Men’s Fertility Solutions
For any man considering testosterone replacement therapy (TRT), whether
young or old, they need to be educated on the risk of decreasing sperm
counts. This is where we strive to be different at Ascend! Please take the
time to read this information thoroughly and schedule your consultation
TODAY if your provider has not discussed any of this with you. Your future
family depends on this.
Testosterone Therapy & Fertility: What Every Man Should Know
Many men don’t realize how closely testosterone and fertility are linked.
Within just 6 months of starting TRT, over 40% of men may see their sperm count drop by 50% or more.
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Important to know:
TRT is not a reliable form of birth control. We’ve seen both situations in our clinic:
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Men on TRT for years who still conceived unexpectedly.
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Men whose sperm count dropped to zero after only a few years on therapy.
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This isn’t something we can see in your routine bloodwork.
To truly understand your fertility, you need a semen analysis.
Step 1: Get a Semen Analysis
We will *always* recommend starting with a semen analysis if you’ve been on TRT and want to know your fertility status when considering having a family.
We are not affiliated with the website/organization, but many of our patients (and several OB-GYN and fertility specialists) trust MeetFellow.com for affordable, CLIA-approved at-home testing — often a fraction of the cost of a fertility clinic visit.
Step 2: Evidence-Based Treatment Options
Your semen analysis results will guide our next steps:
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Human Chorionic Gonadotropin (HCG) is the only medication proven to maintain sperm production while on TRT.
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Starting dose: 500 IU twice weekly to maintain spermatogenesis.
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Higher doses ARE needed if sperm count is already zero.
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Clomiphene and Enclomiphene, which are a selective estrogen receptor modulator (SERM) may need to be added when trying to restart production or to support testosterone after stopping TRT — but it is not effective alone for preserving fertility during TRT. These can also be used to help increase testosterone levels WITHOUT compromising fertility.
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Other medications, like Gonadorelin, are not supported by strong clinical evidence for maintaining sperm production alongside TRT.
At Ascend, if fertility is important to you, it’s important to us.
We follow the latest evidence-based protocols to help men preserve or restore fertility while optimizing hormones.
Schedule your consultation today to discuss your goals, your lab results, and your next steps with a provider who prioritizes your health and your future family.