While we cannot guarantee full preservation of fertility during TRT, we have effective strategies to help maintain fertility markers and support spermatogenesis. Fertility is complex and influenced by various factors, but with tailored approaches, positive outcomes are achievable for many individuals. For instance, injectable TRT, while more suppressive, can be paired with hCG to support intratesticular testosterone levels and sustain spermatogenesis. Topical and oral TRT are less suppressive to the HPTA, allowing enclomiphene to work effectively by boosting LH and FSH levels, which are key to maintaining testicular function and sperm production. By customizing treatments to individual needs, we aim to optimize fertility outcomes and provide options that align with your goals.