If you have low testosterone, you may wonder how it affects your fertility and what treatment options are available.

Being diagnosed with low testosterone can raise questions about its impact on your fertility. Testosterone is a vital hormone responsible for various bodily functions, including the development of the penis and testes, hair growth, regulation of sex drive and mood, muscle and bone mass growth, and sperm and red blood cell production.

If you have low testosterone, you may wonder how it affects your fertility and what treatment options are available. The good news is that several treatments can help preserve fertility. Working closely with your healthcare provider, you can find the right treatment plan that suits your needs.

Let’s dive into some key information about low testosterone and fertility:

Low testosterone in individuals with testes:

Testosterone is produced in the testes through a feedback loop in the hypothalamic-pituitary-gonadal axis. In some cases, issues within this axis or physical problems affecting the testes can lead to insufficient testosterone production.

Does low testosterone cause infertility?

Sperm production, known as spermatogenesis, relies on adequate testosterone levels. While some individuals with low testosterone may still have enough sperm for pregnancy, many face infertility due to reduced sperm production, decreased libido, or erectile dysfunction.

Diagnosing low testosterone:

The American Urological Association suggests diagnosing and treating low testosterone (hypogonadism) when total testosterone levels fall below 300 ng/dL on two separate occasions, accompanied by signs and symptoms such as decreased libido, erectile dysfunction, reduced energy, muscle loss, and more.

Causes of low testosterone:

Risk factors for low testosterone include chronic conditions like obesity, diabetes, hypertension, and stress, as well as testicular damage, genetic conditions like Klinefelter syndrome, and certain medications or substances (opioids, alcohol, marijuana, chemotherapy). Surprisingly, synthetic testosterone use (testosterone replacement therapy or TRT) can also cause low testosterone as the body may reduce its natural production.

Let’s debunk some common myths and misconceptions about low testosterone (low T) and fertility:

Myth #1: Taking supplemental synthetic testosterone (testosterone replacement therapy or TRT) will cure infertility in people diagnosed with low testosterone.

Fact: While TRT can address issues like low libido and erectile dysfunction, it can actually suppress the body’s natural sperm production and potentially lead to azoospermia, a condition where no detectable levels of sperm are found in semen. Discontinuing TRT may allow sperm production to resume, but it’s not guaranteed.

Myth #2: Lifestyle changes alone cannot correct low testosterone or low sperm count.

Fact: Research indicates that weight loss is associated with increased testosterone levels. Notably, the most positive outcomes are observed when weight loss is achieved through vigorous physical activity.

Myth #3: Testosterone “boosters” sold online and in vitamin shops will increase testosterone levels.

Fact: There is limited scientific evidence on the effectiveness of testosterone boosters. To date, no studies have definitively proven that these boosters increase testosterone levels in individuals with low testosterone. A recent study discovered additional ingredients in many supplements, including medications for erectile dysfunction, weight loss, and steroids, which could potentially harm individuals with specific medical conditions.

When seeking information on low testosterone and fertility, it’s essential to rely on accurate and up-to-date sources. Unfortunately, navigating through numerous unclear and outdated resources, often published by companies selling testosterone supplements, can be frustrating. Consulting a trusted healthcare provider can help individuals with suspected low testosterone access reliable information tailored to their specific clinical situation.

Remember, always consult with your healthcare provider for personalised guidance and information relevant to your individual circumstances.

Treatment options:

Various pharmaceuticals, including human chorionic gonadotropin (hCG), selective estrogen receptor modulators (SERMs) like clomiphene citrate or tamoxifen, and aromatase inhibitors (AIs) such as anastrozole and letrozole, can be used alone or in combination to treat low testosterone and preserve fertility. For those with testicular damage or genetic conditions, non-pharmaceutical options like surgical sperm retrieval, assisted reproductive technologies (e.g., intracytoplasmic sperm injection or ICSI), or donor sperm can be considered.

We hope this information helps you better understand low testosterone and its impact on fertility. Remember to consult with your healthcare provider for personalised guidance.



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