Testosterone replacement therapy (TRT) can be life-changing for men with low testosterone. A blood test is essential for confirming low testosterone levels, as many men may assume they need therapy based on symptoms alone, when in reality, their testosterone levels may still fall within the normal range as indicated by the test results. It can boost energy, lift mood, increase your muscle mass, and improve overall well-being. But TRT has a downside: it can affect fertility and even lead to testicular shrinkage. That’s because taking testosterone stops the body from making its own testosterone, which in turn reduces sperm production.
But here’s the good news: if you’re on TRT and still want testosterone treatment to protect your natural fertility too, there are options. Treatments like human chorionic gonadotropin (HCG) and kisspeptin can help keep sperm production and testicular health in check.
When a man starts TRT, the body receives a signal to stop producing two key hormones—luteinizing hormone (LH) and follicle-stimulating hormone (FSH)—that are responsible for triggering testosterone and sperm production.
Without these hormones, the testes can shrink, sperm count drops, and sometimes infertility occurs. This is where HCG and kisspeptin come in. These therapies support the testes to make sperm counts keep working as they should, even male infertility, while on TRT.
HCG works by imitating LH, the hormone that tells your testes to make testosterone naturally. When used alongside TRT, HCG can protect your sperm health and your fertility in three major ways:
HCG helps the testes make testosterone locally, which is key for keeping sperm production going.
Since it keeps the testes active, HCG helps prevent the shrinking that sometimes happens healthy men on TRT.
Some men even notice a more normal range of testosterone level and further boost in mood, sex drive, and sexual function with HCG.
HCG is typically taken by injection two or three times a week at doses that vary depending on individual needs. A doctor can help find the right amount.
Kisspeptin is a natural peptide that encourages the release of GnRH (gonadotropin-releasing hormone) from the brain, which then signals the body to release both LH and FSH. Unlike HCG, kisspeptin doesn’t directly imitate LH—it helps the body make its own.
Kisspeptin boosts the release of LH and FSH in a way that feels more “natural” to the body.
This natural boost in LH and FSH also from testosterone deficiency promotes healthy sperm production.
By promoting the body’s own hormonal pathways, kisspeptin may be less likely to lead to desensitization over time.
Though less common than HCG, kisspeptin has shown promise for preserving male fertility even in men on TRT and is also given by injection.
Choosing between HCG and kisspeptin depends on what feels right for you:
HCG offers a direct boost to LH levels, via testosterone therapy while kisspeptin stimulates the body’s own hormone production.
HCG has more studies backing it, while kisspeptin research is still growing.
HCG is typically easier to find and may be covered by insurance, while kisspeptin can be more expensive.
Some men on TRT find that using both HCG and kisspeptin together offers the best support. HCG gives a direct LH-like effect, while kisspeptin supports a broader hormonal balance.
Be cautious, as too much stimulation can lead to unwanted side effects like high estrogen and testosterone levels too. It is important to evaluate prostate cancer risk before starting TRT. Always work with a healthcare provider to create a balanced approach.
With the right help, you don’t have to give up fertility while on TRT. HCG and kisspeptin offer solid options for men who want the benefits of testosterone use TRT without sacrificing their reproductive health. Talk to a knowledgeable healthcare provider to find the best path forward. With some careful planning, you can enjoy the advantages and effects of testosterone and TRT while still protecting your fertility and overall reproductive health.
```
