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Question: Does low testosterone levels in men cause infertility:

  1. Yes
  2. No

Low testosterone (T) does not cause infertility.

Sperm production is actually stimulated by hormones other than testosterone. Testosterone is required for sperm production, but the level in the testes where sperm are produced is many times higher than in the blood. Even men with low or borderline testosterone levels may have sufficient T levels for sperm production.

However, a side effect of testosterone treatment for low T levels is infertility. Testosterone treatment decreases sperm production by decreasing levels of another hormone, follicle-stimulating hormone (FSH), which is important for stimulating sperm production. In most cases, the infertility caused by testosterone treatment is reversible. Men who have received testosterone for a shorter period of time probably recover more quickly. For a small percentage of men, the infertility is not reversible. It is generally believed that testosterone given by shots and pellets are more likely to cause infertility than gels, although any form of testosterone supplementation can disrupt the normal hormonal balance required for sperm production.

To find out more, read the ASRM Patient Education Fact Sheet: “Testosterone Use and Male Infertility”, now available in English, Spanish, and Chinese.

Also check out these resources on male infertility:
ReproductiveFacts.org
is a patient education website of ASRM.
 

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