For many couples, the decision to start testosterone therapy (TRT) comes after months or years of feeling tired, low in energy, and unlike themselves. When you start TRT, it can feel like a fresh start: more strength, more confidence, more intimacy.
But along with the benefits, another question may quietly creep into your partner’s mind: If my husband takes testosterone injections, can I still get pregnant?
It’s a fair and very common concern. And the truth is complicated. While testosterone therapy can bring improvement in quality of life, it also has a real impact on fertility. As you consider the full picture, what matters most is that you are not alone, and there are safe, medically guided options available.
Yes. Testosterone therapy can lower sperm count or even pause sperm production in men.
This surprises a lot of people. After all, testosterone is the “male hormone,” so shouldn’t more of it equal more fertility, or does TRT cause infertility? The reality is that exogenous testosterone, the type that you inject or apply, tells your brain that your body already has enough. As a result:
That can feel concerning to read, especially if you are starting a family and want to know if you can have kids while on TRT. The good news is that, in most cases, the changes are reversible with the right care and treatment.
It’s also worth noting: TRT is not a reliable form of birth control. While fertility often drops, some men can still father children while on testosterone. That means couples shouldn’t rely on TRT as a method of contraception.
Learn more about how testosterone affects other areas of men’s health.
No, TRT does not cause infertility permanently. For most men, the effects are temporary. Once TRT is paused or stopped, sperm production will begin as usual.
The timing question—how long after stopping testosterone does fertility return—is one many men grapple with. Recovery often happens within a few months, and most men will have normal production of sperm within a year of stopping TRT. It may take longer depending on age, health, and how long you’ve been on therapy. Some men need extra support through medications that stimulate sperm production.
What matters is not trying to manage it on your own. Suddenly quitting TRT can throw your body out of balance. A provider who understands both hormone therapy and fertility can guide you safely through the process.
Every man’s body responds differently to testosterone replacement, but some groups are more likely to experience fertility challenges on TRT than others:
Testosterone treatment should be more than just numbers on a lab test. It should support your goals, your relationships, and your future.
Here are some ways to safeguard fertility while benefiting from TRT:
Not every clinic explains these options. Some simply prescribe without explaining whether testosterone is safe when trying to have a baby. That’s why working with a team that takes your whole health and life into account matters.
Yes, you can preserve fertility if you work with a TRT provider who builds fertility preservation into your treatment plan.
Couples might also be wondering: what if you’re already on TRT and trying to conceive? If you and your partner are already on the TRT journey, you might be feeling anxious or unsure about how to proceed. These feelings are understandable, but many men in this situation go on to father children.
With a provider’s guidance, you may:
It takes patience, but recovery is common. In one study, over 98% of men restored sperm production to normal a year after stopping TRT.
Testosterone therapy can be life-changing. It restores energy, libido, confidence, and joy. But it also has real implications for fertility that deserve care and honesty.
The hopeful truth is that you do not have to choose between optimizing your health and having a family. With the right plan, most men successfully do both.
PG Men’s Health takes a fertility-aware approach to testosterone replacement therapy. We approach TRT with compassion and transparency. We understand that these decisions aren’t just about hormones. They’re about your identity, your relationships, and your dreams for the future.
If you’re considering testosterone therapy but worried about fertility, we’re here to help. If you live near Tampa or Sarasota, Florida, book a free, judgment-free consultation. Together, we’ll create a plan that supports your health.
