Hormones play a significant role in fertility, both female and male. Any male hormone balance can affect fertility, affecting everything from sperm production to libido or the ability to get and maintain an erection.

Most of the time, low testosterone levels (Low T) are the issue if male hormone imbalance negatively impacts fertility. That said, too much testosterone can be just as unhealthy as not enough. So, it’s essential that testosterone levels are tested in a lab with expertise in the area – via a urologist, endocrinologist, fertility specialist, etc.

Both High & Low Testosterone Compromises Sperm Count

Contrary to what you might think, testosterone replacement therapy (TRT) may normalize testosterone levels but it contributes to low sperm count.This is because fertility-related hormone balance is more complicated than high/low T.

Elevating testosterone using TRT negatively affect male FSH and LH levels, both of which are necessary to produce sperm (yes, these are the same hormones necessary in egg follicle maturation). Suppressed FSH and LH levels means a significant reduction in sperm production. As  a result, TRT has even been studied as a potential male birth control option!

If you or your partner has Low T and you’re trying to conceive, lifestyle changes are a top priority. If that doesn’t work, we can talk about sperm washing for IUI and IVF. We never suggest testosterone supplementation for fertility.

3 Ways Low Testosterone (Low T) Can Harm Male Fertility

It’s also important to note that Low T doesn’t always create problems. So, we only address Low T from a medical standpoint if it compromises a patent’s well-being or plays a role in infertility.

Symptoms of Low T

Some of the most common symptoms of low T are:

• Reduced sex drive before age 50.
• Loss of body hair.
• Less beard growth or more patchy whiskers.
• Reduced erectile function (struggling to get or sustain an erection).
• Chronic fatigue (feeling unusually tired all the time).
• Depression or feelings of sadness that aren’t typical or don’t relate to current life events.
• Atypical weight gain or the inability to lose weight.
• Decrease in muscle mass despite normal physical routines.
• Lack of motivation and self-confidence.
• Inability to focus or sustain effort towards a goal.

Declines in testosterone is normal with age (testosterone levels tend to decline by about 1% to 2% every year after age 40), but environmental and lifestyle factors can cause lower T earlier in life, impacting fertility success.

As mentioned above, low T doesn’t automatically equate to any of these symptoms. And lower sperm count doesn’t always equate to infertility issues. However, if you and your partner struggle to get pregnant, testing sperm count and testosterone levels is a simple first step. There are three ways low T impacts fertility.

1. Reduced sperm count

Testosterone is responsible for sperm production, which is why levels are higher in the testicles (where sperm is produced) than in the bloodstream. While Low T doesn’t affect the quality of individual sperm health (shape or movement), it does play a role in the number of sperm produced.

Low sperm count is a common side effect of Low T. While low sperm count doesn’t always affect fertility, it can. The chances of infertility significantly increase if a man has a low sperm count and the female partner has additional infertility factors – such as advanced age, endometriosis, PCOS, etc.

This is why complete infertility testing – for both partners – is essential if you aren’t getting pregnant in the normal time frames for your age.

2. Lack of sex drive

Multiple factors lead to decreased sex drive (libido), and low T is one of them. Others are:

• Depression
• Excessive use of alcohol, marijuana (THC), or other recreational drugs.
• Obesity.
• Stress.

We recommend couples planning to get pregnant adhere to the same healthy lifestyle choices supporting pregnancy and overall health and well-being – two cornerstones of healthy conception, pregnancy, and parenting.

3. Erectile dysfunction

The inability to get and sustain an erection is another symptom of Low T. However, erectile dysfunction (ED) can also signify something else, like excess stress, depression, a history of sexual abuse (especially if that hasn’t been addressed via therapy or other healthy outlets), or the accumulated emotional distress related to the “business” of conception.

In addition to verifying male fertility, including hormone levels, we recommend looking into counseling or therapeutic outlets that support mental or emotional components contributing to erectile dysfunction. Prescription medications are also an option to help men achieve/sustain erection.

Treating Low T to Support Fertility

When and how we treat Low T depends on the symptoms and goals. In almost all cases, unless time is of the essence, we recommend lifestyle changes first. Whenever possible, we like to see if improving your lifestyle boosts natural testosterone levels.

You can do this by prioritizing:

• Quitting the bad stuff. If you smoke, drink more than an average of one or two drinks per day, or use recreational drugs, take a break and see if T levels go up.
  
• A healthy diet. Now’s the time to prioritize whole foods free of herbicides and pesticides (known to reduce sperm count and harm sperm quality). Also, eliminate processed foods and focus on foods known to boost T levels. According to a 2021 study, men who ate a diet high in refined carbohydrates and saturated fats had lower total testosterone levels than those who ate less inflammatory foods.
  
• Good sleep habits. The body uses sleeptime to rebalance hormones, detox, increase immune function, and heal/replace damaged cells and tissue. Do your best to get a good night’s sleep.
  
• Weight management. Being under or overweight are both hard on fertility and hormone balance. Make weight management a priority, especially if you plan to get pregnant in the near future.
  
• Reviewing current medications. Common prescription medications, like statins for cholesterol/heart disease, beta-blockers and other blood pressure medications, and anti-anxiety and antidepressants are all linked to low T. If you take any of the above, schedule a pharmacy consultation or connect with your physician to discuss whether your meds are contributing to Low T. If so, they may have recommendations.

Schedule a Consultation with Fertility Solutions

If lifestyle changes aren’t enough to elevate testosterone levels or sperm count, schedule a consultation with Fertility Solutions. We can discuss other ways to boost sperm power for fertility treatments as well as other options.