Revised 2021
Testosterone (also referred to as “T”) is a hormone produced in men by the testicles. It is involved in muscle and bone development, hair growth, and development of the sex organs such as the penis and prostate. It also contributes to a man’s sense of overall well-being and sexual function. Testosterone is required for sperm production as well.
How do you test for low testosterone and what problems does it cause?
Low testosterone is also called hypogonadism. It can lead to problems with erections, low sex drive, mood changes and problems with sperm health and sperm counts. Testosterone can be measured by a simple blood test and are usually measured in the morning, since that is when levels are highest in men.
Can low testosterone be treated?
Men with low testosterone can be treated! Testosterone replacement comes in many forms, including shots, gels, patches, or implantable pellets. However, it is important to know that testosterone treatment usually leads to either low sperm counts, or no sperm seen whatsoever in the semen.
Can low testosterone lead to infertility?
Low testosterone does not directly cause infertility. Sperm production is stimulated by hormones other than testosterone. Testosterone is required for sperm production, but the level in the testes where sperm is produced is many times higher than in the blood. Even men with low or borderline T levels may have sufficient T levels for sperm production, but it may contribute to lower counts or less healthy sperm.
If a man is taking testosterone and wants to have children, how can low testosterone be treated to help with fertility?
There are some medications that can lower estrogen levels in your body. All men have estrogen in them but lowering it may help with sperm production. These meds include clomiphene citrate, letrozole or anastrozole and are pills. There are also injectable drugs that act like the hormones sent down from glands in your brain that will increase sperm production. Fertility specialists for males will prescribe these drugs, because sometimes they can act to lower sperm counts if they are used incorrectly.
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Male Fertility/Andrology
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The AUA, in collaboration with the American Society for Reproductive Medicine (ASRM), has released the 2024 amendment to the Male Infertility Guideline.
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About 20% of infertility cases are due to a male factor alone. Another 30% involves both male and female factors.
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There are several reasons a man with a spinal cord injury (SCI) might have infertility. View the fact sheetVaricocele
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Vasectomy is currently one of the most common methods of sterilization in the United States. After your vasectomy, if you change your mind about having children, there are two procedures that can help you have a child with your partner. View the Fact SheetTestosterone use and male infertility
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Infertility is typically defined as the inability to achieve pregnancy after one year of unprotected intercourse. View the bookletMale Fertility and Infertility - a patient education video
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Infertility is the result of a disease (an interruption, cessation, or disorder of body functions, systems, or organs) of the male or female reproductive tract which prevents the conception of a child or the ability to carry a pregnancy to delivery. Watch VideoBasic Infertility Evaluation
Dr. Roger Lobo of the American Society for Reproductive Medicine discusses the various methods to evaluate infertility. Watch VideoInfertility Treatments
Dr. Roger Lobo of the American Society for Reproductive Medicine discusses the various treatments for infertility. Watch VideoUnderstanding Fertility
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About 20% of infertility cases are due to a male factor alone. Another 30% involves both male and female factors.
View the Patient JourneyFemale Fertility Journey
If you've been trying to get pregnant for more than a year, you may have infertility. Infertility is a disease of the reproductive system that impairs one of the body's most basic functions: the conception of children.
View the Patient JourneyStress and infertility
It is not clear how exactly stress impacts fertility. Read the Fact SheetHyperprolactinemia (High Prolactin Levels)
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About 20% of infertility cases are due to a male factor alone. Another 30% involves both male and female factors. View the fact sheetDefining Infertility
Infertility is “the inability to conceive after 12 months of unprotected intercourse.” View the Fact SheetFertility Rights and Responsibilities
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Most people understand that smoking increases the risk for heart, vascular, and lung disease. View the fact sheetWhat are fibroids?
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