Fertility After Testosterone

Trying for a baby after testosterone treatment?

Testosterone therapy can significantly reduce sperm production and, in some men, cause no sperm to be seen in the semen. The good news is that sperm production can often recover after testosterone is stopped, although recovery may take time.

A specialist male fertility assessment can help determine the extent of suppression, whether sperm production is recovering and whether treatment may help support your fertility.

✓ Specialist male fertility assessment
✓ Semen analysis and hormone evaluation
✓ Individualised fertility recovery plan
✓ Coordination with your partner’s fertility treatment when required

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Learn about Fertility After Testosterone

Can Fertility Recover After Testosterone?

In many men, sperm production gradually returns after stopping testosterone, but the timeframe varies.

Recovery may take several months and sometimes longer than a year. Factors such as your age, how long testosterone was used, the type of treatment and your underlying testicular function can all influence recovery.

Some men recover naturally, while others may benefit from specialist-directed treatment to stimulate the body's own testosterone and sperm production.

If you are taking prescribed testosterone, changes to treatment should be discussed with your treating doctor.

Assessing Fertility After Testosterone

The first step is understanding what has happened to your sperm production and reproductive hormones.

Assessment may include:

Semen analysis
To determine whether sperm are present and assess sperm concentration and movement.

Hormone testing
Blood tests help assess testosterone and the hormones responsible for stimulating sperm production.

Testosterone history
The type, dose and duration of testosterone treatment can help estimate the likely pattern of recovery.

Male fertility examination
Assessment may identify other factors affecting sperm production that were present before testosterone treatment.

Your partner's fertility and your desired timeframe for pregnancy are also important when deciding how quickly treatment should progress.

Assessing Fertility After Testosterone with Dr Crozier

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Frequently Asked Questions

Yes. Testosterone can dramatically reduce sperm production, but it does not reliably make every man infertile. Pregnancy can still occur while taking TRT, so testosterone should not be considered contraception. If you are trying to conceive, a semen analysis is the simplest way to determine whether sperm are currently present.
hCG is sometimes used in men who need testosterone support while fertility is important because it stimulates the testicles through a pathway similar to luteinising hormone (LH). However, taking hCG alongside testosterone does not guarantee that normal sperm production will be maintained. Your fertility should be assessed with semen analysis rather than assumed.
In selected men, hCG may be used after testosterone has suppressed the body's natural reproductive hormone signals. Depending on the situation, it may be used alone or alongside other fertility-directed treatments. Treatment should be based on your hormone results, semen analysis and timeframe for pregnancy.
Clomiphene, commonly known as Clomid, is sometimes used off-label in men to stimulate the body's own LH and FSH production and increase natural testosterone production. It may be considered in selected men following testosterone use, but it is not appropriate for everyone and response varies.
Yes. Anabolic-androgenic steroids can suppress the same hormonal pathway as prescribed testosterone and may cause a very low sperm count or azoospermia. This includes men who have used testosterone or other performance-enhancing drugs for bodybuilding. If pregnancy is now a priority, assessment can determine whether sperm production is recovering.
Not necessarily. Testosterone can reduce stimulation of the testicles, which may cause them to become smaller while sperm production is suppressed. Testicular size alone cannot determine fertility. Semen analysis and reproductive hormone testing provide much more useful information.
Some men notice a return of symptoms such as reduced energy, libido or wellbeing after stopping testosterone. Fertility treatment therefore needs to consider both sperm production and your underlying testosterone problem. In selected men, fertility-preserving approaches may help support natural testosterone production while trying to conceive.
You do not necessarily need to wait until the sperm count becomes completely normal. If small numbers of sperm return, sperm freezing may be considered, and depending on your partner's fertility and your pregnancy timeframe, natural conception, IUI, IVF or ICSI may be discussed. The most appropriate strategy depends on the couple rather than the sperm count alone.
If you may want children in the future, discussing fertility before starting testosterone is worthwhile. For some men, semen analysis and sperm freezing provide reassurance and preserve future options before sperm production becomes suppressed.
Potentially. Once your current fertility goals have been completed, testosterone treatment can be reconsidered with your treating doctor. If you may want additional children later, sperm freezing before restarting testosterone may also be worth discussing.