Many men use testosterone replacement therapy to restore their hormone levels, but it can lower their sperm count. There are a few ways you can increase your sperm count while on TRT.

The best way to protect fertility is to talk to a medical provider who specializes in TRT or a reproductive specialist. They can help you determine what the cause is of your low testosterone, and they may offer alternate treatments that preserve fertility.


Men with low testosterone are often prescribed Testosterone Replacement Therapy (TRT) to correct their symptoms. This treatment can help to alleviate a variety of problems including decreased muscle mass, low libido, low energy, poor mood and low sperm count.

Unfortunately, many men are not counseled on the fact that TRT can have detrimental effects on fertility. In fact, many men who are taking TRT will experience a severe drop in sperm count which can make it difficult to conceive.

One of the primary reasons for this is because the hormones used in TRT disrupt the balance of hormones in the body. This includes luteinizing hormone (LH), which is critical for sperm production. LH is normally produced in the pituitary gland but when a man takes TRT it can cause the pituitary gland to slow production of LH. This can result in a low sperm count and even azoospermia in some cases.

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Luckily, a healthy lifestyle is an excellent way to increase sperm count while on trt. Performing regular exercise, getting plenty of rest and eating a healthy diet can all boost sperm production. In addition, the use of dietary supplements can also be helpful. Studies have shown that certain nutrients such as zinc and vitamin d, B vitamins, selenium and vitamin A can improve sperm count and quality significantly.

Healthy Diet

A healthy diet is one of the best ways to ensure healthy sperm. In fact, studies show that a man’s diet can affect sperm count and quality — even when he’s not trying to get pregnant.

For starters, he should limit his intake of processed red meats (such as bacon, hot dogs and sausage) and opt for lean cuts of beef or chicken instead. These foods contain zinc, which is essential for sperm health. They should also increase their intake of foods high in vitamin C, such as oranges, kiwis, cantaloupes and tomatoes. Leafy greens, beans and many fruits are rich in folate, which helps to prevent chromosomal abnormalities in sperm cells.

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Shellfish, such as oysters, are also a great source of zinc and omega-3 fatty acids, which have been shown to improve sperm count and motility. He should also aim to eat more cruciferous vegetables (like broccoli, kale and cauliflower), nuts (like walnuts), whole grains and eggs. Avoid foods that are high in saturated fat, sugar and trans fats (like cookies, cakes, pastries and fried food). Finally, he should limit his alcohol intake, as research shows it negatively impacts sperm health. Aim for two or fewer drinks per day, and avoid excessive alcohol consumption. In addition, avoid marijuana and other drugs that can interfere with sperm production.


Testosterone replacement therapy (TRT) has great benefits for men who have low testosterone levels. However, many men don’t realize that it can also decrease sperm count.

The use of exogenous testosterone increases the amount of blood-derived testosterone; this causes the brain to reduce production of LH and FSH, which are necessary for sperm production. This can cause azoospermia or an absence of sperm on a semen analysis. The good news is that this is reversible. However, it can take several months for sperm counts to recover when TRT is stopped.

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Some natural treatments can help increase sperm count while on TRT. Vitamin supplements such as zinc, vitamin C and folic acid can promote sperm health. Adding high-quality protein to the diet can boost testosterone levels and sperm count. Foods to try include chickpeas, kidney beans and other legumes. Limiting the consumption of alcohol and other drugs can improve sperm count. Excessive warmth can also lower sperm count. Avoid sitting for long periods of time, using hot tubs and saunas and wearing tight clothing.

Some men may choose to freeze sperm samples before starting TRT. This will allow them to conceive when they are ready to do so. If you are considering starting TRT, it is important to discuss your long-term fertility goals with a hormone specialist. Alternatively, some men choose to take medications such as hCG or clomiphene citrate to stimulate the pituitary gland and increase fertility chances.