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Male Hormone Causes of Infertility

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Though less common than anatomic causes of infertility, hormone imbalances are often the cause of fertility issues in men with abnormal semen analyses.

If you’ve had an abnormal semen analysis, particularly if the sperm concentration was less than 10 million/mL, you should have an endocrine evaluation.

A basic hormone test for male infertility will measure Follicle-Stimulating Hormone and Testosterone, two keys to sperm production. If further testing is needed based on these results, your doctor may evaluate your Luteinizing Hormone (LH), Prolactin (PRL), and thyroid hormones levels.

Because your hormone levels fluctuate from high to low throughout the day, timing of the hormone test for male infertility is important. Testosterone naturally peaks in the morning, so a morning blood test will be important to accurately measure your hormone levels. The results of this blood test along with your semen analysis, physical exam, and personal history, will give your doctor a clear picture of your fertility.

Symptoms of Male Hormonal Imbalance

Noticeable signs of infertility in men are often associated with hormone imbalances, as anatomic causes often go unnoticed unless examined by a doctor. If you experience the following symptoms, it may be time to have a hormone test for male infertility.

Male Hormonal Imbalance Symptoms

  • Hair loss
  • Fatigue
  • Weight gain
  • Erectile dysfunction
  • Depression
  • Low sex drive
  • Memory loss
  • Loss of muscle mass
  • Mood swings
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Key Fertility Hormones

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Proper balance of the following hormones is key to achieving normal fertility. Each one plays its part in the reproductive process, and if one level is off it can throw a wrench in the whole system.


Testosterone affects libido (sex drive), hair growth, erectile function, muscle mass, fat distribution, and sperm production.

Follicle-Stimulating Hormone (FSH)

FSH stimulates the production of sperm.

Luteinizing Hormone (LH)

LH stimulates the testes to produce Testosterone.

Prolactin (PRL)

Prolactin in elevated levels can affect testicular function, including Testosterone and sperm production, and can affect your ability to get an erection.


In men, Testosterone converts to Estrogen as they age. In some cases, Estrogen levels may be too high, meaning you do not have enough Testosterone to support sufficient sperm production to maintain normal fertility.

Thyroid Stimulating Hormone (TSH)

TSH is produced by the pituitary gland in order to stimulate the thyroid’s production of T3 and T4 hormones.

Thyroid Hormones (T3 & T4)

If the thyroid-producing hormones T3 and T4 are out of balance, you may experience poor semen quality, low sperm count, erectile dysfunction, low sex drive, and reduced testicular function.

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The Pituitary Gland

The pituitary gland is located in the brain, and it tells your body to make FSH, LH, Testosterone, PRL, Estrogen and more (yes, men make estrogen). Any condition that raises or lowers the typical levels of these hormones may result in reduced sperm production. Most often the cause of this type of imbalance is a pituitary tumor.

In almost all cases a pituitary tumor is benign (or non-cancerous), so there is no cause for further alarm. These tumors of the pituitary that can destroy hormone-making cells as they grow. Simply put, their growth is what causes hormones to become out of balance.

Pituitary tumors can be treated with surgery, radiotherapy, and/or medication, depending on the type of tumor and its effects on hormone production.

The Thyroid Gland

The thyroid is a butterfly-shaped gland at the front of the neck that produces T3 and T4 hormones and releases them into your bloodstream. These thyroid hormones are important for male fertility, as low levels of T3 and T4 can cause poor semen quality, reduced sperm count and testicular function, low sex drive and erectile dysfunction. This condition, called hypothyroidism, can also lower other hormones necessary for fertility like Testosterone, LH, and FSH.

Ultimately, the pituitary and thyroid glands work together to maintain hormone levels. For example, when thyroid hormones T3 and T4 drop too low, the pituitary gland produces Thyroid Stimulating Hormone (TSH), which tells the thyroid gland to make more hormones.

Your TSH level may be tested as part of hormone testing for male infertility, as it can be indicative of a larger issue. If your TSH level is high, it means you have hypothyroidism, as the pituitary gland is releasing more TSH to activate additional T3 and T4 production. However, if TSH is low, it means your thyroid is overactive and less TSH is being released by the pituitary gland in order to slow production of T3 and T4.

Where can I get hormone testing for male infertility?

Though not a necessary part of the initial fertility evaluation for every patient, your semen analysis or self-reported symptoms may indicate a hormone issue that should be checked. If this is the case, your Inovi fertility specialist will order a blood test to check your hormone levels.