On the other hand, factors like obesity, chronic illness, or high levels of stress can slow down the process. On the other hand, if your levels were only slightly low, it might take longer to see noticeable differences. These changes typically start to become noticeable after several weeks to a few months of consistent treatment. This is because TRT can stimulate the production of fluids in the prostate and seminal vesicles. Over half of the male partners were non-smokers and had obtained a college or graduate degree (Table 1). The male partners had a mean age of 34.2 (+/− 5.7) years, with a mean BMI of 28.9 (+/− 5.7) kg/m2. The female partner was required to be between 18 and 40 years of age, with regular menstrual cycles, a normal uterus, and at least one patent fallopian tube (8). This IRB approved study enrolled 900 couples with unexplained infertility. This large, multicenter clinical trial determined pregnancy, live birth, and multiple gestation rates following up to four cycles of ovarian stimulation with intrauterine insemination in couples with unexplained infertility (7–8). The odds of live birth decreased by 40% in couples whose male partner had low TT (unadjusted OR 0.60, 95% CI (0.36, 1.00); adjusted OR 0.65, 95% CI (0.38, 1.12)). Semen analysis with an ejaculate of at least 5 million total motile sperm was required for enrollment. Some men report enhanced sensation and satisfaction, while others might experience minimal changes. TRT may affect the sensation during ejaculation, but this varies between individuals. If this occurs, it's important to discuss it with a healthcare provider. In some cases, combining TRT with other treatments or therapies may be necessary to achieve the best results. A significant male factor is found in 50% of infertile couples and is implicated as the sole cause for infertility in up to 30% of couples (1). It's essential to discuss any changes in treatment with a healthcare provider. Men concerned about fertility should discuss options with their healthcare provider before starting TRT. However, any changes in ejaculation should be discussed with a healthcare provider to rule out other potential causes. Retrograde ejaculation, where semen enters the bladder instead of exiting through the urethra, is not a common side effect of TRT. Lifestyle factors, such as diet, exercise, and stress management, can also play a significant role in sexual function. If you have been diagnosed with a low sperm count, also known as oligospermia, there is no reason to lose hope. This is one of the single most effective changes a man can make to improve his fertility. Smoking reduces seminal antioxidant levels by about 30% and causes direct DNA damage to sperm. Managing stress through exercise, meditation, adequate sleep (7-8 hours), and relaxation techniques is one of the most impactful and cost-free ways to support male fertility. Prolonged stress raises cortisol levels, which in turn suppresses testosterone production and can slow or even halt sperm production entirely. Yes, testosterone supplements can actually lower sperm count by telling your brain to stop producing the hormones needed for sperm production. Testosterone is crucial for sperm production, but here’s the thing—if you’re taking testosterone supplements, it could actually lower your sperm count. Efforts to further evaluate and optimize even asymptomatic low testosterone levels in male partners should be considered in the treatment of the infertile couple. Yes, low testosterone levels can negatively impact ejaculation, often leading to a decreased ejaculate volume or reduced pleasure during ejaculation. This may happen because adjusting testosterone levels can affect the balance of hormones that regulate sexual function.
