Does Low Testosterone Cause Infertility?

Young man holding his arm weakly due to low testosterone

For couples trying to conceive, fertility can be a frustrating and complex issue with many potential contributing factors. One question that often comes up is what role testosterone plays, if any, in male fertility.

Testosterone is commonly known as the primary male sex hormone, but does that mean low testosterone levels can directly cause problems with infertility? In this article, we’ll explore the intricacies of the relationship between testosterone and fertility.

To start, we’ll clearly define what constitutes “low testosterone” by looking at normal ranges and symptoms. We’ll then look into the specifics of how testosterone acts on the male reproductive system and sperm production.

While research suggests there are connections between low testosterone and reduced fertility, there are also other common causes of infertility we need to consider. By the end of this exploration, you’ll have a better understanding of how testosterone and other factors influence male fertility.

What is Low Testosterone?

Testosterone is the main sex hormone in men, and it plays a crucial role in several areas of health and wellbeing. Testosterone is responsible for developing male reproductive tissues and maintaining secondary sex characteristics like muscle mass, bone density, and body hair.

This hormone is produced primarily in the testes, with the adrenal glands and peripheral tissues like fat also contributing small amounts.

Normal total testosterone levels in adult males typically range from 300 to 1,000 nanograms per deciliter (ng/dL). Doctors diagnose low testosterone, also called hypogonadism, when levels consistently fall below 300 ng/dL on blood testing.

The symptoms of low testosterone can include low libido, erectile dysfunction, reduced muscle mass, depression, fatigue, and irritability.

There are several potential causes of low testosterone. Primary hypogonadism means the testes themselves are not functioning properly due to injury, infection, or other health conditions. Secondary hypogonadism indicates the pituitary gland or hypothalamus are not adequately signaling the testes to produce testosterone.

Normal aging can also lower testosterone levels, typically by about 1% per year after age 30. Other causes include obesity, chronic illness, inflammation, and certain medications. Diagnosing and treating the underlying cause of low testosterone is important for managing this condition.

How Does Testosterone Affect Fertility?

When it comes to fertility, testosterone plays a vital role in the male reproductive system. This hormone is essential for spermatogenesis, which is the formation and maturation of sperm cells in the testes.

Specifically, testosterone triggers and regulates the process of meiosis that allows sperm cell precursors to divide and develop into mature sperm. It also assists with the release of fully developed sperm through a process called spermiation. Additionally, testosterone impacts the function of Sertoli cells that nurture and support sperm production.

With low testosterone, the testes may produce fewer sperm, and the sperm may be abnormally shaped or have impaired motility. Multiple research studies have shown a correlation between low testosterone levels and reduced sperm counts along with poor sperm quality.

One study found men with total testosterone under 300 ng/dL had sperm concentrations that were 35% lower compared to men with normal testosterone.

However, the full relationship between testosterone and male fertility is complex. While low testosterone can contribute to fertility problems, it is not the only factor. Genetic abnormalities, health conditions, injuries, and lifestyle factors like smoking or alcohol use can also affect fertility independently of testosterone levels.

Evaluating all potential causes is important when a couple is struggling to conceive.

Other Potential Causes of Infertility

While low testosterone has been linked to reduced fertility in men, it is not the only possible cause of infertility. There are various other factors that can impact a man’s sperm production and function.

Genetics play a key role. Chromosomal abnormalities like Klinefelter syndrome are associated with smaller testes and low sperm counts. Issues with genes involved in sperm production can also impair fertility even with normal testosterone levels.

Medical conditions such as diabetes, cystic fibrosis, liver disease, and autoimmune disorders can interfere with sperm health and motility. Some infections like mumps and orchitis can cause testicular inflammation and permanent damage.

Physical problems in the reproductive tract like varicocele veins, duct obstructions, or undescended testes may also contribute to infertility by disrupting temperature regulation and sperm transport.

Additionally, lifestyle factors should be considered. Alcohol use, smoking, stress, and advanced paternal age are tied to reductions in semen quality, even if testosterone levels are normal. Environmental toxins and radiation exposure can impair sperm production over time as well.

A thorough evaluation and testing are necessary to identify all possible causes in men struggling with infertility. While boosting low testosterone may help in some cases, other underlying issues could require different treatments to improve chances of conception. Looking beyond testosterone alone provides a more complete picture.


There does appear to be a connection between low testosterone levels and reduced male fertility. As the primary sex hormone in men, testosterone plays a crucial role in regulating sperm production and quality.

Diminished testosterone can disrupt normal spermatogenesis and lead to fewer, poorly developed sperm. However, testosterone deficiency is not the only cause of infertility.

Genetic abnormalities, chronic health conditions, anatomical problems, infections, and lifestyle factors can all impair fertility independently of low testosterone. While some research shows boosting testosterone may aid conception in infertile men, other underlying causes could require different treatments.

Evaluating all potential contributors provides a better understanding of an individual’s situation.

If you have concerns about fertility, have your testosterone levels checked along with a semen analysis. Be completely open with your doctor about your health, genetics, and lifestyle to identify possible risk factors.

From there you can work to manage any issues impeding your chances of conception. With the right guidance, many causes of infertility are treatable. Don’t get discouraged, be proactive and keep looking for solutions.

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