Guide

TRT and Fertility: Family Planning Questions to Ask Before Starting

Educational framework only. Not medical or legal advice.

Educational only. Not medical advice.

If you only read one thing: Do not start TRT without a fertility conversation if you might want kids—ask for a plan, not reassurance.

What this covers

TRT can affect fertility. If family planning matters, you should discuss options, tradeoffs, and monitoring before you start.

Good TRT care is mostly about decision quality and monitoring. The goal is to treat symptoms safely while watching labs and side effects over time.

This guide is educational and designed to help you ask better questions before you start, or if you’re adjusting an existing protocol.

Your baseline symptoms, goals, and relevant medical history (sleep apnea, clotting history, prostate history, fertility goals).

Which formulation fits your lifestyle (injections, gels/creams, pellets) and why.

A clear monitoring plan: which labs, how often, and what changes would trigger dose adjustments.

Most protocols include repeat testosterone levels, CBC/hematocrit, and a broader health panel tailored to your situation.

Ask how the clinic tracks symptoms alongside labs—numbers matter, but so do blood pressure, sleep, mood, and energy.

Starting without baseline labs or without a follow-up schedule.

Dose changes without documenting symptoms and lab timing.

Ignoring sleep, stress, alcohol, and weight—these can drive fatigue and libido issues even when testosterone numbers look “good.”

What symptoms would make you reconsider TRT or pause treatment?

How do you manage elevated hematocrit or acne/mood changes if they occur?

What does my first 90 days look like—labs, check-ins, and decision points?