How To Decrease Infertility Risk While On Testosterone Replacement Therapy How To Decrease Infertility Risk While On Testosterone Replacement Therapy

What You Need To Know About Reducing Infertility Risk While on Testosterone Replacement Therapy

As men grow older, their testosterone levels decrease, leading to a range of issues and a decrease in quality of life. To combat this, some turn to testosterone replacement therapy (TRT). While this treatment can bring about many positive changes, it still carries a certain degree of risk. It is essential to be aware of these risks before beginning TRT.

Men who use testosterone replacement therapy (TRT) may see a decrease in their sperm count, making conception more difficult. Before beginning TRT, some measures can be taken to help preserve fertility, such as freezing sperm, using clomiphene, and taking testosterone with HCG. This article will provide more information on low testosterone, infertility, TRT, and ways to minimise its effects on fertility.

The Impact Of Low Testosterone

Testosterone is a hormone that is present in both males and females. It is responsible for the onset of puberty and can also affect sexual desire and fertility. In addition, testosterone can also influence physical characteristics, such as body hair, muscle mass, strength, and bone mass. In men, testosterone is primarily produced in the testes.

Male hormone levels normally exceed females; however, they vary over time according to the body's requirements. Testosterone levels also decline with age, leading to negative impacts on a person's well-being. Individuals with low testosterone levels may experience issues such as:

  • Irritability

  • Fatigue

  • Less body hair growth

  • Diminished muscle mass

  • Decreased libido

  • Erectile dysfunction (ED)

  • Depressed symptoms

At Mobi Doctor, a medical provider can determine if your testosterone levels are low. They can provide testing methods, review the results and advise on the best action. Possible solutions include dietary and lifestyle alterations or testosterone replacement therapy to help bring testosterone levels back up.

The Relationship Between Low Testosterone And Fertility

If you are having difficulty conceiving, you may think that low testosterone is the cause. However, there can be several factors that contribute to infertility. Testosterone is one of several hormones that can help with sperm production, but having low levels of testosterone does not necessarily mean you are infertile. Even if testosterone levels are lower than average, there is still a chance of conceiving naturally.

However, even if your sperm count is in the normal range, testosterone levels that are too low can still impact fertility. This is because low testosterone can lead to erectile dysfunction and a decreased sex drive, both of which are necessary for successful conception. Thus, low testosterone can make it harder for you to conceive a child.

After you are diagnosed with low T, your medical provider may suggest beginning hormone therapy right away. Additionally, they may conduct tests to check your sperm levels if fertility is an issue. By obtaining this information, they can tackle underlying and connected issues.

How Can TRT Affect Your Fertility?

Testosterone replacement therapy (TRT) may be able to help raise your testosterone levels, but it can also have some adverse side effects, especially when it comes to fertility. A common issue linked to TRT is a lowered sperm count.

To understand the cause of this phenomenon, we must first examine the process of sperm production in the body. Low levels of testosterone in the body send a signal to the pituitary gland, prompting the release of two crucial hormones: luteinising hormone (LH) and follicle-stimulating hormone (FSH). This process causes the testes to start manufacturing sperm.

TRT, or testosterone replacement therapy, can interfere with the body's normal sperm production process. The body does not register low testosterone levels, so the pituitary gland does not create the hormones needed for sperm production, leading to a lower sperm count. While this does not necessarily make a person infertile, it can make it more difficult for them to conceive.

It is not possible to say precisely when a person's sperm count will begin to decrease when they start testosterone replacement therapy. Every individual's body is different, and the rate of fertility decline can vary. It can be sudden or gradual, depending on how quickly and effectively the body responds to the increased testosterone levels.

Is The Impact Of Testosterone On Your Sperm Count Permanent?

Testosterone Replacement Therapy (TRT) can often cause temporary infertility, but it is usually reversible. If TRT is stopped, infertility and testosterone levels typically go back to where they were before treatment began. However, in a small number of cases, fertility does not return after stopping TRT. To avoid infertility altogether, TRT should only be discontinued under medical supervision. Fertility treatments can cost tens of thousands of dollars, so it is essential to try and prevent it from happening if possible.


It is possible to reverse the effects of testosterone replacement therapy (TRT) if the treatment is discontinued. Usually, sperm levels return to pre-testosterone replacement therapy levels within one year. The duration and success of this reversal largely depend on the time the person was on TRT, the type of dose they were receiving, and their age. Generally, younger men who were using TRT for a short period are more likely to experience faster recovery than older individuals who have been receiving treatment for a more extended period.

Should You Stop Using TRT If You Want Children?

Before making any changes to your TRT, it is essential to consult with a medical professional. Doing so will ensure that you can safely lower your testosterone levels while still preserving your fertility.

It's possible to keep your fertility while taking TRT through methods such as freezing sperm, trying a different treatment for low testosterone, or combining testosterone and human chorionic gonadotropin. Further information about these options can be found in the text below.

Discuss Long-Term Goals With Your Doctor Before Starting TRT

Before beginning testosterone replacement therapy, it is essential to consult with your doctor or hormone specialist about your long-term objectives. Think about if you are planning on having children soon or in the far future. No matter if you are heterosexual or homosexual who is considering intra-vitro fertilisation (IVF), intrauterine insemination (IUI) or surrogacy, you should talk to a medical provider at Mobi Doctor about the risks of TRT for infertility and how it could affect sperm production, as well as any possible treatment options.

After conducting some tests to determine your sperm levels, your medical provider will be able to better understand the cause of your low testosterone and infertility. If you are considering becoming a parent, they can give you advice on how to manage your low testosterone levels while still being able to conceive a child.

Cryopreservation And Freeze Your Sperm

Cryopreservation, or freezing sperm, is an excellent option for those looking to protect their family's future or leave a lasting legacy. This process is an ideal solution for hopeful fathers before beginning testosterone replacement therapy or for those already undergoing TRT who have viable and healthy levels of testosterone.

Healthcare professionals and specialised labs recommend freezing at least two samples in multiple vials. They analyse these samples to confirm they are healthy and that there is enough material to freeze. Once frozen, the samples can be stored indefinitely if freezing conditions remain constant. When freezing sperm, you should store your samples for as long as you need to until you are ready to start a family. It is also suggested to keep your samples with multiple companies to ensure no issue when withdrawing them for fertilisation.

Use HCG With TRT

Combining testosterone replacement therapy (TRT) with other treatments can help to combat any undesired side effects, such as low sperm counts and testicular shrinkage. One such treatment is human chorionic gonadotropin (HCG), which stimulates the testicles to produce more testosterone. HCG mimics luteinising hormone, an essential component of sperm production. HCG is usually supplied in two vials, one containing a diluent, such as bacteriostatic water, and the other a powder. The two are mixed and injected subcutaneously with a small syringe. It must be refrigerated after each use to ensure its potency and efficacy. The dosage of HCG varies from patient to patient.

Men with hypogonadism, a condition where the body does not produce enough natural hormones to function normally, may benefit from the use of testosterone and HCG to treat low testosterone levels. Testosterone and HCG can help to increase testosterone levels, testicular size, and fertility. While HCG is not a guarantee to prevent infertility, it is better to use it in conjunction with testosterone replacement therapy to reduce the risk of infertility. Therefore, it is recommended to freeze sperm before beginning the treatment as an additional measure.


Treat The Cause Of Your Infertility

Can TRT lead to infertility? Yes, it can potentially affect fertility in some men. However, fertility issues might not always be linked to low testosterone levels or TRT. Low testosterone can result from various health conditions, including:

  • Hypothalamic disease

  • Pituitary disease

  • Delayed puberty

  • Testicular damage

  • Noncancerous pituitary tumor

  • Genetic conditions like Klinefelter syndrome, myotonic dystrophy, and Kallmann syndrome

If factors other than ageing cause your low testosterone, your healthcare provider can address the underlying issue, improve testosterone levels without TRT, and safeguard your fertility. It's advisable to consult with a specialist in TRT or reproductive health for personalised guidance.

Preventing Infertility Risk With TRT

Before beginning TRT, we suggest speaking to a doctor about any potential side effects that could cause infertility. Additionally, it may be beneficial to freeze sperm samples as a safeguard. If you have any questions or fears about infertility related to taking TRT, don't hesitate to contact Mobi Doctor.

Many different factors can cause infertility, and its causes vary from individual to individual. In some cases, testosterone replacement therapy (TRT) can complicate conception due to the potential side effects of erectile dysfunction, reduced libido, and reduced sperm count. If TRT is desired, but the risk of infertility is a concern, other solutions may be available, such as storing sperm samples before treatment or using other treatments such as clomiphene citrate and/or HCG in place of testosterone. It is important to note, however, that none of these will be effective if the original medical cause of infertility is not identified.


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