My Husband Takes Testosterone Injections - Can I Still Get Pregnant?

Testosterone is like a two-birds-with-one-stone sort of hormone.

It is a hormone that helps produce sperm in men and helps regulate the menstrual cycle in women.

Especially when you’re trying to conceive, testosterone plays a key role in men as it helps with sperm production, maturation, and release.

If your husband or male partner takes testosterone or is on Testosterone Replacement Therapy (TRT), you may be left wondering:

Can I still get pregnant?

Does his TRT affect our chances during TTC?

Well, the answers are a mix of yes and no.

So what exactly should you be on the lookout for, with TRT and pregnancy?

Let’s explore it all together. 👇

In this article: 📝

What does testosterone do to sperm?

Think of testosterone as Bob the Builder.

Testosterone actually helps produce and grow sperm!

It helps with crucial functions such as maturing the sperm, attachment of their “swimmer tail” and release of sperm from the testes.

The signal to produce testosterone is given by the hormone headquarters 🏢 (aka, the pituitary gland) in the brain.

It releases FSH and LH, which tells the testes to produce testosterone.

Clever, right?!

Do testosterone injections stop sperm?

Well, not completely… and here’s why.

Testosterone injections come with their own basket of benefits. 💉

They help with decreased mood, and libido and help improve sexual function.

But studies have found that it has a negative effect on fertility.

How exactly?

Well, taking testosterone externally can decrease the natural production of FSH and LH, and ultimately, natural testosterone.

(Basically, because the brain thinks hey… there’s enough testo, why am I out here producing FSH and LH?!) 🧠

Additionally, inside the testes are sertoli cells, which house and grow sperm.

They respond to FSH, and when FSH decreases, their activities toward helping sperm grow are impaired as well.

This can impact growth, and maturation and may even lead to death of sperm cells.

Can a man taking testosterone shots get a woman pregnant?

A frank answer?

Yes — but it may be a bit more challenging.

Men taking testosterone shots may have lower sperm count.

So it doesn’t make getting pregnant impossible, but it does pose a small hurdle.

Here’s why.

Many men get on testosterone replacement therapy if they experience low testosterone naturally (hypogonadism).

In such cases, testosterone shots (or cream or gel) may be advised to bridge the gap.

But remember how the brain went, “Why the heck is there so much testo? I gotta stop producing FSH and LH”. 🧠

Yep, you guessed it… the same mechanism happens here too.

External testosterone imparted by creams, gels, or patches is great but, ultimately, it disrupts sperm production.

So it’s important to have a chat with your healthcare provider if you’re TTC and on testosterone shots to discuss the best course for a safer and better chance at conception.

How likely is it for someone on testosterone to get pregnant?

There’s no other way to say it — taking external testosterone doesn’t really help your baby-making efforts.

Now, it is possible to get pregnant, but the effects of taking testosterone may be a slight barrier when you’re trying to conceive.

In fact, it’s not recommended unless you’ve been prescribed the medication as a part of treatment for low testosterone.

But, if you’re transitioning from female to male, you may be taking testosterone as a part of your treatment.

If you think you are pregnant in this duration, it’s best to talk to your healthcare provider to either reduce or stop testosterone.

Can I get pregnant if my husband has high testosterone?

Before we get into the details, it’s worth noting that even high testosterone reduces sperm count!

It’s the same mechanism, again, but without external testosterone.

Because there’s an overproduction of testosterone already in the body, the brain goes “hold on… I’m tired. No more FSH and LH”. 🧠

So, you can get pregnant, yes, but the reduction in sperm count again poses a barrier.

If your partner is experiencing symptoms of high testosterone, we recommend reaching out to your healthcare provider to detect any underlying causes (and start a treatment plan too!).

Does high testosterone mean infertility?

High testosterone levels don’t directly mean infertility but, over time, higher levels of this hormone can lead to reduced sperm count.

Studies found that external intake of testosterone through shots, patches, or injections, reduces the testosterone levels within the testes (where the sperm are made).

This led to azoospermia (semen with no sperm) in about 6 months in about 75% of the participants of the study.

So yeah, that call to the doctor’s?

It’s definitely necessary when you’re trying to conceive. 📞

Can high testosterone cause miscarriage?

While your husband or partner’s high testosterone levels do not contribute to miscarriage, for women, it was found that recurrent miscarriages were associated with high testosterone levels.

This can happen in situations such as hyper androgenicity in PCOS.

Because of the high level of androgens, there is a negative effect on endometrial function.

This can make it harder for your future baby to hang on and grow in the uterus.

Can a man taking testosterone cause birth defects?

Hold on, birth defects?

We’re not trying to scare you 😅

But hey, it’s a valid question.

Taking testosterone does affect the quantity of the sperm produced, but may not have that profound of an effect on the quality.

So, genetics of the sperm? Not that affected.

Testosterone may affect conception in the first place, due to the decrease in sperm count, but as the quality isn’t affected, usage of testosterone does not contribute to birth defects.

How do you stay fertile on TRT?

So, you’re wondering how to stay fertile with TRT around, affecting your sperm count.

But, worry not, it’s possible.

The first step is to keep taking TRT for the time being, and talk to your healthcare provider about the options you have.

Some ways to stay fertile or preserve fertility while on TRT include:

1. ❄️ Freezing sperm beforehand: You can cryo preserve a vial or two of sperm, based on recommendations from your healthcare provider. This can work as a backup option if you’re trying to conceive during or after TRT.
   
2. 💉 Using hCG with TRT: Here’s the trick — when you combine TRT with other therapies, there’s a chance of combating its negative effects. One such treatment is hCG, which stimulates the testicles to produce more testosterone. That’s why combining hCG with TRT may reduce the side effects of TRT. But, this might not work in some cases, such as increased testosterone levels, like in this study.
   
3. 💊 Use Clomiphene instead of TRT: Clomiphene is a fertility drug that can encourage your body to produce more LH and FSH to stimulate sperm production. Clomiphene may be used instead of TRT, but it may not work in all cases, and isn’t as effective as TRT, like in this study.

A lot to take in? We get it.

Navigating all of this can be a little tricky. 😵‍💫

But that still shouldn’t discourage you from having that chat with your healthcare provider.

This can provide clarity on things, and help you discover alternatives to TRT that help your fertility journey.

Does testosterone affect fertility in females?

Here’s the thing — testosterone is a member of the female fertility gang, too!

Testosterone in women acts as a precursor for estrogen synthesis and is synthesized in the ovary and adrenal glands. 👩‍🔬

So, very high or low testosterone levels can lead to subfertility or infertility.

For instance, females with PCOS may experience higher levels of testosterone.

They may experience irregular menstrual cycle and anovulation.

In such cases, oral contraceptives, or metformin, can be used to regulate testosterone levels.

In other cases, testosterone may actually be helpful. 🤷‍♀️

Especially where females respond poorly to gonadotropin medication during IVF cycles, studies found that using testosterone gel to boost their response leads to better IVF outcomes and increased pregnancy rates.

The verdict? 👩‍⚖️

Too much, or too little, testosterone can affect fertility in females.

Based on your levels, your healthcare provider might propose a personalized solution that can help you when trying to conceive.

Can my husband’s testosterone cream affect me?

This may sound silly… but, actually, yes, it can!

Studies have found that using testosterone cream carries the risk of transfer to others with close skin contact.

So, if you have skin-on-skin contact with your partner at the application site, it can cause secondary transference, which in turn, can increase your serum testosterone levels to almost 80% above baseline.

That’s… crazy.

But worry not — it’s preventable.

So, what should your partner do from his end to avoid it?

It’s recommended to wash your hands after applying the gel, wear clothing over the application site, or wash the application site/take a shower before contact.

This can reduce the chances of secondary exposure and transfer.

What happens if you have a baby on testosterone?

Testosterone is a teratogenic drug, as it can affect the baby’s development negatively.

It is not recommended if you are a female taking testosterone, or if you are a female transitioning to male.

If you have a baby on testosterone, it may lead to abnormal genital development in a female fetus.

It can be a tricky situation to take testosterone when your levels are low and also have your fertility be impacted by it.

There are also concerns about those levels affecting you and your future baby.

But, remember that there are ways around it and precautions that you can take for testosterone to be on the beneficial side when you’re trying to conceive.

It’s worth discussing with your doc on the best action plan when you’re trying to conceive, and when your husband is on testosterone.

If you want to connect with women who know what you are going through, you can always join the conversation on Peanut.

We’ve got you. ❤️