true—testosterone and fertility go hand in hand, as do low testosterone and infertility.

Testosterone plays a key role in the production of sperm and a low sperm count—if your testosterone is low, your sperm count will be too.

Testosterone also factors heavily into your sex drive, interest in sex, and your ability to have and maintain an erection, all of which are necessary to conceive a child. And while a man with low testosterone can perhaps still father a child, optimum fertility seems directly linked to healthy levels of hormones in the body.

Given all these connections, it seems like low testosterone should contribute to infertility.

It would stand to reason that higher levels of testosterone would mean higher levels of fertility, right? We should see an inverse relationship between low testosterone and fertility, one easily reversible by increasing testosterone levels. Well, hang on.

How Low Testosterone And Fertility Are Connected

While it’s true that low levels of testosterone could be the culprit for low sperm production or a lack of sexual performance, simply treating your low testosterone is not necessarily an effective solution to your infertility.

Low testosterone brings on a myriad of symptoms most of us would rather avoid. Among these are a lack of energy, poor mood, low libido, increased body fat and the aforementioned infertility.

Thankfully, most of these symptoms are treatable with Testosterone Replacement Therapy, or TRT. However, infertility cannot be treated with testosterone.

According to this study in JCEM, “fertility can be restored with appropriate hormonal stimulation in patients with secondary hypogonadism [stimulation failure], but not primary hypogonadism [testicular failure]”.

If you have secondary hypogonadism (caused by a failure in your pituitary gland or hypothalamus), certain hormonal therapy may help restore fertility.

The bad news is, if you have primary testicular failure (direct damage to the testes) or secondary hypogonadism, testosterone replacement therapy will likely make your infertility worse.

You can learn more about the different types of hypogonadism (and possible causes) here.

But… how does more testosterone not help with infertility if low testosterone is among the causes?

testosterone and libido (happy couple embracing in a bungalow)

Effects of Testosterone Replacement Therapy on Fertility

The goal of Testosterone Replacement Therapy is to place you within optimal hormone levels, but it does this by adding outside testosterone to the body.

When this happens, the brain registers the hormone levels in the body and shuts down its normal production of testosterone — which in turn stops the production of sperm!

However, if your testes are producing a normal amount of testosterone and your glands are actually the problem, introducing other stimulatory hormones like hCG or medications like Clomid may restore fertility.

So while TRT can be a tremendous boon in combating other unwanted symptoms of low testosterone and can help some types of low testosterone, it’s not useful for correcting infertility.

Making Decisions About Low Testosterone And Fertility

If you’re looking into Testosterone Replacement Therapy for reasons other than infertility, it’s important to ask yourself if having children now (or in the future) is something you are still considering.

Only a medical care provider with experience in men’s health and testosterone replacement therapy can help you determine what type of hypogonadism you have. Many times, the direct cause is unclear.

For more information about Testosterone Replacement Therapy, treatment of the symptoms of Low Testosterone, and the impact of TRT on fertility, contact Testosterone Centers of Texas and request a free consultation with an experienced and licensed health care professional.

And if you’re suffering from ED in addition to fertility issues, click here to learn how testosterone treatment can help with ED. Both low testosterone and fertility are issues that can be addressed, separately or in combination—start a conversation with your medical care provider and get the process moving.

You don’t have to live with either—there is hope.



(Bill) William J. White, PA-C

(Bill) William J. White, PA-C brings over 20 years of surgical experience to our practice. He is a decorated veteran of the United States Army where he served for nearly 6 years with duty assignments, both here and abroad.   During his military career, Bill was trained as a Certified Surgical Technologist, and following an Honorable Discharge from the Army, he attended Texas Tech University.   He graduated with a Bachelor of Science in Biology and went on to attend PA School at the University of Texas Southwestern Medical Center at Dallas. He spent the first 10 years of his career in Neurosurgery.

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