Testosterone Therapy and Fertility: What Every Man Under 45 Should Know
October 6, 2026 · 5 min read · Clinically reviewed
Why testosterone can lower sperm count
When you take testosterone, your brain senses there's enough and stops sending the signals that tell your testes to make both testosterone and sperm. For many men, sperm count drops significantly.
Options if you still want children
Depending on your labs and goals, a clinician may suggest medications that boost your own production instead of replacing it, or add hCG alongside testosterone to help preserve fertility. Some men bank sperm before starting.
What to ask any TRT clinic
Do you screen for family plans before prescribing? Will you check a semen analysis if I'm concerned? What's your plan if I decide to try for a baby later?