Male Factor Infertility

With the proper therapies your husband should see a return of sperm. Treatments like HCG injections to boost his own sperm production and restart the sperm production will likely be one avenue discussed. He can see a return in as little as 3 months.

Was the doctor that prescribed the Testosterone an Urologist? If so he should be able to work with that doctor for infertility and return of sperm production. If not, look for Urologist in your area with male factor infertility fellowship training.

It is amazing how often Testosterone is prescribed to men of reproductive age without even discussing the effects on fertility.

With the help of the right doctor his fertility should return but hard to say to what level of sperm production. Hang in there and I wish you luck in your quest for fertility!

Amy Perkins, MS, TS (ABB)
Laboratory Supervisor
Arizona Andrology Laboratory & Cryobank
International Center for Vasectomy Reversal

I am in a very similar situation to yours. My husband too started testosterone injections in Decemeber of 2010 after his regular MD diagnosed him with low testosterone (which by the way it was actually in the normal range for a 31 year old man, we've since found this out from our RE). We started trying to have another baby earlier this year with no luck so he had a SA done in August of this year. His numbers were extremely low. 1 million sperm with only 15% motitility. The morph was also low. We have since seen an RE and he immediatly had him stop testosterone and he will soon be starting HCG injections to hopefully get his sperm count back up. In the meantime he is taking many different vitamins/minerals. I'm feeling very defeated and very nervous it wont rebound. I was just curious what treatment your husband has undergone and how it has worked. Thank you.

Hi Amy,
Thank you, I'd been meaning to reply to your post for a while. I was pleased to read what you wrote, which confirmed what I'd found through the research I'd done online. Of course, timing for us was terrible, since I already waited very long before deciding to get pregnant, and this incident caused a 6-months delay before we even diagnosed the issue.

The doctor who prescribed the T-therapy was NOT an urologist, NOR did he know the potential - actually, pretty much GUARANTEED decrease in sperm production, and consequential effects on fertility. He was in shock to find out.

We have been seeing an urologist, one of the best here, and he has put my husband on half a Clomid a day since about mid June. After a very slight increase (still way below the norm) in sperm count, he finally reached normal levels around mid-September, although the motility was still not stellar, but also on the way up. This was thanks to the 'little help' from Clomid, which the urologist wants him to continue to take until we manage to get pregnant, as he fears that without the stimulation, the production could drop drastically until it finds it's normal level again naturally.

We tried a round of IUI last month unsuccessfully, but are still hopeful it may work for us, as his sperm has been improving consistently.

Thanks again for your support on here, it helps to be able to talk to someone who's knowledgeable on the subject (before one has a chance to go to a specialist, which sometimes takes weeks to arrange) as opposed to simply trying to figure it out online.

Hi BLDavis,
I'm so sorry to hear that, you too, were rendered sterile because of incompetent advice from an actual doctor.

Well, I have good news for you. My husband actually went back to a 'normal' sperm count (yet likely low for him) in about 3 months on Clomid. I am unsure about the injections your husband will be administered, and why they need to wait - but my husband was put on half a Clomid pill a day right away and in 3 months, the count was considered normal. There are still some issues with the motility, but that has been improving consistently too. He was at about 10% I think, and gradually increased to 40% at his last exam, considered normal. Within the motility qualifier, he went from 1 (on a scale of 1-4, 1 being still/no-forward movement and 4 being good progressive movement) to about 3 now. So we are hopeful that in a few months, that too will go back to a level 4, which is the norm, and that the 40% number will go up as well.

I am hopeful that your husband, given his normal testosterone level pre-T-therapy, will also quickly recover enough to allow you guys to start trying, or to allow for IUI, which is what we have done. Unfortunately, our IUI last month was not successful - I believe that even though my husband's numbers are mostly normal, it's not all there yet.... We are hoping we will get luckier this month.
Given that you already had a child, I am certain that your husband was fine before, and confident that he will be so again soon. Ask your RE about Clomid, it seems like a 'lighter', less invasive technique to achieve the same results. Maybe the injections will provide faster results, although I find that hard to believe given that a sperm production cycle takes about 3 months, so I wouldn't expect major improvements until then.

Also - word of advice: we went back to the general doctor who prescribed the unnecessary, and 'castrating' hormonal therapy to my husand, and demanded that he pay for the fertility treatment, including all RE visits, urologist visits, and medication, all the way to the actual IUI. He immeadiately said he would take care of it, and he has put in a claim with his mal-practice insurance to cover our bills. We requested, and hope and believe, that he informed all his other patients on T-therapy of the fertility side effect issue. He was not a bad guy, and we actually felt bad for him as he truly didn't know. But that doesn't excuse the fact that he should have known, or researched it, before prescribing this treatment to anyone. Our urologist said about 1/3 to more of his patients are in the same situation as our husbands', and he's been trying to spread the word in the medical community.

I wish you luck, and I am confident you will be fine. I'm just sorry you had to lose all this time, but thankfully you guys are not as old as we are, so you have time on your side