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Testosterone Therapy for Male Fertility

Your sex life is ho-hum, you have no sex drive at all, and conception is a problem. If your first thought is to rush out and get testosterone therapy, think again. Most doctors today do not prescribe testosterone therapy for male fertility.

If that surprises you, you are not alone. Many men naturally assume that testosterone production is the problem if they have a low sperm count. Now, that may very well be true.

The pathway to sperm production is complicated:

  • The process begins with the secretion of gonadotropin-releasing hormone (GnRH) from the hypothalamus
  • GnRH enters the pituitary gland and stimulates the release of two hormones crucial for fertility:
    • Luteinizing hormone – LH
    • Follicle stimulating hormone – FSH
  • Luteinizing hormone leaves the pituitary gland and undergoes transport through the bloodstream to the testes where it tells the Leydig cells to manufacture testosterone
  • Follicle stimulating hormone also goes to the testes to begin the process of sperm cell creation – spermatogenesis
  • Testosterone helps stimulate the maturation of the sperm cells

Only the testosterone that the Leydig cells produce can influence spermatogenesis. Therefore, the use of testosterone treatment for male infertility will be counterproductive.

What happens if a man receives testosterone therapy to reverse the effects of Low T?

First, please know that testosterone treatment is crucial if you have low testosterone levels. Low T can lead to many serious health issues if left untreated. The only time to hold off is if you are trying to conceive a baby with your spouse.

When you medically increase the testosterone level, male infertility can worsen. The reason is that only the testosterone produced in the testes can influence sperm maturation.

Are There Benefits of Testosterone Therapy for Male Fertility?

When we look closely at testosterone therapy and male fertility, we find that the benefits do not always fall in line. On the one hand, you have a man with a low sex drive who needs supplemental testosterone to help him perform. On the other hand, the same testosterone that gets him moving in bed may reduce sperm count.

How does that happen?

As testosterone enters the bloodstream, it relays signals to the hypothalamus. If the signals are high, GnRH production declines, affecting all hormones down the pathway. If the signals are low, GnRH secretion increases.

The use of testosterone therapy for male fertility can decrease FSH signals that promote spermatogenesis.

Is there anything that can provide the benefits of increasing testosterone without affecting sperm count?

Yes, one of the treatment options for men with Low T who wish to conceive is HCG. Human chorionic gonadotropin provides the same signal as LH to the testes to boost natural testosterone production. It is a short-term only method of increasing both testosterone and sperm maturation.

Why should HCG not be used long-term?

Continued use of HCG can desensitize the Leydig cells to luteinizing hormone. The goal of HCG is a short-term increase of testosterone secretion to improve fertility. Doctors also prescribe HCG in conjunction with testosterone therapy to ensure that the testes continue to produce natural testosterone at the end of each treatment cycle.

When You Should Not Use Testosterone Therapy for Male Fertility

The decision to use testosterone injections for male fertility is one that requires an open conversation with a medical specialist. It is vital to ensure that you have adequate testosterone as well as sperm when trying to conceive.

For some men, the need for testosterone is so great that they have no choice but to resort to testosterone replacement therapy. If that is the case, then perhaps banking your sperm or trying artificial insemination is an option.

Knowing that testosterone therapy may reduce sperm count is something that every man needs to understand. This is especially crucial for those who use testosterone illegally for bodybuilding. Infertility is a side effect of raising testosterone levels too high.

For answers to your questions about using testosterone therapy for male fertility, please contact HT Medical Center. We are here to provide honest help, diagnostic testing, and treatment options that you need. Consultations are confidential and provided at no charge.