Testosterone therapy could affect fertility

Posted at 10:47 PM, Feb 21, 2018
and last updated 2018-02-22 05:02:15-05

TULSA -- Fertility is something we often only associate with women, but that is not always the case.

"This is a two person deal," Dr. Stanley Prough with the Tulsa Fertility Clinic said. "We will not treat women in our clinic without evaluating the male first." 

Dr. Prough said about 40-percent of the time at his office the problem is with the male. He said there are many factors that can contribute to that. One of them is testosterone replacement therapy. 

Testosterone replacement therapy is said to get rid of stubborn belly fat, mental fogginess and fatigue. 

Doctors have found testosterone levels fall by 1-percent every year in men when they hit 40-years old. 

Owner of the Oklahoma Men's Clinic, Greg Gerard, said men turn to testosterone therapy to make them feel young again. 

"It's a quality of life issue," Gerard said. "You can either be one of those grumpy old men we used to know back when we were growing up across the street -- they were probably really nice guys -- they were probably just low on testosterone or you can go out and enjoy life."

Dr. Prough said men who are trying to have a child should be cautioned against testosterone therapy. 

"I don't think there is a lot of consideration given beforehand as to why they're placed on hormone replacement therapy," Dr. Prough said. 

He said his office sees about 10 men a month who cannot get their wives pregnant and it turns out they are on testosterone, which he called a birth control for men. 

"It basically tells the brain we have plenty of hormones so it stops sending the signal to the testes, so they stop working," Dr. Prough said. "They don't need to make testosterone and they stop making sperm."

Gerard agrees testosterone therapy is not good for men trying to have a child. At his clinic, they are switched to HCG therapy. 

He said it does not give the full benefit of testosterone but will still make men feel better and even gives them a boost with their fertility. 

Dr. Prough said more testing needs to be done to determine if these men even have a hormone deficiency and need to be on anything at all. 

"HCG is a substitute for [Luteinizing hormone] in the testes and will make you make more testosterone, but do they really need more testosterone?" Dr. Prough asked. "That may not be the issue. Just running it off of, 'Oh your testosterone is a little bit low.' If sperm function is normal, if sexual function is normal, testosterone is not the problem."

Gerard said the doctors at his clinic do run several blood tests before starting patients on testosterone therapy. 

Dr. Prough said rarely is a man's reproductive potential taken into account. He said getting off the testosterone does not always mean they will be able to produce sperm like they were before starting. 

"It shuts it down and most men if you do it fairly quickly they will have recovery of function, but some men don't have much recovery of function," Dr. Prough said. "Problem is, you don't know where they were beforehand."

Dr. Prough does admit some men do have a testosterone deficiency and should be treated, but their whole health needs to be taken into account. 

"At any time if you are treating a person with medications regardless, look at everything that is going on with that person before you start throwing medicines at them," Dr. Prough said. 


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