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Testosterone Replacement and Fertility

When we talk about testosterone replacement and fertility in men, it’s important to understand more about the role of testosterone in reproduction.

Couple in consultation at IVF clinic — testosterone replacement and fertility

Testosterone Replacement and Fertility — The Benefits to Sexual Function

For starters, your issues may be related to sexual performance rather than a low sperm count, and in this way, there is definitely a connection between testosterone replacement and fertility.

If you’re experiencing symptoms such as a lack of interest in sex, a low libido, chronic fatigue, difficulty maintaining an erection, or ED (erectile disfunction), TRT may be right for you.

(You can read more about the symptoms of low T here, many of which are directly connected to sexual performance.)

Simply put, it’s difficult to conceive if there is a loss of sex drive or sexual function.

Low Testosterone and Male Fertility

There are two major parts of the brain involved — the hypothalamus and the pituitary gland.

The hypothalamus produces GnRH (gonadotropin-releasing hormone), which signals the pituitary gland to produce two very important hormones, LH (luteinizing hormone) and FSH (follicular stimulating hormone).

FSH is responsible for triggering spermatogenesis, the production of sperm cells, and LH signals the testes to produce the needed optimal level of testosterone for sperm cell production.

It stands to reason that low testosterone could hinder or “short circuit” this process since adequate testosterone levels are required.

If you suffer from Low T, a low sperm count is a possible result.

It seems a logical conclusion that increasing your testosterone would then simply reactivate or boost the process, right?

It actually isn’t that simple.

Learn More About Male Infertility

Testosterone Replacement and Fertility — Interrupting the Process

There are a number of ways TRT can help your overall fertility conditions, which we’ll talk more about below, but it may only be effective at resolving certain types of infertility in certain circumstances.

In fact, when we use testosterone replacement therapy, it can actually hinder your sperm production and lower your fertility.

That’s because when we introduce levels of testosterone into your system, false messages are sent to the hypothalamus — it believes it has done its job and shuts down its production (or drastically decreases the production) of gonadotropin-releasing hormone (GnRH).

In a chain reaction, a decrease in GnRH means less LH and FSH are produced, and spermatization decreases.

In other words, we interrupt the very process of sperm production by introducing additional testosterone into the biochemical equation.

Testosterone Replacement and Fertility — A Difficult Decision

If you’re looking to restore or improve sexual function through restoration of testosterone levels, TRT is one possibility.

However, if you and your partner are hoping to expand your family in the near future, it may be necessary to look at other possible avenues of Low T treatment that will maintain sperm production (such as hCG supplementation).

In other words, TRT is right for some some situations but can complicate reproduction itself.

There are still options.

Learn More About Male Infertility

Testosterone Replacement and Fertility — Some Other Options

Another common condition that hinders fertility is secondary hypogonadism, when the hypothalamus or pituitary glands are not functioning properly.

Because of the potential for TRT to further interrupt this system (described above), TRT could actually make the situation worse.

In that case, the situation could possibly be improved instead with hCG supplementation or other medication.

The course of treatment will depend on your diagnosis as well as your goals and should be discussed in detail with your medical provider.

If having children remains a goal for your family yet you need relief from symptoms of low T, one option is sperm banking, which would allow you to undergo testosterone replacement while maintaining the option to attempt conception in the future.

Low Testosterone and Female Fertility

Just in case you were wondering, androgens (male hormones) including testosterone also play a role in female fertility.

This article by the University of Rochester Medical Center explains how proper levels of androgens increase the growth and strength of the female follicles, which is one of the primary aims of fertility treatment.

That being said, TRT is never recommended for a female who is or plans on becoming pregnant as exogenous testosterone can have harmful effects on a developing fetus.

Testosterone Replacement and Fertility — Learn More

You might have already been asking the question or now wondering whether you are suffering from infertility.

To learn more about signs of infertility click the button below.

It will help you determine if a visit to your medical provider is advised, as well as help you prepare for that conversation about testosterone replacement and fertility.

Click Here to Read the Article



(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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