Does testosterone therapy affect fertility?

Testosterone given from outside the body tells the pituitary that there is plenty on board. That signal turns down the hormones that drive sperm production in the testes. For many men, that means sperm counts fall markedly, sometimes to zero, while on therapy.

Recovery after stopping varies, and it can take many months. It is not guaranteed to return to baseline in every man, which is why I ask about family plans at the first visit rather than the fifth.

When fertility matters, there are other paths worth discussing with a physician — including treating an underlying cause, or hormone strategies designed to preserve testicular function. Whether any of those is appropriate depends on the diagnosis, the labs and your own goals, and in some cases referral to a fertility specialist is the right step.