Condition & Treatments
/ Fertility after steroids
Used testosterone or steroids and now want children? Fertility can usually be restarted.
Testosterone therapy (TRT) and anabolic steroids switch off sperm production. For many men it comes back, but it can take months and sometimes needs treatment. There is no judgement here, only a plan to get you there.
I N S H O R T
Testosterone from outside the body tells the brain to stop the signals that drive sperm production.
After stopping, recovery can take 6 to 12 months or longer, and some men need medication to restart it.
Treatment can protect how you feel while sperm production recovers, so you don't have to choose between the two
Why it happens
The testes need two signals from the brain, LH and FSH, to make sperm. Testosterone injections, gels or steroid cycles make the brain switch both off. Sperm production then slows or stops completely, even while you feel well.
The longer the use and the higher the dose, the longer recovery tends to take.
Treatment options
A planned stop.
Stopping abruptly can leave you tired and low for months. Prof Raheem plans how to come off, with support so the dip is shorter.
Medicines that restart the signals.
Tablets such as clomiphene encourage the brain to send LH and FSH again
hCG injections
These act like LH, keeping testosterone up inside the testes so sperm production can restart. They can be started while you are still on TRT.
FSH injections.
Added when sperm production is slow to return.
Sperm freezing
As soon as sperm appears, it can be frozen as a safeguard
Why this matters to your care
Men are often told either to stop and wait, or to stay on testosterone without their fertility being addressed. Prof Raheem tailors combined treatment so you stay well while your fertility comes back
Can I stay on TRT while trying for a baby?
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Not on testosterone alone. Some men can continue with hCG added, under close monitoring.
How long until sperm comes back?
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3–12 months.
What if it doesn't come back?
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Sperm can sometimes still be found surgically with micro-TESE.