Can You Use Testosterone Therapy for Infertility?

There are many reasons for men and women to undergo testosterone replacement therapy after being diagnosed with Low T, but the issue of fertility is an entirely different subject.

A man who seeks testosterone therapy for infertility often does so not understanding fully the way in which testosterone secreted by the testes and supplemental testosterone administered to the body differ.

While both forms of testosterone work to build strong muscles and bones, sharpen memory and cognitive performance, improve libido and sexual performance, and aid metabolism, only naturally secreted testosterone will help increase sperm count in men. For that reason, the use of testosterone replacement therapy for infertility in males is not often recommended.

Testosterone administered via injection, gel, patch, or other method bypasses the testes and circulates through the bloodstream to affect change. Testosterone produced in the testes stimulates spermatogenesis right there before it goes out into the bloodstream.

Another reason why doctors do not typically use testosterone treatment for infertility is that Low T levels are not the primary cause of male infertility. Varicoceles – enlarged veins in the scrotum – often raise the temperature around the testes causing a decrease in sperm production. That is also why men trying to impregnate their partner are told to avoid hot tubs and tight underwear.

Low Testosterone and Male Infertility

Part of the reason that testosterone therapy and infertility go together is that the hypothalamus measures how much testosterone is in the bloodstream. When it senses too much, it holds back on sending out gonadotropin-releasing hormone (GnRH) to the pituitary gland. Without the GnRH signal, the pituitary gland does not produce luteinizing hormone (LH) and follicle stimulating hormone (FSH). LH signals the Leydig cells in the testes to produce testosterone. FSH supplies the signal for sperm cell production.

Testosterone therapy affects fertility by suppressing the LH and FSH signals coming out of the pituitary gland to the testes, lowering the production of mature sperm.

Doctors often recommend that men looking at conception hold off on testosterone treatment until after their partner has conceived.

Some alternatives when dealing with testosterone treatment and infertility are:

• HCG – human chorionic gonadotropin helps to preserve the function of the testes by increasing LH production in the pituitary gland and stimulate the testes to support testosterone and sperm production
• Clomiphene – helps stimulate production of testosterone
• Anastrozole – prevents the conversion of testosterone into estrogen, leaving more testosterone in the body to aid in sperm production
• Banking sperm – if holding off on testosterone replacement therapy is not an option due to the symptom interference in your life, you may want to discuss banking your sperm with your doctor

Sperm count generally returns to normal a few months after the cessation of testosterone therapy, so if treatment for Low T is necessary, and you are ok with waiting nine months to a year before conception, then there should be no concern about using TRT at this time.

What Testosterone Levels Mean for Female Infertility

Androgen hormones such as testosterone are often viewed as male sex hormones, but they are equally important for women, especially those who are trying to conceive.

Unlike with men who may suffer from infertility by utilizing testosterone therapy, women often find testosterone treatment for female infertility to be a promising venture.

The use of testosterone therapy for fertility provides the following benefits to women:

• Testosterone prevents ovarian follicles from premature death by halting apoptosis
• Testosterone increases the sensitivity of ovarian cells to follicle stimulating hormone
• Testosterone increases FSH receptors on the surface of ovarian cells which improves the follicle making process – especially helpful for older women trying to conceive who have a decreased amount of follicles

Utilizing an androgen such as testosterone therapy for infertility can help women increase the odds of conception.

For additional information about the use of testosterone therapy for infertility in females, or how to prevent infertility in males who need TRT, contact Kingsberg Medical for a free consultation.

Brian Leeber