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Low testosterone as cause of infertility in men

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Low libido, or sexual desire, can be a sign of infertility in men. Though it may seem like a mild complaint, it can actually indicate a hormonal imbalance affecting fertility. When men first experience a drop in libido, they might think starting Testosterone therapy is the answer. Unfortunately, Testosterone therapy can cause more harm than good when it comes to the ability to conceive.

What is low testosterone?

Low Testosterone is a medical condition called hypogonadism that occurs when the blood Testosterone level is below 270 ng/dL. An abnormal blood test result should be repeated for accuracy, as Testosterone levels vary throughout the day.

Signs of Low Testosterone in Men

  • Low sex drive
  • Hair loss
  • Low semen volume
  • Fatigue
  • Erectile dysfunction
  • Loss of muscle mass
  • Increased body fat
  • Mood swings
  • Smaller testicles
  • Memory issues
  • Decreased bone mass
  • Anemia

Testosterone Therapy & Fertility

A decrease in a man’s Testosterone level is an understandable concern for couples trying to conceive. Low Testosterone affects fertility by reducing a man’s desire for sex and his ability to attain and maintain an erection. However, simply treating the condition with added Testosterone actually decreases sperm production, sometimes to the point of having no sperm.

Taking Testosterone affects fertility in two ways. First, adding Testosterone to the bloodstream via patches, gels or other methods tells the brain that the body has enough Testosterone, causing it to signal the testes to halt testosterone production. When your testes don’t produce Testosterone, sperm production goes down.

Secondly, Testosterone therapy has a negative affect on sperm production because it decreases another hormone necessary for sperm called Follicle-Stimulating Hormone (FSH). While Testosterone is needed for sperm production, it does not actually stimulate it; FSH does along with Luteinizing Hormone (LH). In fact, low Testosterone levels as indicated on a blood test may not mean you’re infertile. Testosterone is much higher in the testes than in the blood, so enough may be present for adequate sperm production.

Although Testosterone can have devastating effects on sperm counts, those effects may be reversed. If you or your partner have been taking Testosterone, your Inovi fertility specialist can guide you to the best option for reversing its affects.

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Fertility Friendly Medications for Low Testosterone

While Testosterone therapy is not a good fit for couples trying to conceive, there are other options that treat low libido without negatively affecting sperm production.
Clomiphene citrate, more commonly known as Clomid, is a medication traditionally associated with women’s fertility treatment, but it is often prescribed as an off-label treatment for infertility in men. Clomid blocks Estrogen’s interactions with the pituitary gland, resulting in an increase in both Testosterone and Follicle-Stimulating Hormone (FSH), which increases sperm production.

Clomid does have possible side effects, so it may not be the best fit for you. Side effects can include acne, irritability, muscle tenderness, vision changes, and accelerated growth of pre-existing prostate cancer.

If you find Clomid doesn’t work well for you, other medications are available to treat low Testosterone in men. Human Chorionic Gonadotropin (hCG) is a hormone traditionally associated with women and pregnancy, but it can be used to improve low Testosterone levels in men. Naturally, the testes are influenced to produce Testosterone by the Luteinizing Hormone (LH). If you’re experiencing signs of low Testosterone, your testes may have stopped producing it. Injections of hCG can jumpstart the production of Testosterone by acting like LH in your body.

Some men may experience low Testosterone levels due to increased Estrogen levels. Estrogen in men usually maintains itself in correct balance with Testosterone, but it becomes elevated with age and an increased fat-to-muscle ratio. When Estrogen levels increase, Testosterone levels typically decrease. If this is the case, Anastrozole (Arimidex) may be the right treatment for you. Originally developed to treat breast cancer, Arimidex works to increase Testosterone levels by preventing Testosterone’s conversion to Estrogen in the body.