When discussing infertility, many people tend to focus mainly on the female side. However, male hormones are also very important. Testosterone is the primary male hormone, produced by the testes and adrenal glands. If testosterone levels are too low or too high, sperm production may be impaired, leading to infertility.
Role of Testosterone in IVF or ICSI
Stimulates the testes to produce sperm
Helps sperm develop in sufficient numbers, with good quality, strength, and motility
Improves sperm integrity and reduces the risk of DNA fragmentation (DFI)
Regulates FSH and LH, hormones that play an essential role in sperm production
Effects of Low Testosterone on IVF/ICSI
Weak, abnormal, poor-quality sperm, or no sperm at all
Poor response to PESA/TESE procedures
Embryos may develop slowly, abnormally, or with poor quality, reducing the chance of fertilization with the egg
Causes of Low Testosterone
Aging: Testosterone production naturally decreases with age
Overweight/obesity: Excess fat converts testosterone into estrogen, gradually lowering testosterone levels and raising estrogen, which suppresses sperm production and LH/FSH release in the brain
Chronic stress: High cortisol reduces sex hormone production
Medical conditions: Diabetes, chronic kidney failure, liver disease
Hypogonadism: Underactive testes (e.g., Klinefelter syndrome, testicular infections)
Medications: Certain drugs, such as steroids
Radiation or chemotherapy
Injury or surgery to the testes, causing permanent decline in hormone production
Effects of High Testosterone on IVF/ICSI
Suppresses FSH/LH production, leading to halted sperm production
No sperm present in semen (though sometimes still found in the testes)
Risk of testicular shrinkage or reproductive system shutdown
Causes of High Testosterone
Use of testosterone supplements for muscle building (e.g., in bodybuilders)
Testicular or adrenal tumors producing abnormally high testosterone
Misuse of sexual enhancement drugs or hormonal stimulants
Pituitary or hypothalamic dysfunction, causing abnormal LH/FSH secretion and impaired regulation of testosterone
In conclusion, testosterone does more than affect sexual performance—it plays a crucial role in sperm production and the reproductive system. Abnormally high or low levels of testosterone can be a sign of male infertility.
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