Man speaking with doctor about his symptoms

Early evidence suggests GLP-1 medications may help some overweight men improve their fertility, and a urologist explains why

With GLP-1 medications becoming more common, some men may wonder whether the treatment could affect their fertility. About 1 in 5 couples in the United States have trouble conceiving, and male factors contribute to roughly half of infertility cases in couples.  

While clinical evidence is still emerging, Herbert C. Ruckle, MD, chair of urology at Loma Linda University Health, says GLP-1 receptor agonists may help improve fertility in overweight or obese men whose fertility issues stem from metabolic conditions.  

What is the link between GLP-1 medications and fertility?  

In men, excess body fat can lower testosterone and raise estrogen, which may reduce both sperm count and quality. Because GLP-1 receptor agonists regulate appetite and blood sugar, they can help patients lose weight, and Ruckle says that weight loss often boosts testosterone, improves regular sperm production, and increases fertility.  

“Visceral fat, which is the fat that surrounds the organs, produces a lot of estrogen, which isn’t helpful when trying to conceive,” Ruckle says. “GLP-1 medications work by decreasing visceral fat and lowering estrogen levels, which in turn boosts testosterone and helps your reproductive organs work better.”  

Are GLP-1s my only option for improving fertility?  

Although GLP-1 receptor agonists can be a good option for overweight and obese men hoping to improve their fertility, they aren’t the only one. Research suggests the benefit comes from the weight loss itself, which means men who lose weight through lifestyle changes may see similar results without medication.  

“If an obese man is struggling with fertility and starts eating healthier, working out, and loses weight, he would likely see a similar increase in his sperm quality and count,” Ruckle explains.  

For men who do choose GLP-1 medications to improve their metabolic health, the drugs work best alongside healthy habits such as balanced meals, regular physical activity, and adequate sleep, Ruckle says. Relying too heavily on medication for weight loss may result in losing more muscle than fat, which can harm overall health.  

It’s also worth noting that these benefits mainly apply to men with metabolic and hormonal fertility conditions. For men with other concerns, such as testicular atrophy or anatomical abnormalities, GLP-1s may not offer the same advantage. Anyone struggling with fertility should start by talking with a primary care provider about a semen analysis to rule out other medical conditions.  

 

Concerned about your reproductive health? Men can learn more or schedule an appointment with our Urology Department.