Low Testosterone and Fertility – Is There a Connection?
The headlines may be contradictory:
Low Testosterone Does Not Cause Male Infertility ~ Low Testosterone Could Be Responsible for a Low Sperm Count ~ Low Testosterone Could Impede Female Fertility
So, what is the truth about low testosterone and fertility – is there a connection between the two?
Clearly, it depends on who you ask. Some doctors today are using testosterone replacement therapy to help couples become pregnant while others do not believe this treatment will help. Of course, it is all about the results, and any woman who has become pregnant because either she or her partner received supplemental testosterone will tell you that it works.
How does low testosterone affect fertility?
For men, it may be all about the sperm count. The lower the sperm count, the harder it will be to father a child. If the testes are not working properly, or if a problem exists along the production path with either the hypothalamus or the pituitary gland not secreting enough gonadotropin-releasing hormone (hypothalamus) or luteinizing hormone and follicle-stimulating hormone (pituitary gland), the testes will most likely not produce enough testosterone needed for sperm production.
When it comes to low testosterone levels, fertility issues in women center around how testosterone helps promote follicle development that is crucial for the release of eggs. We will delve deeper into this subject in the next section.
Female Infertility and Low Testosterone
As we examine low testosterone and female fertility, we see that testosterone may help prevent follicles from an early death – making it easier for them to progress to a mature stage where they can produce and release an egg. Testosterone also helps make a woman’s ovarian cells more sensitive to FSH – follicle stimulating hormone that is responsible for promoting follicle growth. This is accomplished through the creation of additional FSH receptor molecules on the surface of ovarian cells that stimulate the process.
The treatment of low testosterone and female infertility often goes together. When you provide supplemental testosterone administered through the skin via patch or cream, that testosterone helps to stimulate the production and release of an egg from the ovaries. It is important to note that this form of fertility treatment does not help every woman become pregnant. It will be most useful for those who are tested and found to have low levels of testosterone. It will be necessary to receive diagnostic blood testing for Low T. A hormone specialist may be able to help you get to the root of the problem, especially when other forms of fertility treatments do not work.
Low Testosterone and Male Infertility
There is even more to understand about very low testosterone and fertility issues in men. You have a situation where the hypothalamus releases GnRH that signals the pituitary gland to secrete FSH and LH. Luteinizing hormone lets the testes know it is time to produce testosterone. The follicle-stimulating hormone is the trigger for the creation of sperm cells.
What happens when you introduce supplemental testosterone into a male’s body? In some cases, the hypothalamus receives a signal that there are already adequate supplies of testosterone present, so no GnRH is released. Now, since the hypothalamus is not letting the pituitary gland receive the signal from GnRH to secrete LH and FSH, you may have a problem with fertility since the signals to produce sperm are no longer getting through.
This is why treatment for low testosterone and fertility treatment sometimes do not align. The doctor needs to determine the best approach. The sperm need testosterone for their production, but that testosterone must be in the testes, and not supplemental added through testosterone replacement therapy where the extra testosterone is found only in the bloodstream. Remember, too much testosterone in the blood will stop the testes from producing testosterone. The goal of treatment will be to increase the LH and FSH signals to the testes so that testosterone levels increase naturally.
For additional information or answers to your questions about low free testosterone and fertility, please contact the hormone replacement therapy specialists at Kingsberg Medical for a confidential consultation at no charge or obligation.
Brian Leeber