Should I Take Testosterone to Help My Fertility? … NO, NO, NO

If “low T” is slowing down your sex drive, testosterone supplements can speed it up – and make you infertile in the process


Testosterone is a very important hormone in males. It is important for pubertal changes such as muscle and bone growth, hair growth and development of the sex organs. It plays a very important role in libido and sexual function. Finally, it is essential for sperm production.

So when testosterone levels are low, especially when this is interfering with sex drive, sexual functioning and energy level, supplements are often prescribed. This may be as an injection, gel, patch or injectable pellets. Testosterone replacement is very effective at improving these symptoms.

Marketing blitzes are propelling more men than ever before to take testosterone to combat signs of low testosterone (low T is the popular term). Men are urged to talk to their doctor about this therapy if they have possible signs of low T, such as “feeling tired.”

A 2015 Journal of the American Medical Association report indicated that since 2001, the number of older and middle-aged men prescribed such supplements has tripled. The highest increase is among men in their 40s. Since testosterone naturally decreases about 1 percent annually in men after the age of 30, that makes sense.

However, taking this hormone can result in infertility. And that’s a problem for men seeking to boost their sex drive so they can get their partner pregnant. This is something that we are seeing more of in fertility medicine.

Our Male Infertility Treatments

How testosterone therapy eats away a man’s fertility

Taking testosterone decreases production of the follicle-stimulating hormone (FSH) from the brain, which is the hormone that drives sperm production. As FSH levels drop, so does sperm production. Low T therapy can also cause testicular atrophy, which can also result in fertility problems.

So while the supplements may help with libido, they are dropping fertility. In most cases stopping the therapy will result in return of the sperm production. Generally, men recover their fertility quicker if they had been taking testosterone for a shorter period of time.

But regaining fertility may take months, and in some cases of long-term injectable testosterone that can work for six months, there may be a permanent loss in sperm production. Any manner of testosterone delivery has the potential to cause infertility.

The best practice for a man is to not have testosterone therapy until he has fathered all the children he wants. If a man wants to father children and has low testosterone, he could freeze his sperm for future use, then undergo testosterone therapy.

Short of that, treatment other than testosterone supplements is indicated. He should see a reproductive urologist to test for underlying causes of low T.

There are other medications that can be used such as clomiphene citrate or fertility injections to increase both testosterone production and sperm production. Hormone levels and sperm count should be monitored while using these medication.

Men of reproductive age desiring current fertility or at any time in the future should avoid all forms of testosterone treatment.