Yes, there are alternatives to traditional TRT that can help boost testosterone levels while preserving fertility. Standard testosterone replacement therapy can suppress natural testosterone production, which in turn reduces sperm production. However, certain medications can stimulate the body’s natural testosterone production while maintaining or even improving fertility.
Common fertility-preserving options:
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hCG (Human Chorionic Gonadotropin) Monotherapy
- hCG mimics luteinising hormone (LH), which signals the testes to produce testosterone naturally.
- It can be used on its own to increase testosterone while maintaining sperm production.
- Often prescribed for men looking to improve both testosterone levels and fertility.
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Clomiphene Citrate (Clomid)
- A selective oestrogen receptor modulator (SERM) that stimulates the brain to produce more LH and FSH (follicle-stimulating hormone), leading to increased natural testosterone and sperm production.
- Commonly used for men with low testosterone who still wish to conceive.
- Unlike TRT, Clomid does not suppress the body's natural production of sperm.
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Enclomiphene (a purified version of Clomid)
- Works similarly to Clomid but with fewer estrogen-related side effects.
- May be a better choice for some men who want to maintain fertility while optimizing testosterone levels.
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FSH (Follicle-Stimulating Hormone) Therapy
- In some cases, FSH injections may be added alongside hCG to further enhance sperm production, particularly for men with severe fertility issues.
Which option is right for you?
The best approach depends on individual hormone levels, fertility goals, and overall health.
If maintaining fertility is a priority, it’s important to discuss alternatives before starting TRT, as long-term testosterone therapy can significantly reduce sperm production.
Read our blogs on Protecting fertility while on TRT and How to increase testosterone naturally