Can fertility return after stopping testosterone therapy?

Question

Hello doctor,

Will hCG make me fertile again now that I have stopped testosterone replacement therapy? My sperm count went from 300 million before TRT to zero after starting it. My LH and FSH levels are also zero.

I am currently taking 300 IU of hCG daily for about eight weeks, but my sperm count is still zero. Will this return to pre-TRT levels as I am trying to conceive?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your query and understand your concern.

Your LH (luteinizing hormone) and FSH (follicular-stimulating hormone) levels can become suppressed after testosterone replacement therapy, which leads to a reduction sperm production. This is a known and reversible effect in many cases.

This happens because external testosterone signals the brain to reduce natural LH and FSH production, which are essential for sperm formation.

hCG (human chorionic gonadotropin) helps by mimicking LH and stimulating the testes to produce testosterone naturally, which can help restart the sperm production process. However, in many cases, hCG alone may not be sufficient, and FSH injections may also be needed to directly stimulate sperm production.

Even after starting hCG, it is common for sperm count to remain zero in the early phase of treatment. Recovery usually takes time, often around three to six months or longer, depending on individual response.

With continued and appropriately guided hormonal therapy, recovery of sperm production and return of fertility is possible in many cases, but it requires patience and regular monitoring of hormone levels and semen analysis.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.