Can testosterone boost sperm count? Why NICE says no

Published 11 November 2026 · Matt O'Brien

Short answer: no. NICE's 2026 fertility guideline says clinicians should not offer androgens (testosterone-type hormones) to treat semen problems, and its committee noted that taking them may even harm fertility. If you want to improve your sperm count, extra testosterone is not the route, whether it comes from a prescription or a gym bag.

This matters for men of any age. The NHS says low sperm count can happen at any age, and it is easy to assume that more testosterone means more fertile.

Why the idea sounds logical

The NHS page on causes of infertility describes testosterone as the male sex hormone involved in making sperm, and it lists hypogonadism, an abnormally low level of testosterone, as one possible cause of male infertility. So adding testosterone sounds like it should help.

UK guidance says otherwise. NICE's recommendations on managing male factor fertility problems say not to offer androgens to treat semen abnormalities. The NICE committee's rationale found no evidence of improved pregnancy rates with androgens, and said that, based on their knowledge and experience, taking them may even harm fertility.

For one specific type of hormone problem found on testing, NICE recommends a different treatment under specialist care, not testosterone. That is a decision for a specialist after proper tests, not something to work out yourself.

Gym steroids: the same mistake, with more risk

The NHS page on anabolic steroid misuse explains that anabolic steroids are manufactured medicines that copy the effects of male hormones such as testosterone. Misusing them can cause reduced sperm count, infertility and shrunken testicles. The NHS infertility page adds that long-term misuse can reduce sperm count and how well sperm move. If you have used them, tell your GP. It helps them understand the full picture.

If you are on, or considering, TRT

Testosterone replacement therapy (TRT) is prescribed to treat a confirmed deficiency. It is not a fertility treatment. NICE's advice on factors that can affect fertility tells clinicians to ask people worried about their fertility whether they take prescription drugs, naming testosterone-replacement therapy as an example, and to advise on the potential impact.

If you already use prescribed testosterone, do not stop or change it on your own. Talk to the clinician who prescribes it. For the conversation to have before any treatment starts, read our guide to TRT and fertility. For how NHS and private routes differ, see TRT on the NHS vs private. Our testosterone and energy hub has the wider picture. This page does not recommend any medicine, brand or clinic.

What NICE and the NHS say does help

NICE says excessive alcohol harms semen quality, while drinking within the 14 units a week guidance, spread across several days, is unlikely to. It links smoking with reduced semen quality, and says men with a BMI of 30 or over have an increased risk of reduced fertility. The NHS low sperm count page adds losing weight if you are overweight, stopping smoking, loose underwear and avoiding recreational drugs such as anabolic steroids. For where to begin, see male fertility: where to start.

When to get help

Trying for a baby: the NHS says see a GP if you have had regular sex without contraception for over a year (or 6 months if your partner is 36 or over) without a pregnancy. A GP can arrange tests for both of you, including a semen analysis.
Symptoms of low testosterone: book a GP appointment. The NHS page on the "male menopause" explains you may be referred to an endocrinologist if tests suggest a deficiency.
Unsure or urgent: use NHS 111 for urgent advice, and 999 or A&E in an emergency.

From Matt

"These questions sound unromantic. Good. Healthcare should survive ordinary questions."

I wrote that about treatment conversations in general, and it fits here. "Will this help me have kids?" is an ordinary question, and the answer for testosterone is clear. As I say in the book: "Take your history and questions. You do not need to decide before you go."

Source: Get Your Life Back, book draft by Matt O'Brien. Matt is not a clinician; this page is general information, not medical advice. This site does not sell or promote prescription medicines.

Sources

Last updated 11 November 2026.