Hormones, Hormone Therapy and Male FertilityJust as in women, fertility and the male reproductive system is driven by hormones. Different types of hormone therapy can impact male fertility in different ways.
Several hormones are involved in fertility in males. Sperm production and sperm count rely on a complex interaction between testosterone, Follicle-Stimulating Hormone (FSH), Luteinizing Hormone (LH), and Human Growth Hormone (HGH). Hormonal treatments like HGH replacement can increase sperm count and could help men facing fertility issues. On the other hand, testosterone replacement therapy, or TRT, can sometimes negatively affect fertility if not administered carefully.
Let’s take a closer look at the male reproductive system, hormones, hormone therapy, and fertility problems in men.
When people think of testosterone, they often associate it with male virility and reproductive health. While testosterone does play a part in male fertility, the relationship is a bit more nuanced than many realize.
Testosterone is indeed essential for sperm cell development, a process called spermatogenesis, but it is not the only reproductive hormone that drives it. That role primarily falls to the pituitary hormones: luteinizing hormone (LH) and follicle-stimulating hormone (FSH). LH triggers the testes to produce testosterone, while FSH works alongside that testosterone to promote healthy sperm production. In short, testosterone is part of the equation but not the main driver reproductive health or male fertility problems.
Low testosterone levels can interfere with sexual function, but that doesn’t necessarily mean it can cause infertility in males. In fact, sperm production inside the testes occurs in an environment where testosterone levels are already far higher than those found in the bloodstream. So even when blood testosterone levels are low, as when you receive a diagnosis of “low testosterone,” there is likely still enough testosterone in the testes for normal sperm development.
However, lower-than-normal testosterone levels can negatively affect other aspects of male reproduction unrelated to sperm count. Men with reduced testosterone levels may experience:
These issues can impair a man’s ability to conceive a child with his partner — not due to a sperm count issue directly, but through reduced sexual function or sperm quality. Importantly, it’s a misconception that testosterone deficiency alone causes infertility.
Before considering any hormonal treatments for fertility issues in males, doctors need to get at the root of the problem. Diagnosing fertility issues in men involves a combination of medical history, physical exams, blood tests, and semen analysis. During a semen evaluation, specialists examine:
This comprehensive assessment helps determine whether low fertility is due to a hormonal imbalance, structural issue, infection, or other factor.
It might seem intuitive that boosting testosterone levels with testosterone replacement injections would help improve fertility, but that’s not the case. In fact, testosterone replacement therapy is usually not recommended for men actively trying to father children.
Here’s why: testosterone therapy signals the body that it has enough testosterone, which leads the brain to reduce its production of FSH. Without FSH — which is essential for sperm production — sperm count can plummet. In some cases, men undergoing TRT have seen their sperm count drop to levels so low it’s comparable to chemical contraception. That’s right — testosterone injections are being studied as a possible form of male birth control for this very reason.
So, while testosterone injections may help with libido, mood, and muscle tone, they’re not a viable treatment for male infertility. In fact, they may have the opposite effect. Studies have found that the type of TRT can make a difference with some indicating that oral testosterone has less of a negative impact on sperm count than topical testosterone or testosterone injections. Therefore, men wishing to father children who are in need of TRT may want to opt for oral TRT. However, only your healthcare provider can determine what form of TRT is best for your particular situation.
Testosterone and TRT is not the only hormone or hormone therapy that can have a direct or indirect effect on male fertility. Two other hormones that bear mentioning are HCG and HGH.
Human Chorionic Gonadotropin, or HCG, is a glycoprotein hormone produced during pregnancy. Under a doctor’s supervision and when combined with a calorie-restrictive diet and nutritional consoling, HCG is also used as a hormone treatment for weight loss. HCG is also often given to men who are undergoing TRT to help persevere or increase fertility.
Men’s bodies produce a small amount of HCG. In men, HCG plays a role in fertility, sperm count, and testosterone production. In males, testosterone production is controlled by the hypothalamus. The hypothalamus produces and releases Gonadotropin-releasing hormone (GnRH). The release of GnRH, in turn, stimulates the pituitary gland to produce and release two hormones, luteinizing hormone (LH) and folliculin-stimulating hormone (FSH). LH is the hormone that signals the testicles to produce testosterone.
Because one of the functions of HCG is to produce LH, it is approved by the FDA as a fertility treatment for men. LH is essential for sperm production and the level of testosterone in the testes. Studies have found that in men who are having fertility issues due to low testosterone, HCG injections can increase testosterone and improve sperm count.
HGH plays many roles in a man’s health, not the least of which is its impact on fertility, libido, and sexual function.
Human growth hormone (HGH) is a vital hormone produced by the pituitary gland located at the base of the brain. Although commonly associated with growth and development during childhood and adolescence, HGH continues to play a crucial role in adult life, including reproductive health and sexual performance.
In recent years, there has been quite a bit of research delving into the benefits of HGH therapy for improving fertility and enhancing libido in men. Most of this research indicates that supplemental HGH can help improve fertility, enhance sexual function, and increase sex drive in men.
HGH has an impact on fertility and sexual function primarily due to the role it plays in the regulation of hormones relating to both. As to libido, it has an additional impact because of the specific role it also plays in male sexual function, arousal, and emotions relating to sex drive.
It is also important to understand that HGH levels decline as you age, which can lead to decreased vitality and potential reproductive challenges. Studies have found that by supplementing HGH levels through prescription growth hormone therapy, men can experience improvements in both fertility and libido.
As a pituitary hormone, HGH’s impact on fertility mainly has to do with the role it plays in spermatogenesis and in maintaining the balance of other hormones related to fertility and reproduction.
Unlike low testosterone, pituitary hormone deficiencies such as growth hormone deficiency can have a more direct impact on fertility. Therefore hormone supplementation with recombinant-growth hormone injections has a greater ability to improve fertility in males than TRT.
Fortunately, for men who are struggling with sperm quality or are simply planning to become fathers, several natural strategies can enhance reproductive health. These same steps can support healthy testosterone levels as well.
Exercise Consistently
Resistance training and regular physical activity are known to promote natural testosterone production and improve hormone balance.
Prioritize Sleep
Testosterone and other hormones like HGH are primarily released during deep sleep. Poor sleep patterns can drastically impair hormone production.
Cut Back on Alcohol
Heavy or frequent alcohol use suppresses testosterone and can impair fertility by elevating cortisol levels.
Quit Smoking
Smoking is linked to decreased testosterone levels and may affect sperm quality and motility.
Manage Stress
High stress levels increase cortisol, a hormone that can interfere with testosterone and reduce sperm production.
Optimize Nutrient Intake
Key nutrients for male reproductive health include zinc, vitamin D, folate, and vitamin C — all of which support hormonal and sperm health.
Consider Fertility-Friendly Supplements
Herbal supplements such as ashwagandha, maca root, fenugreek, and CoQ10 may help improve testosterone levels and support sperm function.
Avoid Excess Soy Products
Soy contains phytoestrogens that can act like estrogen in the body and may contribute to reduced testosterone levels in men.
Fertility problems are only one of many conditions that can be cause by hormonal imbalances in males. Now that you understand a lot more about the complex relationship between hormones, hormone therapies, and fertility in males, why not Contact Us and learn more about how HRT for men may help with any health challenges you may be facing.
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