Testosterone Therapy and Fertility: What Men Should Know Before Starting

Does testosterone therapy affect fertility?

Yes. Testosterone taken as a medication can reduce the body's own signals to the testicles to make sperm. Sperm counts can fall significantly, and in some men production stops altogether.

What do the guidelines say?

The American Urological Association says testosterone therapy should not be prescribed to men who are currently trying to conceive, and that future fertility should be discussed with any man considering it.

Is it reversible?

Sperm counts often recover after stopping, but it can take months, and recovery cannot be guaranteed.

Does it work as birth control?

No. A lower sperm count is not a zero sperm count, so testosterone should never be relied on to prevent pregnancy.

What should you do first?

Tell your provider if you want children now or might later, before starting anything. Low testosterone should be confirmed with morning blood tests alongside symptoms, not a single result. If fertility matters to you, options exist, including sperm banking before treatment, and your provider can walk through them.

Raising fertility before treatment starts keeps more options open.