Testosterone Replacement Therapy and Fertility: What Men Need to Know in 2025
- Elizabeth Nguyen
- Jul 23
- 2 min read
Testosterone Therapy Is On The Rise... But So Are Fertility Concerns
Testosterone replacement therapy (TRT) is experiencing a surge in popularity, with prescriptions nearly tripling over the past decade. CBS News reports that prescriptions for testosterone rose from 7.3 million in 2019 to over 11 million in 2024.
Testosterone, a male hormone, plays a vital role in the health and fertility of both men and women. Men are turning to TRT to combat symptoms of low testosterone like fatigue, low libido, mood changes, and reduced muscle mass. But while TRT can improve quality of life, it can also have a serious side effect that many men don’t expect: it can significantly reduce sperm production and impair fertility.
How TRT Impacts Male Fertility
Testosterone plays a key role in sperm production. When the body receives testosterone from an external source (like injections, gels, or patches), it signals the brain to reduce production of two hormones, LH (luteinizing hormone) and FSH (follicle-stimulating hormone), that are essential for sperm development.
As a result, men on TRT may experience:
Lower sperm counts
Reduced semen volume
In some cases, complete absence of sperm (azoospermia)
These effects can begin within weeks of starting therapy and may take months or even years to reverse after stopping treatment.
Planning Ahead: Preserving Fertility Before TRT
If you’re in the process of starting testosterone replacement therapy, or considering starting, it is important to understand the benefits and the risks associated with it. While TRT can offer increased energy, improved mood, and enhanced muscle mass, it can also cause negative effects on fertility.
If you’re considering testosterone therapy and hope to have children in the future, sperm preservation is a proactive, effective step. At STL Fertility, we offer sperm banking in a single, private visit. Here’s how it works:
Register in our nAble patient portal to begin the process. Our team will contact you to schedule your appointment.
Collect your sample at home or in our private clinic collection room.
Complete a quick blood draw when you drop off your sample or come in for collection.
Your sperm is safely frozen and stored for future use.
This simple process gives you peace of mind so you can start TRT knowing your family-building goals are protected.
You Deserve to Feel Your Best Without Sacrificing Your Future
TRT can be life-changing for men with low testosterone. But it’s important to understand the full picture. If you’re thinking about starting testosterone therapy, talk to a fertility specialist first. With the right plan, you can protect your reproductive future and improve your health today.
Ready to get started?
Comments