Are you considering taking TRT, but are unsure because you want to know more about the connection between TRT and male fertility? Perhaps you’re considering starting a family and want to know you can do that. You might have heard people talking about TRT and are now wondering, “Will TRT make me infertile?”
Before you give up and think that it’s impossible to deal with both the problems of low testosterone and the need to have a family, keep reading. We’ve asked the doctor—Dr. Rand McClain—and this is what he had to say about fertility while on TRT and staying fertile on TRT.
Isn’t Testosterone Great for Male Fertility?
Most people know testosterone is supposedly good for fertility. Men with low testosterone tend to have less sperm than those with normal and high testosterone levels. It stands to reason you’d think getting more testosterone would boost sperm count and improve fertility.
Unfortunately, male sexual health isn’t that black and white. TRT and fertility don’t typically go hand-in-hand. While it’s true you need testosterone to produce sperm, the testosterone used for that process comes from the body and isn’t the kind replaced by TRT.
What happens is your brain creates a hormone called gonadotropin-releasing hormone (GnRH) that tells testes to produce more testosterone, which is needed for a healthy sperm count. When taking TRT, the extra testosterone added to your bloodstream comes from other sources.
The problem is that your brain picks up on this extra testosterone and decides you’ve got enough of the stuff. It stops telling the testes to produce more testosterone because it thinks you have enough. When your testes stop producing testosterone because there are no brain signals making it happen, sperm production starts to go down.
The effect is you have less sperm and reduced fertility because of it. The simple fact is any outside testosterone introduced to your body will reduce fertility.
Is Staying Fertile on TRT Possible?
There are three options to improve fertility while on TRT:
Try to Conceive Anyway
While TRT can reduce your sperm count, it doesn’t necessarily cause infertility. Many men are still able to have children while taking TRT. This also means you shouldn’t assume you don’t need contraceptives because you’re on TRT!
However, continuing to try anyway is risky because there’s no telling how fertile you are on testosterone. It’s likely you’ll need other medication to counter the effects. It’s always possible to conceive even with less sperm, but it does mean there’s a seriously reduced chance of conception.
Freeze Your Sperm Now to Have Children Later
Not every man who starts TRT is thinking about having kids immediately. Freezing your sperm until you need it is a great way to protect against potential infertility. Some men are put off by the cost of freezing sperm. If you don’t want to invest so much in freezing your sperm, there is a third option.
Use HCG/HMG Therapy to Ensure Your Testes Continue to Produce Sperm
HCG has been shown to act as a luteinizing hormone analogue, meaning it works the same way as luteinizing hormone. Luteinizing hormone is what tells the testes to produce testosterone. Taking HCG has the same effect, leading to increased sperm production and testicular growth in men.
There are several studies that support the idea of using HCG to improve male fertility in men supplementing testosterone who are no longer as fertile as they used to be. One study followed 26 men taking HCG alongside testosterone and found that they remained their fertility for more than a year afterwards.
Another study, this one involving 49 men and conducted by Wenker et all in 2015, had similar results. Almost every man in the study had normal sperm count at the end of the study. One of them even reported that his girlfriend had become pregnant, proving it’s possible to remain fertile and conceive a child when taking TRT.
Kim et al showed using HCG maintained fertility for men taking testosterone, as did Matsumoto et al and Bouloux et al. All these studies show how using HCG helps to maintain fertility when using TRT by restoring natural sperm production.
There is evidence that TRT can reduce fertility. However, there are ways around it. If you want to have children in the future, sperm freezing is a good idea. Or you might consider taking HCG as a supplement. It’s a good idea to talk to your doctor about all these options and other male fertility problems you might be having. There’s nothing your doctor hasn’t seen before so there’s no shame in talking to them about any issues you might be having.
How Can I Test My Fertility?
There are several ways for men to test their fertility. One of the easiest and most affordable options is an at-home testing kit approved and validated by the World Health Organization (WHO). These testing kits are so simple that you can do them at home without any formal training. You can also visit a fertility clinic to get tested.
Final Thoughts
Testosterone replacement therapy is incredible for the men that need it. For the longest time, this treatment was only given to older men and people who had very low testosterone levels because of how it affected fertility.
In those days, men had to weigh the benefits of getting more testosterone with the drawback of knowing that they could be trading their chance at having children. The good news is that this is no longer a “one or the other” choice and there are options to maintain fertility on TRT.
New medications such as HCG have opened the door for every man to ensure they stay fertile and sexually healthy while taking TRT.