16/06/2026
It is well known that synthetic testosterone is used as a contraceptive for men – excessively high levels of this hormone suppress fertility. However, equally, too low a level of testosterone can also lead to an inability to father children. I will now explain why this happens and what the implications are.
What do we mean by male fertility?
It’s quite simple: male fertility is the ability to produce s***m, the male reproductive cells. And in truly vast quantities: to maximise the chances of conception, a single millilitre of ej*****te must contain at least 20 million s***m, and the total volume of ej*****te must be at least two millilitres.
But even these are not the only required conditions: s***m motility is also important (at least a quarter of the total count must be motile), as is their correct shape (at least 14% of s***m must be free of defects). S***m motility, count and shape can be assessed through a test known as a semen analysis.
There are two further facts that are important to us. Firstly, s***m are produced in the testicles — or, more precisely, in the seminiferous tubules — and the Sertoli cells found there play a vital role: they nourish the s***m and enable them to mature properly.
And secondly: the full cycle of s***matogenesis lasts 73-75 days (according to some sources, even up to 90 days). So if you’re experiencing fertility issues, I’d advise you to be patient — it will take a long time to recover.
S***matogenesis begins in adolescence and, in theory, can continue into old age. In practice, however, s***m motility begins to decline once a man reaches the age of 40-50, and one of the reasons for this is a change in hormone levels — primarily testosterone. Although it is not only testosterone, but also follicle-stimulating hormone (FSH).
On the role of testosterone
Yes, FSH and testosterone have a major influence on s***matogenesis. The former initiates the process of s***m production; without FSH, nothing will happen. However, simply initiating the process is not enough: as you know, there needs to be a large number of s***m, and they must also be healthy and motile. And that’s where testosterone comes in.
This is because it is testosterone that acts on the Sertoli cells, causing them to release the nutrients needed for the development of s*x cells. If testosterone levels are too low, there will either be an insufficient number of s***m, very few healthy ones, or their motility will be poor. Most likely, it will be a combination of all three.
You’ve probably noticed that I haven’t specified which type of testosterone I’m referring to. Generally, total testosterone levels are taken into account: it is believed that if these fall below nine or ten nanomoles per litre, problems with conception may arise.
However, recent research suggests that the s***m count and motility in men with total testosterone levels of around 8.64 nmol/l (to remind you, this is the lower limit of the normal range) are virtually indistinguishable from those in men with much higher total testosterone levels.
However, the picture changes dramatically if we consider not total testosterone levels, but free testosterone levels. And not just that, but also dihydrotestosterone levels, which also play an active role in the process of s***matogenesis. Too low levels of these hormones will almost certainly lead to problems with conception.
Let me emphasise: these are merely issues. Neither a follicle-stimulating hormone level that has fallen below the lower limit of the normal range, nor a free testosterone level hovering around zero, means that conception is impossible. It’s just that the likelihood of it happening will be extremely low.
And here’s the interesting thing…
The Appendix to this book contains a chapter entitled ‘How to Improve Fertility’ which lists all the possible supplements and pharmaceutical drugs that can significantly increase the likelihood of conception. Now, however, I would like to share one interesting fact.
Did you know that in some cases synthetic testosterone is used to boost fertility? And not just that, but also certain anabolic steroids—such as stanozolol tablets or mesterolone (Proviron)? Both of these drugs, incidentally, are analogues of DHT, which is also essential for fertility.
What I’m getting at is that high levels of testosterone in the blood (sometimes even exceeding the upper limit of the normal range) can actually be a blessing. Not a hindrance, but a help when it comes to conception. On the other hand, low levels of both dihydrotestosterone and free testosterone are bound to cause you problems.