Sven Wombwell
Article by: Sven Wombwell
Estimated 7 minutes read
Quick summary
Testosterone replacement therapy can hugely benefit long-term health but may also interfere with fertility in men. Low testosterone levels can affect a man's sperm count and make it more difficult to have a family, leaving women to wonder, if my husband takes testosterone, can I still get pregnant? There are alternative medications that still boost testosterone levels while maintaining fertility. Clomid, for example, can increase testosterone or be combined with TRT to increase testosterone levels and sperm count for men wanting to conceive.

When a man has low testosterone, it can affect him in various ways, including low energy levels, a declining sex drive and erectile dysfunction, but it can also affect his relationship. For many men experiencing low testosterone levels, testosterone replacement therapy (TRT) can be very beneficial. However, women often ask, if my husband takes testosterone, can I still get pregnant? 

When planning to have children, there are some things to understand before moving forward with testosterone replacement therapy.

What is Testosterone?

Testosterone is an androgen hormone produced in the testicles. It's the hormone responsible for sperm production and the traits considered to give men their masculinity, such as muscle development, a deep voice, hair growth, bone development, and the development of the sex organs.

It's responsible for libido and sexual function and is vital for overall good health and well-being and for preventing long-term disease risks. While women produce small amounts of testosterone, men have about 10x as much, which is why it's called the male sex hormone.

Low Testosterone and Fertility

Testosterone levels drop naturally as men age (1) at about 1 percent a year, starting at about age 35. As testosterone levels drop, some men may experience signs of low testosterone, such as:

  • Low energy levels
  • Decreased libido
  • Muscle loss
  • Irritability
  • Erectile dysfunction
  • Mood swings
  • Weight gain
  • Hair loss 

According to Dr. Puneet Masson of Penn Medicine, (2) low testosterone can alter the libido and lead to problems with sexual desire. It can also affect sexual functions such as erections and sperm development, directly impacting the ability to father a child.

Can Testosterone Replacement Therapy (TRT) Increase Fertility?

Although it seems like testosterone replacement therapy should increase fertility, studies show the opposite (3). The reason is that TRT doesn't increase testosterone in the testicles where it produces sperm and can interfere with the body's ability to produce sperm on its own, which affects male fertility. 

According to Kevin Pantalone, DO, an endocrinologist at Cleveland Clinic, (4) testosterone therapy can increase circulating testosterone in your blood, but not the testicles, where it's needed to produce sperm. And can, in fact, reduce sperm count further.

When you are getting testosterone through pills, injections, creams or patches, the body thinks it's got an abundant supply and stops producing it, but since it's not being made in the testes, it won't produce the sperm needed for pregnancy.

How to Increase Testosterone Levels

When considering having a family, TRT may not be a good option, but there are some things you can do to increase testosterone levels that include:

  • Eating a nutritious diet
  • Stop smoking
  • Limit alcohol use

In short, health and lifestyle factors can impact testosterone levels, but even when you get that right, you may experience low testosterone levels and have problems conceiving a child. 

A TRT Alternative That Increases Fertility

There are alternatives if you are looking to get pregnant if your husband is on testosterone. TRT is a low testosterone treatment typically used for men over 35. One reason is due to the impact it can have on men's fertility. But for men starting families over 35 with low testosterone, there is an alternative. 

Clomiphene citrate, known by the brand name Clomid®, is an FDA-approved medication that's historically been used to treat women's fertility problems. More recently, clomiphene and its proprietary drug, Triclozene, are being used off-label to treat male infertility problems and low testosterone.

The term off-label means it's being used to treat things other than the FDA-approved uses.

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How Clomid works

Clomid makes the body think that testosterone and estrogen levels are lower than they are, which notifies the pituitary gland to release more follicle-stimulating hormone (FSH) and luteinizing hormone (LH). That triggers the testes to produce more testosterone and sperm, which can benefit men that struggle with infertility.

What Does Clomid Do?

Clomid works by selectively binding to estrogen receptors that block the effects of estrogen, which increases the production of follicle-stimulating hormone (FSH) and luteinizing hormone (LH). One of the benefits of Clomid for fertility is that it helps your body make more sperm.

Benefits of Clomid for Men Wanting to Conceive

Since TRT can interfere with the natural production of testosterone, it may not be the best option, especially regarding fertility. One alternative so you can still get pregnant if your husband is on testosterone could be clomid. Its benefits include:

  • Affordability
  • Stimulates natural testosterone and sperm production
  • Few side effects
  • Taken as a tablet, so no injections

According to studies (5), a 25-50 mg dose daily can increase sperm count and testosterone levels in a few months.

HCG and TRT to Preserve Fertility

Another option for people on TRT who take testosterone and want to get pregnant is HGC. Human chorionic gonadotropin (HCG) is a crucial hormone in fertility and reproductive health. 

In men who are on testosterone therapy, HCG is a supplemental treatment to mitigate the potential adverse effects of testosterone on fertility.

Men undergoing testosterone therapy often suppress their natural production of luteinizing hormone (LH) and follicle-stimulating hormone (FSH). These hormones are responsible for stimulating the testes to produce testosterone and sperm. Consequently, decreased LH and FSH production can reduce sperm production and fertility.

HCG can help address this issue by mimicking the action of LH in the body. By administering HCG alongside testosterone therapy, it can stimulate the Leydig cells in the testes to produce testosterone. Consequentially, this helps maintain testosterone levels and supports natural sperm production.

By incorporating HCG into the treatment plan, men on testosterone therapy may have a better chance of preserving their fertility. It can help maintain testicular function, prevent testicular shrinkage (testicular atrophy), and protect sperm production. This is especially important for men who wish to conceive a child in the future.

One issue with HCG injections is that they are costly, varying between $400-$789 each month. If you add that to the cost of testosterone replacement therapy, it can become out of reach for many people. If you compare the prices of HGC to an alternative like Clomid, which works almost as well, Clomid becomes the obvious choice. 

Clomid vs. TRT

Traditional testosterone replacement therapy and Clomid work differently while having similar benefits. For example, TRT doesn't increase testosterone in the testes to produce sperm and can interfere with the production of sperm. Still, Clomid offers a 100 to 200% increase in testosterone levels and increased sperm count (6) and alleviates symptoms of low testosterone while maintaining or improving fertility. 

Benefits of Clomid include:

According to a study (7), Clomid is more beneficial than TRT injections and creams if you want to get pregnant and your husband is on testosterone. Clomid promotes natural testosterone production in the testes with few side effects. However, with that being said, there can be side effects (8) to be aware of.

Potential downsides of Clomid include:

  • Weight gain
  • Moodiness
  • Blurred vision
  • Sore breasts
  • High blood pressure
  • Nausea

Clomid can also take more time to see the difference than TRT and can negatively affect libido in some men, although it's rare. 

Conclusion: My Husband Takes Testosterone Can I Still Get Pregnant

To answer the question, if my husband takes testosterone, can I still get pregnant? The answer is yes, as long as you choose the proper medications to maintain sperm production. Unfortunately, testosterone replacement therapy (TRT) can negatively impact the production of sperm, which makes it more challenging to get pregnant. Although traditional TRT isn't the best option, Clomid is an alternative that can be taken alone or combined with TRT, which helps increase testosterone while preserving fertility in men.

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