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TRT and Infertility

It might be surprising, but there is a link between TRT, or testosterone, and infertility in men

Male infertility can be complex because there aren’t just one or two things that cause it. Injuries, surgeries and medical conditions can be responsible, as well as problems with hormone production or testicular development. Lifestyle factors, including taking testosterone replacement therapy, can also make it more difficult for a man to father a child. Many men are shocked when they learn there is a link between TRT and infertility in men.

It seems counterintuitive that a supplement that makes someone feel more masculine could make them less fertile. However, our San Antonio infertility doctors will tell you that the research says just that. Thankfully, our fertility specialists offer effective solutions for patients hoping to become fathers.

A deeper look at TRT and infertility

Many men take supplements trying to increase their muscle mass and strength. However, bodybuilding steroids and testosterone can both cause problems with fertility, often causing sperm counts to go down, sometimes all the way to zero.

When a man uses testosterone or similar substances, the brain interprets the increase in testosterone as coming from his own testicles. As a result, the brain sees the higher testosterone levels and responds by decreasing stimulation to the testicles, since so much testosterone is around. When that happens, it leads to a decrease in the production of both testosterone and sperm.

Over time, testosterone use can cause the testicles to shrink and sperm counts to fall, sometimes to zero. The longer or more chronic the testosterone or steroid use is, the longer it can take for sperm counts to come back. This link between TRT and infertility is undesirable if a man is trying to conceive with his partner.

Unfortunately, many men don’t recall getting this information about the link between TRT and infertility when they start using these medications, so they don’t realize there could be fertility damage until it’s too late.

Our reproductive endocrinologists offer several treatments for male infertility

Once a man stops taking testosterone, there is some variability in how long it takes testicular function to return. In some cases, a man will see his fertility return after being off testosterone for at least three months. However, it may take longer if a man has been taking testosterone replacement, or TRT, for a long time. In some rare cases, a man’s fertility may not return at all.

Because each man is different, our San Antonio infertility doctors develop customized treatment plans for male infertility. Our physicians may recommend treatments such as intrauterine insemination (IUI) and in vitro fertilization (IVF) in cases of low sperm counts. Our fertility specialists can also prescribe medications to try to increase both testosterone and sperm production, depending on the cause. In rare cases in which a man’s fertility does not return, donor sperm can help make fatherhood possible.

If you have more questions about TRT and infertility, contact us to schedule an appointment. Our San Antonio infertility doctors can help you learn more and explore your options for treating male infertility.