About two-thirds of formerly azoospermic men regain measurable sperm within a year; the rest need longer or do not return to their old baseline. Stopping therapy lets GnRH, LH, and FSH wake up, but recovery is not instant. LH triggers the Leydig cells in the testes to make testosterone. The brain’s hypothalamus releases gonadotropin-releasing hormone (GnRH). Hormones are part of a complex system, and when something is off balance, it can affect more than one area of health. They also look for safer treatments for men who want to feel better but still have children. Doctors and researchers are still working to understand all the ways Low T affects fertility. They also want to know if treatments for Low T will help or hurt their chances of having a child. These chemicals are called endocrine disruptors because they interfere with the body’s hormone systems. In addition, men who are overweight or obese often have poor sleep and lower physical activity, both of which can also lower testosterone. Other brain injuries, surgeries, or conditions like hemochromatosis (too much iron in the body) can also affect hormone signaling. Even though it has some LH activity, HMG is not able to preserve the Leydig cell function and sufficient spermatogenesis. Treatment with LH in addition to FSH has been widely used in hypogonadotropic hypogonadism patients. One study showed that 1500 IU of HCG administered three times/week induced spermatogenesis in 70% of men with isolated hypogonadotropic hypogonadism. Some men who have a testosterone deficiency have symptoms or conditions related to their low testosterone that will improve when they take testosterone replacement. All of this reduces the active (free) form of testosterone in the body. In recent years, researchers (and pharmaceutical companies) have focused on the effects of testosterone deficiency, especially among men. In addition, what may seem like a symptom of testosterone excess (see below) may actually be unrelated to this hormone. Blood levels of testosterone vary dramatically over time and even during the course of a day. However, very intense or long workouts without rest may have the opposite effect and lower hormone levels. Both strength training and aerobic exercise improve hormone levels. Obesity can also raise insulin levels and increase inflammation, both of which can reduce testosterone. Although this new information is somewhat reassuring, men and their doctors should still weigh these issues before committing to long term testosterone therapy. For men who clearly have testosterone deficiency, there is no apparent increased risk of heart attack or stroke or greater chance of developing a new prostate cancer from testosterone replacement therapy. If a man's testosterone is below the normal range, it's best to repeat it once more to be sure before starting testosterone therapy - often staying on it indefinitely. It can lead to problems with erections, low sex drive, mood changes and problems with sperm health and sperm counts. In finality, there is a major link between taking testosterone and fertility, even if you are only taking testosterone supplements that are easily accessible over the counter. Of course, it is never recommended to abruptly stop doctor-prescribed treatment with testosterone without first talking to your doctor. Many doctors will recommend putting off testosterone replacement therapy until after you have children. In fact, testosterone has been examined for its potential to be used as a male contraceptive for this very purpose. For example, men on long-term testosterone replacement therapy may have a higher risk of heart problems. Women may have a testosterone deficiency due to diseases of the pituitary, hypothalamus or adrenal glands, in addition to removal of the ovaries. Men taking testosterone replacement must be carefully monitored for prostate cancer. There are times when low testosterone is not such a bad thing. For example, a man with osteoporosis and low testosterone can increase bone strength and reduce his fracture risk with testosterone replacement.
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