Low Testosterone, Sperm Production, and Infertility

Male-factor infertility can arise due to many different reasons. Low sperm counts, problems with sperm shapes (morphology), hormone deficiencies affecting the sperm production process, and many other causes I could list can result in male infertility.

In this article, I will answer important questions such as "What is the male hormone (testosterone)?", "What happens if testosterone decreases?", and "What is the relationship between testosterone and male-factor infertility?".

Testosterone is the most important male hormone that plays an active role in many vital processes such as sperm production (spermatogenesis), preservation of muscle mass, proportional distribution of body fat, and red blood cell production. When the functions of testosterone are considered, it can be clearly understood that there is a close relationship between having an ideal level of testosterone and both general and sexual health.

Testosterone levels may decrease periodically or chronically; at the core of this decrease, there may be the effect of lifestyle, advancing age, or a physiological disorder that damages testicular functions, such as varicocele. The variety of its causes and the complaints it leads to includes low testosterone in the classification of health problems that need to be evaluated in detail.

What is the Male Hormone (Testosterone)?

As I mentioned earlier, testosterone is one of the most necessary male hormones for the smooth functioning of metabolism. Testosterone levels rise to maximum levels during puberty and begin to fall as age advances. If the testosterone level is less than ideal, men may experience many different health problems simultaneously.

What Happens If Testosterone Decreases?

Men's testosterone levels may drop due to reasons such as damage to testicular functions, testicular inflammations (orchitis), long-term medication use, hormonal imbalances, systemic and genetic diseases.

When testosterone decreases, men may experience different symptoms such as:

• Sexual reluctance (Low libido),

• Decrease in sperm production,

• Gynecomastia (breast enlargement in men),

• Erectile dysfunction,

• Decrease in muscle mass,

• Hair loss,

• Mood changes,

• Decrease in bone density (osteoporosis).

Testosterone and Male-Factor Infertility

A decrease in testosterone levels can damage the sperm production process. Although low testosterone levels are not always directly related to total male infertility and healthy sperm production may continue, a decrease in sperm count (oligospermia) may occur. Another danger awaiting men in case of low testosterone is the decrease in the production of seminal fluid, which aids sperm motility.

Low testosterone does not only cause a decrease in sperm count or the production of seminal fluid; erectile problems, low libido, and mood disorders may occur in men due to testosterone deficiency.

Clinical tests are required for the definitive diagnosis of low testosterone, which can occur independently of age. By evaluating the results of the tests performed, a treatment method is determined to increase the testosterone level and sperm count.

"If pregnancy does not occur despite regular unprotected sexual intercourse for 1 year, men should have their examinations done by urology and andrology specialists, and women by gynecologists. The first step in the infertility evaluation of men is the Semen Analysis (Spermiogram) test. Thanks to the Spermiogram test, detailed information about men's sperm quality is obtained. If a decrease in sperm values is detected, a testosterone hormone test is performed. For further infertility evaluation, the Scrotal Color Doppler USG method is resorted to. Varicocele disease, which reduces testosterone release and sperm quality by damaging testicular functions, can be definitely diagnosed with Color Doppler USG."

At this point, it should not be forgotten that the causes of infertility can also come to the agenda as a result of health problems related to women. Problems in female reproductive organs such as the uterus, ovaries, and fallopian tubes, or a decrease in ovarian reserves can also prevent couples from having a baby. In this context, treatment is planned as a result of the factor causing infertility and the health evaluations of the couples. Since the main goal is a healthy birth, it may also become necessary to resort to Assisted Reproductive Technologies (ART) such as IVF (In Vitro Fertilization) treatment. Stages in IVF treatment are also planned specifically for couples.

How is Low Testosterone Treated?

The treatment of low testosterone may vary according to the person's expectations, the causes of low testosterone, and the severity of the symptoms experienced due to it.

Within the scope of low testosterone treatment:

• The person may be asked to change their lifestyle,

• Hormone Replacement Therapies (TRT) may need to be applied,

• Or if the cause of low testosterone is varicocele disease, resorting to Micro-Varicocelectomy surgery may become the only option for infertility treatment.

What is important at this stage is to determine treatment alternatives suitable for the general health status, age, and expectations of the patient experiencing low testosterone.