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Meet Our Fertility Specialists

Low Testosterone

If your semen analysis comes back abnormal, your TFC physician may order a test for low testosterone.

If your semen analysis comes back abnormal, your fertility specialist may ask you to obtain a blood test to check hormones involved in sperm production. One of these is testosterone, a hormone made by the testicle that is important for men’s reproductive health. Low testosterone levels, or low T, can be caused by poor brain signaling, testicular dysfunction, or a combination of both.

If your testosterone is low, further testing should be done to determine the cause. You may also be referred to a urologist for a physical examination and additional blood work. A combination of tests helps determine where the problem lies and also helps us identify what treatments are most likely to produce a successful outcome.

Infertility, low T and the brain

A low testosterone level combined with a low sperm count may be due to abnormal production of brain hormones: follicle stimulating hormone (FSH) and luteinizing hormone (LH). These hormones are made by the pituitary gland, a pea-sized gland located behind your nose at the base of the brain. They stimulate the production of both sperm and testosterone by the testicles.

Low FSH and LH levels typically lead to low sperm and low testosterone production. Some men with low FSH and LH levels may be treated with medications like clomiphene citrate (Clomid) or human chorionic gonadotropin (hCG) to stimulate both testosterone and sperm production.

Testicular insufficiency and low testosterone

A low testosterone level could also be due to testicular insufficiency or failure. This means that even though the pituitary gland is making enough FSH and LH to stimulate sperm and testosterone production, the testicles are not responding. Additional tests may be performed to evaluate why testicular failure has occurred. Options for treatment depend on semen analysis results, but if the sperm counts are very low, IVF may be the most appropriate treatment.

Testosterone replacement

Some men with testicular insufficiency or failure are treated with testosterone, sometimes without obtaining a semen analysis first. However, testosterone treatment will usually reduce sperm counts, sometimes completely eliminating sperm from the ejaculate.

If you are on testosterone replacement, and your sperm counts are low, your fertility specialist may advise you to discontinue testosterone in favor of other treatments that improve both testosterone and sperm production. Testosterone replacement should only be taken once conception has occurred. Long term, the testosterone level should be kept within normal levels to improve well-being, maintain a normal libido, and prevent against osteoporosis.

Contact us to arrange for a new patient appointment with our low T specialists. If you have been trying to get pregnant and suspect the cause may be male infertility, we can help. Our doctors have the experience and skill to help most men successfully overcome a diagnosis of male infertility, so they can go on to have healthy children.