Testosterone and Fertility, Does is affect it?

Testosterone replacement therapy is helping men of all ages regain a full, vibrant life. Many men though still have hopes of fathering more children, which is why it’s important to consider the effects of testosterone treatment on male fertility.

The Hypothalamus-Pituitary-Gonadal Axis’s role in fertility

Both testosterone and sperm are produced through the Hypothalamus-Pituitary-Gonadal Axis, a conduction channel of chemical communication built in a man’s body. The hypothalamus is located in the forebrain region and communicates impulses and reactions to the pituitary gland with a gonadotropin-releasing hormone called GnRH.

When the pituitary gland receives the GnRH signal, it’s designed to produce two crucial fertility hormones: luteinizing hormone (LH) and follicular stimulating hormone (FSH). FSH helps produce sperm cells and LH produces testosterone. Thanks for the biology lesson, but what does this have to do with infertility and testosterone replacement therapy?

TRT is designed to raise the body’s testosterone levels, but part of the process also reduces the body’s natural production of LH and FSH. This happens because the body naturally recognizes when testosterone hormones are at a healthy level and decreases GnRH production. Reduced GnRH signals means the pituitary gland isn’t being stimulated to produce LH and FSH, thus lowering sperm production.

Alternatives to TRT

Before you begin receiving TRT, you might want to consider these alternatives:

Banking your sperm before TRT

One possible options is to bank your sperm before beginning testosterone replacement therapy. Sperm can be preserved for well over a decade. Studies show that testosterone production does return to normal levels after complete TRT, but additional peace of mind may be found by banking your sperm ahead of time.

Clomiphene citrate

Clomiphene citrate, or Clomid as it’s often called, is typically prescribed as a testosterone therapy alternative for men with a testosterone:estradiol ratio greater than 10:1 and with an estradiol level >60 pg/mL. Multiple studies have proven clomiphene citrate is both safe and highly effective in treating men with hypoandrogenism. (BJU Int 2012; 110:573-8)

Aromatase Inhibitors

As the name suggests, aromatase inhibitors block the body’s production of aromatase, a hormone-conversion agent that turns testosterone into estradiol inside a man’s body. Two common aromatase inhibitors are anastrazole (Arimidex) and letrozole (Femara).

Discuss fertility protection and TRT with the Low T St. Louis

Our team at Low T St. Louis created a free ebook, available for immediate download to help you learn more about the effect of low testosterone. You can learn more about how low testosterone may be affecting your life and those closest to you.

Our Low T St. Louis specialists can also discuss testosterone replacement therapy and how to best protect your fertility throughout the treatment process. Click here to schedule your appointment today.