The amount of testosterone produced by the gonads reduces with age. This is a common side effect of aging and is often associated with male menopause or andropause. However, some men suffer from low testosterone while still in their reproductive years. This condition, commonly referred to as hypogonadism, can lead to erectile dysfunction and reduced sperm count. If a man is diagnosed with hypogonadism, testosterone therapy may help reverse the symptoms of the condition and increased fertility.

What is hypogonadism?
Hypogonadism causes the body to produce less gonadotropin. Less gonadotropin means less testosterone and reduced fertility, in some cases. Hypogonadism is often associated with injury or disease to the testes, hypothalamus or pituitary gland, but there are other causes of the condition.

Hypogonadism can develop at any age. Some men are born with the condition and other men develop the condition later in life. Treatments for the condition, including the use of testosterone therapy, will be used on a case-by-case basis.

Testosterone Replacement Therapy and Male Fertility
If testosterone levels are lower than normal and you are experiencing infertility, your fertility doctor may suggest testosterone injections or some other form of testosterone therapy. Testosterone therapy requires regular monitoring of testosterone levels as levels are constantly changing in the body and too much testosterone can lead to negative side effects. Possible negative side effects of testosterone therapy may include:

• Water retention
• Liver toxicity
• Reduced natural production of testosterone
• Enlarged breasts
• Prostate growth

Men who have prostate cancer are not eligible for testosterone replacement therapy, even if the therapy would cure infertility. Testosterone may increase the growth rate of cancerous cells in the prostate.

The effectiveness of the testosterone therapy will depend on the condition or cause of the hypogonadism. In some cases, not even testosterone therapy is enough to increase fertility.

How long will you have to be on testosterone replacement therapy?
If there are other symptoms, aside from reduced fertility, associated with low testosterone, you may want to discuss long-term testosterone treatment with your physician. Testosterone therapy can reduce some of the most significant side effects of low testosterone, which can increase quality of life for men with testosterone production problems.

Testosterone replacement therapy is one of the many treatments available for male infertility. Not all men facing fertility problems have low testosterone production, so a blood test is required to test hormone levels before testosterone therapy is prescribed. Additional blood tests may be required to ensure healthy testosterone levels are maintained throughout treatment.