Revised 2021
Testosterone (also referred to as “T”) is a hormone produced in men by the testicles. It is involved in muscle and bone development, hair growth, and development of the sex organs such as the penis and prostate. It also contributes to a man’s sense of overall well-being and sexual function. Testosterone is required for sperm production as well.
How do you test for low testosterone and what problems does it cause?
Low testosterone is also called hypogonadism. It can lead to problems with erections, low sex drive, mood changes and problems with sperm health and sperm counts. Testosterone can be measured by a simple blood test and are usually measured in the morning, since that is when levels are highest in men.
Can low testosterone be treated?
Men with low testosterone can be treated! Testosterone replacement comes in many forms, including shots, gels, patches, or implantable pellets. However, it is important to know that testosterone treatment usually leads to either low sperm counts, or no sperm seen whatsoever in the semen.
Can low testosterone lead to infertility?
Low testosterone does not directly cause infertility. Sperm production is stimulated by hormones other than testosterone. Testosterone is required for sperm production, but the level in the testes where sperm is produced is many times higher than in the blood. Even men with low or borderline T levels may have sufficient T levels for sperm production, but it may contribute to lower counts or less healthy sperm.
If a man is taking testosterone and wants to have children, how can low testosterone be treated to help with fertility?
There are some medications that can lower estrogen levels in your body. All men have estrogen in them but lowering it may help with sperm production. These meds include clomiphene citrate, letrozole or anastrozole and are pills. There are also injectable drugs that act like the hormones sent down from glands in your brain that will increase sperm production. Fertility specialists for males will prescribe these drugs, because sometimes they can act to lower sperm counts if they are used incorrectly.
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Male Fertility/Andrology
AUA Releases Male Infertility Guideline Amendment
The AUA, in collaboration with the American Society for Reproductive Medicine (ASRM), has released the 2024 amendment to the Male Infertility Guideline.
View the Press ReleaseSART Fertility Experts - Wellness and Fertility: Diet, Sleep and Exercise
Drs. Timothy Hickman and Rashmi Kudesia discuss the links between lifestyle and fertility. Listen to the EpisodeMale Fertility Journey
About 20% of infertility cases are due to a male factor alone. Another 30% involves both male and female factors.
View the Patient JourneySART Fertility Experts - Urology and Male Reproductive Health
Stress and infertility
It is not clear how exactly stress impacts fertility. Read the Fact SheetOptimizing Natural Fertility
Before attempting pregnancy, a woman should make sure she is healthy enough for pregnancy by adopting a healthier lifestyle and taking prenatal vitamins. If she has a medical or genetic condition or risk of one, she should seek advice from a medical professional before conceiving (becoming pregnant) View the fact sheetOptimizing Male Fertility
About 20% of infertility cases are due to a male factor alone. Another 30% involves both male and female factors. View the fact sheetCancer and its impact on sperm, cryopreservation, and fertility
This can be confusing since the terms are often used interchangeably in the media and casual conversation. View the fact sheetMale Fertility Evaluation: What do I need to know?
Infertility is the inability to achieve pregnancy after one year of unprotected sex. View the fact sheetSperm morphology (shape): Does it affect fertility?
The most common test of a man’s fertility is a semen analysis. View the fact sheetFertility Options for Men with Spinal Cord Injury
There are several reasons a man with a spinal cord injury (SCI) might have infertility. View the fact sheetVaricocele
A varicocele is a variation of normal anatomy in which veins in the scrotum (the sac that holds the testicles) become enlarged and sometimes even visible. View the fact sheetWeight and fertility
One of the easiest ways to determine if you are underweight or overweight is to calculate your body mass index (BMI). View the fact sheetSART Fertility Experts - Male Factor
Intracytoplasmic sperm injection (ICSI)
A procedure called intracytoplasmic sperm injection (ICSI) can be done along with in vitro fertilization (IVF) if a sperm cannot penetrate the outer layer of an egg. Read the Fact SheetSART Fertility Experts - IVF: Cycles of Hope and Heartbreak
Does stress cause infertility or is it the other way round? Listen to the EpisodeFertility Options After Vasectomy
Vasectomy is currently one of the most common methods of sterilization in the United States. After your vasectomy, if you change your mind about having children, there are two procedures that can help you have a child with your partner. View the Fact SheetTestosterone use and male infertility
Testosterone (also referred to as “T”) is a hormone produced in men by the testes (testicles). View the fact sheetSART Fertility Experts - Male Fertility
Did you know that up to 40% of infertile couples suffer from male factor infertility? Listen to the EpisodeInfertility: an Overview (booklet)
Infertility is typically defined as the inability to achieve pregnancy after one year of unprotected intercourse. View the bookletMale Fertility and Infertility - a patient education video
Male Factor Infertility is responsible for about 30% of infertility cases and can contribute infertility to an additional 20% of cases. Watch VideoBasic Infertility Evaluation
Dr. Roger Lobo of the American Society for Reproductive Medicine discusses the various methods to evaluate infertility. Watch VideoInfertility Treatments
Dr. Roger Lobo of the American Society for Reproductive Medicine discusses the various treatments for infertility. Watch VideoUnderstanding Fertility
In this video series, Dr. Roger Lobo explains the basics of infertility, including causes, treatments and coping methods. Watch VideoSurviving the Roller Coaster Emotions of Infertility Treatment
The experience of infertility is a rollercoaster of hope and disappointment. Treatment presents an opportunity for hope as well as a new set of challenges. Watch VideoCauses of Male Infertility
Dr. Roger Lobo, of the American Society for Reproductive Medicine explains the causes of male infertility. Watch VideoFAQ About Infertility
Infertility is not an inconvenience; it's a disease of the reproductive system that impairs the body's ability to perform the basic function of reproduction. Learn the factsMale Fertility Infographics
ASRM has prepared infographics to illustrate the subject of Male Fertility better. View the infographicsInfertility
SART Fertility Experts - Military Families and Fertility
Active-duty individuals in the military sometimes face unique circumstances when seeking fertility care. Learn more with a former military fertility physician. Listen to the EpisodeSART Fertility Experts - Q&A on Infertility
Infertility can create many questions for a patient. Listen to common questions and answers about infertility, egg freezing, and genetic testing. Listen to the EpisodeFertility Care Gets Important Win in California
ASRM celebrates California's SB 729, expanding IVF coverage for same-sex couples and singles, advancing equitable fertility care access.
View the Press ReleaseNational Infertility Awareness Week
April 20-26, 2025, is National Infertility Awareness Week (NIAW)!
View the NIAW ToolkitASRM announces support for HOPE with Fertility Services Act
The American Society for Reproductive Medicine is proud to endorse the HOPE with Fertility Services Act (HR 8821).
View the Press ReleaseSART Fertility Experts - Environmental Impacts on Fertility
In this episode, the fertility experts discuss the impact of the environment, including air, climate, and chemical exposures on infertility. Listen to the EpisodeSART Fertility Experts - Recurrent Pregnancy Loss and Implantation Failure
"I can get pregnant, but I can't stay pregnant," is echoed by patients with recurrent pregnancy loss. Listen to the EpisodeSART Fertility Experts - Wellness and Fertility: Diet, Sleep and Exercise
Drs. Timothy Hickman and Rashmi Kudesia discuss the links between lifestyle and fertility. Listen to the EpisodeSART Fertility Experts - Navigating IVF as a Couple
Mary Casey Jacob, PhD is interviewed by Dr. Daniel Grow, and together they explore the emotional and practical support that couples need. Listen to the EpisodeMale Fertility Journey
About 20% of infertility cases are due to a male factor alone. Another 30% involves both male and female factors.
View the Patient JourneyFemale Fertility Journey
If you've been trying to get pregnant for more than a year, you may have infertility. Infertility is a disease of the reproductive system that impairs one of the body's most basic functions: the conception of children.
View the Patient JourneyStress and infertility
It is not clear how exactly stress impacts fertility. Read the Fact SheetHyperprolactinemia (High Prolactin Levels)
Prolactin is a hormone produced by your pituitary gland which sits at the bottom of the brain. Read the fact sheetOptimizing Natural Fertility
Before attempting pregnancy, a woman should make sure she is healthy enough for pregnancy by adopting a healthier lifestyle and taking prenatal vitamins. If she has a medical or genetic condition or risk of one, she should seek advice from a medical professional before conceiving (becoming pregnant) View the fact sheetOptimizing Male Fertility
About 20% of infertility cases are due to a male factor alone. Another 30% involves both male and female factors. View the fact sheetDefining Infertility
Infertility is “the inability to conceive after 12 months of unprotected intercourse.” View the Fact SheetFertility Rights and Responsibilities
Can a fertility program or clinic deny treatment to patient(s) if there is concern about the ability to care for the child(ren)? Yes. Fertility programs can withhold services if there are signs that patients will not be able to care for child(ren). View this Fact SheetMale Fertility Evaluation: What do I need to know?
Infertility is the inability to achieve pregnancy after one year of unprotected sex. View the fact sheetSmoking and infertility
Most people understand that smoking increases the risk for heart, vascular, and lung disease. View the fact sheetWhat are fibroids?
Uterine fibroids (also called myomas or leiomyomas) are benign (noncancerous) tumors of muscle tissue found in the uterus. View the fact sheetInfertility Counseling and Support: When and Where to Find It
Infertility is a medical condition that touches all aspects of your life. View the fact sheetWhat is In Vitro Maturation (IVM)?
In vitro maturation (IVM) is when a woman’s eggs are collected and matured outside the body. This is done as part of an in vitro fertilization (IVF) procedure. View the fact sheetSART Fertility Experts - Endometriosis
Endometriosis is a condition that can affect many facets of a person’s life, from pelvic pain to struggles with infertility. Listen to the EpisodeSART Fertility Experts - Recurrent Pregnancy Loss
Candace discusses her experience with infertility, IVF, multiple pregnancy losses and ultimately a successful delivery with Dr. Julia Woodward.Listen to the Episode