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There’s a question that comes up often regarding the effects of testosterone replacement on fertility. So if a man is low or normal testosterone, you may be perfectly fertile. When testosterone administration begins, however, there’s a feedback mechanism in the body that shuts off the production of sperm. This is why men on testosterone therapy almost immediately become infertile. I would summarize by saying this: men with low testosterone may be fertile. Men on testosterone replacement almost never are. So before a man of childbearing years, someone who wants children in his lifetime, starts on formal testosterone replacement, he needs to give serious consideration to the fact that his fertility may never return to normal. Even if he takes it for six months or a year and stops it, it’s possible that the effects on fertility are permanently deleterious. In other words, he may never regain his ability to be fertile.