That’s why doctors carefully review test results, symptoms, and medical history before making a treatment plan. Giving testosterone to someone with normal levels can be harmful. Diagnosing low testosterone correctly is important because the treatment depends on the cause. If LH and FSH levels are high, but testosterone is low, the problem is likely in the testicles themselves.. Compared with initial values, LH (from about 3 to 1 IU/L) and FSH (from about 5 to 2 IU/L) levels significantly and chronically decreased for the duration of the intervention without additional improvements after 6 months.|After 6–12 months of treatment, all patients could ejaculate, and spermatogenesis was recovered in 71% of the patients . The mean first sperm density was 22.6 million/mL, with average FSH levels of 4.04 mIU (an increase of 191% vs. baseline), average LH levels of 3.12 mIU (an increase of 267% vs. baseline), and average testosterone levels of 475.8 ng/dL (a decrease of 17.0% vs. baseline) . The mean baseline FSH, LH, and testosterone levels before termination of testosterone therapy were 1.39 mIU, 0.85 mIU, and 573.5 ng/dL, respectively. In this case, it is crucial to understand which drugs can restore endogenous testosterone and sperm production. The testosterone levels did not show significant changes from pre- (616 ng/dL) to post-treatment (596 ng/dL) .|If you stop taking testosterone, your body will have to recover its ability to make testosterone again. This means that you’ll need the medication to continue having a normal level of testosterone in your body. This can help improve the symptoms of low testosterone, like low libido and lack of energy. With TRT, you take a manufactured form of testosterone to regulate your levels. Before starting TRT, your healthcare provider will make sure low testosterone is an accurate diagnosis. As of 2025, it’s not yet approved for males who naturally experience a decline in testosterone as they age. Here is how to take a cautious approach to testosterone therapy.}
Therefore, it is often used in combination with HCG to trigger spermatogenesis in patients with hypogonadotropic hypogonadism . All testosterone groups reported a significant reduction in sperm density and the percentage of spermatozoa with progressive motility, while the HCG group preserved these parameters . After treatment, the HCG group displayed significantly higher serum concentrations of 25-OH-vitamin D and significantly lower serum concentrations of estrogens, hematocrit, PSA, and prostate volume compared with testosterone. Another study conducted on 11 hypogonadotropic hypogonadal men (azoospermic) seeking fertility restoration received a single weekly HCG injection for a minimum of 12 weeks . These methods focus on triggering endogenous testosterone production in the testes, rather than directly administering exogenous testosterone. Topical testosterone gel is also on the milder side with regard to fertility issues.
However, a subsequent study showed that taking 3 grams of D-aspartic acid did not affect testosterone levels. Several types of supplements claim to increase your testosterone levels. These are supplements that contain things like vitamins, minerals, and herbs that are meant to increase your body's natural production of testosterone. More than 33% of men over 45 may have lower than normal testosterone levels. Most guidelines recommend treatment if morning total testosterone is clearly low on two separate days (often Testing should be done in the morning (before 10 a.m.) when levels peak, and repeated on a separate day.
However, taking testosterone may not actually mean a man is more fertile. Nevertheless, both risks can be carefully monitored as long as the patient is consistent with seeing their doctor during treatment and receives adequate periodic testing. Long-term use of testosterone comes along with even more worrisome risks. As a secondary problem, the illegal use of synthetic testosterone (aka "steroids") is also a problem among men, especially those in certain athletic fields.
For men who want to boost their testosterone levels and still protect or improve fertility, other treatments are available. Doctors often use blood tests and semen analysis to check both hormone levels and sperm health. Sometimes, medications or hormone therapy can restart the body’s normal signals and help improve testosterone and fertility. Poor sleep or not getting enough rest can lower testosterone levels, even in healthy men.
One study recruited 29 men with normal reproductive function and administered 200 mg/week of testosterone enanthate in addition to either a saline placebo or 125, 250, or 500 IU of HCG every other day for 3 weeks . It was shown that subcutaneous injections of HCG into intact immature female mice triggered follicular maturation, luteinization, and hemorrhage into the ovarian stroma. HCG was first recorded in the blood and urine of pregnant women in 1927, with the belief that it was released from the anterior pituitary.
Testosterone levels are too carefully controlled by the brain for that to occur. But having high cholesterol doesn't mean your testosterone will be high. Testosterone is synthesized in the body from cholesterol. The proper balance between testosterone (along with other androgens) and estrogen is important for the ovaries to work normally. If you thought testosterone was only important in men, you'd be mistaken. There may be other important functions of this hormone that have not yet been discovered.
A blood test measuring total and sometimes free testosterone levels, ideally in the morning, is used to diagnose Low T. Clomiphene citrate, hCG injections, and aromatase inhibitors can boost testosterone while maintaining or improving sperm production. No, TRT can actually decrease sperm production by suppressing the brain’s signal to the testes, potentially worsening fertility. Low testosterone is a condition where the body produces less testosterone than normal, often defined as total testosterone levels below 300 ng/dL. Research into male fertility and hormone health is ongoing. When testosterone is given from outside the body, it can signal the brain to stop making the hormones that help the testes produce sperm. On the other hand, some men may have normal testosterone levels but still have problems with fertility for other reasons.
ASRM's Frequently Asked Questions (FAQ) provides answers to common questions about reproductive health. If you've been trying to get pregnant for more than a year, you may have infertility. April 19-25, 2026, is National Infertility Awareness Week (NIAW)!