Why Sperm Counts Matter
On a macro scale, fertility rate is a statistical measure of how many children women have. At the societal level, fertility rates can be used to predict future population growth. The US, with a 1.77 fertility rate, means that women have fewer than 2 babies each not enough to keep the population steady. The 2-baby threshold is called the replacement level by public health officials. Any fertility rate under 2 signals potential trouble on the horizon.
Low sperm counts have profound effects on a mans personal life as well. Low sperm count and/or low quality of sperm can be a major burden for men and their partners who hope to start a family. Even otherwise healthy couples with plans for children often struggle to achieve pregnancy. Again, the causes for an inability to become pregnant vary, but sperm count is a common factor. Heres how sperm affects fertility.
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What Is Low Blood Testosterone
In men, testosterone is responsible for maintaining:
- sex drive
- facial, pubic, and body hair
- muscle mass
“It is also important for overall energy level,” says Sriram Eleswarapu, MD, PhD, assistant professor of urology at the David Geffen School of Medicine, UCLA.
Did you know the amount of testosterone in a mans body changes throughout the day, and its usually highest in the morning? A normal range is 300 nanograms per deciliter to 1,000 ng/dl.
Low T is defined by blood testosterone levels of less than 300 ng/dL on two tests, generally obtained in the morning on two different days.
“Pretty much everyone is in agreement on that,” says Spyros Mezitis, MD, an endocrinologist at Lenox Hill Hospital, New York, NY.
Experts have discovered that in men over age 65, the daytime to nighttime variation in testosterone levels is much less apparent, says Dr. Eleswarapu. So while testing is typically done in the morning, ”in older men it wouldn’t make that much difference.”
Routine blood workwhen your doctor decides it is time to check your cholesterol, blood sugar and other health indicatorsdoesn’t typically include getting a testosterone level, Dr. Mezitis says: “Usually the question comes up with talk about a lower sex drive.”
The blood test for low T measures testosterone, of course, along with a hormone known as SHBG and pituitary hormones involved in male hormone production.
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The Misuse Of Testosterone As A Fertility Treatment
If the risks of TRT were widely known and talked about openly by doctors and patients alike, this wouldnt be such a big problemeach man could decide for himself is the risk is acceptable. But many men dont know that their testosterone medications could be impacting their fertility in both the short and long term. Even worse, some doctors are still prescribing testosterone to treat infertility. One survey of practicing American Urological Association members found that 25% of respondents were prescribing TRT to infertile men who were actively pursuing pregnancy. International studies have had similar results and indicate that a significant number of practitioners incorrectly believe that testosterone therapy increases sperm count.
In some ways, the thought process makes sense. Testosterone plays some part in the reproductive function of the male body. If a man is found to be infertile, why not administer doses of this incredibly accessible treatment?
Its all a matter of education. The doctors who prescribe TRT as male infertility treatment arent aware of the consequences and may not have the necessary qualifications to be administering complex hormone treatment in the first place. More education on the effects of exogenous testosterone on male fertility could help reduce this unfortunate occurrence.
How Do I Decide On A Treatment Plan
“People have to understand there can be various causes of low testosterone,” Dr. Mezitis says. It’s not just a question of whether the testicles are making enough, he says. “The question is, ‘Why is this happening?”’
Dr. Mezitis agrees that your doctor needs to distinguish whether the low T is primarily a testicle issue or a pituitary issue.
In addition, Dr. Mezitis says, he considers many other things before suggesting testosterone therapy, such as the status of a man’s prostate health: “If there is a prostate issue, I am careful about replacing testosterone.”
According to guidelines from the American Urological Association, there is currently inadequate evidence to quantify the risk of testosterone therapy in men who had prostate cancer.
He would also consider a patient’s risk of cardiovascular disease, as ”the jury is out” on the relationship between testosterone therapy and cardiovascular risk.
Treatment ”has to be tailored to the individual patient,” he says. Patients on testosterone replacement should be checked for prostate pathology, high red cell mass and blood clotting, and other hormone disorders. The choice of testosterone replacement and the low T patients management should be decided with the expertise of an endocrinologist.
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What Is The Connection Between Low Testosterone And Infertility
Hypogonadism is a condition often affecting aging men but increasingly common in younger age groups in which the testes fail to produce an adequate supply of testosterone for distribution throughout the body.
Healthy testosterone levels vary depending on individual factors with total testosterone levels in the range of 300-1,000 nanograms per deciliter indicating normal amounts of the hormone.
Normal free testosterone levels for men fall within 47-244 picograms per milliliter .
How Testosterone Promotes Sperm Production
Testosterone is the primary male sex hormone, playing a crucial role in reproduction. Testosterone is produced in the male testes, the same glands in the body where sperm is manufactured. Medical literature describes sperm production as hormonally driven, meaning that the body requires the proper signaling from testosterone, working in tandem with other hormones, to catalyze sperm production.
Other than testosterone, the other two hormones that direct sperm production are called luteinizing hormone and follicle-stimulating hormone .In the medical literature, spermatogenesis refers to the process of sperm production. Scientists have recently uncovered a deeper understanding of how spermatogenesis works and why it depends so heavily on testosterone.
Testosterone is intricately involved in spermatogenesis from start to finish. Without proper levels of testosterone in circulation, sperm production is severely limited. This is one of the major reasons that older men who are planning for families often struggle to impregnate their partners.
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Testosterone Therapy & Fertility
A decrease in a mans Testosterone level is an understandable concern for couples trying to conceive. Low Testosterone affects fertility by reducing a mans desire for sex and his ability to attain and maintain an erection. However, simply treating the condition with added Testosterone actually decreases sperm production, sometimes to the point of having no sperm.
Taking Testosterone affects fertility in two ways. First, adding Testosterone to the bloodstream via patches, gels or other methods tells the brain that the body has enough Testosterone, causing it to signal the testes to halt testosterone production. When your testes dont produce Testosterone, sperm production goes down.
Secondly, Testosterone therapy has a negative affect on sperm production because it decreases another hormone necessary for sperm called Follicle-Stimulating Hormone . While Testosterone is needed for sperm production, it does not actually stimulate it FSH does along with Luteinizing Hormone . In fact, low Testosterone levels as indicated on a blood test may not mean youre infertile. Testosterone is much higher in the testes than in the blood, so enough may be present for adequate sperm production.
Although Testosterone can have devastating effects on sperm counts, those effects may be reversed. If you or your partner have been taking Testosterone, your Inovi fertility specialist can guide you to the best option for reversing its affects.
What Effects Can Drugs Have On Male Infertility
Some drugs — legal and illegal — can have a negative effect on male fertility . If you want to father a child, be sure to talk to your healthcare provider about any drugs you are taking and their potential side effects related to fertility. Be especially careful with non-FDA approved male fertility supplements. They may be widely advertised as fertility enhancers, but they havent been scientifically evaluated and may cause harm.
If you have trouble fathering a child you should undergo a complete history and physical. If youre experiencing an unexpected side effect from a medication, you may need to try a different one.
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If A Man Is Infertile And Taking Testosterone What Are His Options
A man should see a male reproductive specialist who will perform a complete history and physical examination for him. He will need to have hormone testing, at least two semen analyses, and possible additional testing performed. He will need to stop taking testosterone and have hormone tests and semen analyses checked periodically as it could be months before his sperm count returns to baseline.
Does Low Testosterone Cause Low Sperm Count
One of those points involves the use of TRT , which can actually reduce a mans sperm count while increasing his deficient male hormone supply. While the naturally produced testosterone that men have plays a vital role in supporting their ability to produce sperm, the introduction of bio-identical male hormone into a mans system has the opposite effect. It sends a message to the hormones in his brain that signal his testes to produce the testosterone that produces sperm that they dont have to do their job because his testosterone levels are fine.
So the answer to does low testosterone cause low sperm count is that it often does and just as often, it contributes to this problem whenever there are other factors that are involved. But what can be done about it? Fertility doctors will often recommend the therapeutic use of gonadotropin, which is a hormone that stimulates the function of gonads. They will also recommend weight loss if they feel that a mans condition of obesity is inhibiting his natural testosterone production along with other healthy improvements such as getting regular exercise and eating more nutritiously. The incorporation of these sensible health habits into a mans daily routine has been shown to have a positive effect on male hormone production.
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Does Masturbation Decrease Testosterone
Masturbation was taboo for many years, and only a few studies covered that particular topic. But it is necessary and curious for males to know what happens when they masturbate.
Is something changing in their hormones? Does masturbation decrease testosterone? What about muscle building?
In this article, we will answer all of those questions and more.
What Are The Signs Of Low Testosterone
Once again, we said in the introduction paragraph that mens health is full of myths. Men of all ages worry about their testosterone at some point in their lives. Sometimes very early on because they dont see facial hair growing in their puberty. Or later in life because they had an episode of erectile dysfunction.
But the signs and symptoms of low testosterone can be displayed by almost anyone. We can live with these symptoms, and it doesnt meat testosterone levels are low. Together, they make up a significant suspicion, but this suspicion should be tested. Thats why doctors go through your symptoms and then order a few tests.
Still, it is very important to know the signs of low testosterone. That way, you will be able to tell if youre fine. The more items in this list that you check, the most likely it is you have low T levels.
This is the list of symptoms of low testosterone :
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Boosting Fertility When Testosterone Levels Are Low
If you have low testosterone, one way to improve sperm count is with gonadotropin injections. This stimulates the production of sperm. It may be considered as a way to increase men’s fertility when they and their partner are having trouble conceiving a child.
Mezitis says it’s standard practice to check a man’s sperm count when a couple has difficulty getting pregnant. If his sperm count is low, the next step is to measure his testosterone.
“If it’s below normal, we can then inject the signal to produce more testosterone,” Mezitis says of gonadotropin injections. “This is done solely to promote fertility.”
At this point, Mezitis advises men to seek out a specialist.
“If you have low testosterone and desire fertility, you should work with a reproductive endocrinologist,” he says.
You should also make sure to follow a lifestyle of regular exercise and a healthy diet if you want to father a child. Overweight and obese men tend to have lower testosterone levels because excess belly fat converts testosterone to estrogen, another hormone. Shedding those extra pounds will likely have a positive effect on your fertility.
“Losing weight can definitely increase testosterone,” says Eisenberg. “It’s a very good strategy. It’s difficult to lose weight, but for men who are very motivated, it’s a good place to start.”
There Has Been A Lot Of Information About Low
Low-T refers to a low testosterone level which can result in a number of symptoms in men. Testosterone is a hormone that is produced primarily in a mans testicles. When the testosterone level is low it may cause symptoms such as lower sex drive, a lack of energy or increased fatigue, reduced muscle strength or endurance, less strong erections, and male infertility.
If you have one or more of these symptoms you may want to talk to your provider about having your testosterone level checked. It is normal for testosterone levels to gradually decrease as you get older. However, if you have a low T and have the symptoms associated with low T you may want to consider your options for treatment.
Before you start treatment it is important to have a discussion about your future fertility plans because taking testosterone supplements will dramatically reduce the amount of sperm your testes produce.
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Causes Of A Low Sperm Count
In many cases, it’s not obvious what causes a low sperm count.
Sometimes problems with sperm count and quality are associated with:
- a hormone imbalance, such as hypogonadism
- a genetic problem such as Klinefelter syndrome
- having had undescended testicles as a baby
- a structural problem for example, the tubes that carry sperm being damaged and blocked by illness or injury, or being absent from birth
- a genital infection such as chlamydia, gonorrhoea or prostatitis
- previous surgery to the testicles or hernia repairs
- the testicles becoming overheated
- excessive alcohol consumption, smoking and using drugs such as marijuana or cocaine
- certain medications, including testosterone replacement therapy, long-term anabolic steroid use, cancer medications , some antibiotics and some antidepressants
- being overweight or obese
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Boosting Testosterone When Trying To Conceive
Stop smoking! Smokers generally have lower levels of various hormones including those which impact on male fertility. When trying to conceive you can improve your chances significantly by kicking this habit.
Losing weight is also a great way to help boost your testosterone levels. A study has shown that obese men have 30% lower testosterone levels than men at a regular weight. The numbers look even worse as you get more overweight, with another study showing that 70% of morbidly obese men have testosterone deficiency. So, if you are overweight, adjusting your diet and getting regular exercise are both great options to help boost testosterone levels and therefore your fertility.
Being diagnosed with low testosterone does not signal the end of your hopes when trying to conceive. Testosterone is directly associated with the quantity of sperm produced, whereas the quality is dictated by other factors. If you make lifestyle changes and get treatment as soon as you can then you still have a great chance of success. Learn more about male fertility supplements.
Treating Testosterone Issues In Women
When treating high testosterone levels, your doctor will consider your goals and your symptoms. Treatment is different if youre trying to conceive. For example, one possible treatment is birth control pills, but that wouldnt be appropriate for someone trying to get pregnant.
Another possibility is the anti-androgen drug spironolactone Spironolactone is not safe to take when pregnant, so it isnt appropriate for those trying to conceive. Options for women hoping to have a baby include:
- Weight loss and exercise: Losing excess weight and regular exercise, especially in women with PCOS, can help lower testosterone levels and may even restart ovulation.
- Metformin: Treating insulin resistance with the diabetes drug metformin may help reduce PCOS symptoms and even restart ovulation.
- Fertility drugs: You will likely need both lifestyle changes and fertility drugs to conceive. Clomid and letrozole are the first line fertility treatments for women with PCOS.
- Cosmetic treatments: For women trying to conceive, cosmetic treatments like waxing or plucking are possible solutions for unwanted hair growth.
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