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Podcast Episode

TRT and Fertility: The Myth That Keeps Young Men Untreated

The HRT University® Podcast··2 October 2026·1h 14m

About this episode

Zach's testosterone came back at 302, in a range that runs from 300 to 1000, and his endocrinologist told him he was fine. He had brain fog, no energy, and no sex drive. In his words, she was judging him off an app. On this episode, Nico Misleh, MSN, FNP-C, talks with Zach, a patient and a friend. Zach gives the side of this story providers rarely hear firsthand. They talk about a belief that keeps young men out of care, the idea that testosterone ends fertility. Zach started treatment anyway. He came off testosterone before herniated disc surgery. He restarted his own production on Clomid, and his numbers were back within about 90 days. He has a 15 month old now, and another on the way. Nico explains why he moved away from Clomid. He also thinks that leaving a symptomatic man untreated for a decade causes more harm than treating him. Zach is just as clear about what testosterone did not fix. A hard stretch at work was a work problem, not a dose problem, and no amount of testosterone changed that. If you have young men asking about testosterone and fertility in the same visit, this conversation gives you the patient's side of it. Male testosterone therapy is module two of the HRT University Master Course. The course is jointly accredited through Pinnacle Conference, LLC, with ACCME, ACPE, and ANCC accreditation, and providers earn 30 CE hours, including 12 hours of pharmacology. The Master Course, the podcast archive, the Second Opinion newsletter, and the provider community are all linked below. Master Course: https://hrtuniversity.com/hrtcourse/More episodes: https://hrtuniversity.com/hrtu-podcast/Second Opinion newsletter: https://nicomislehnp.kit.com/8050eeea5fProvider community: https://www.facebook.com/groups/1179376819949373/