GLP-1 medications (such as semaglutide and tirzepatide) play a supportive role in male fertility. While they are not designed as fertility treatments, their downstream benefits in weight loss, hormone balance, testosterone improvement, and sperm health could create a positive impact on overall reproductive function. Studies link them to higher testosterone and better semen health. Let’s take a deeper look at what science reveals about these benefits.
What Are GLP-1 Receptor Agonists and How Do They Work?
GLP-1 receptor agonists mimic the natural hormone GLP-1, which helps regulate blood sugar and appetite. Primarily used for type 2 diabetes and obesity, they improve blood sugar control, reduce appetite, and can promote weight loss.
How semaglutide and tirzepatide work:
Stimulate insulin release to lower blood sugar.
Inhibit glucagon release to improve blood sugar control.
Slow gastric emptying and reducing hunger.
Cardiovascular benefits may include heart protection.
Neurological benefits could support cognitive function.
These drugs, like semaglutide, offer a comprehensive approach to managing diabetes and weight while influencing multiple bodily functions that ultimately improves fertility.
Why Male Fertility May Benefit from Metabolic Improvement
According to a meta-analysis1 on GLP-1 receptor agonists, such as semaglutide, found a significant rise in total testosterone (~1.39 ng/mL) and improvements in gonadotropins (LH and FSH), alongside notable weight reduction. All these effects indicate that the use of GLP-1s may have some positive effects on male fertility through better hormonal balance and resolving metabolic problems, such as obesity, which are highly correlated with infertility.
Moreover, in a 2025 systematic review2 by Raheem et al. found that GLP-1 receptor agonists (liraglutide, semaglutide, dulaglutide) significantly increased total testosterone and improved gonadotropin levels, especially in obese men.
GLP-1 medications demonstrated notable benefits for male reproductive health and better sperm quality. Research highlights following benefits:
Enhanced sperm concentration: measurable increase compared to baseline.
Increased motility: stronger sperm movement, aiding fertility potential.
Improved morphology: higher percentage of normally shaped sperm.
Support metabolic health: unlike testosterone therapy, GLP-1s improved weight, insulin sensitivity, and cardiovascular markers.
Hormonal balance: indirect improvements in testosterone regulation without suppressing natural production.
Clinical Evidence: GLP-1s and Sperm Health
Recent research from the AUA 2025 study3 provides compelling evidence that GLP-1 receptor agonists (GLP-1 RAs), like semaglutide, have a significant connection in improving sperm count in overweight and obese men. The study examined nearly 4,000 men with abnormal sperm parameters and found that 3% of GLP-1 RA-exposed men achieved normal sperm counts, a result not seen in the control group.
Here’s how the numbers break down:
10 out of 351 GLP-1 RA-exposed men showed improvements in sperm count, compared to none in the control group (Absolute Risk: +2.8%; P = .001).
No significant improvements were found in sperm motility (AR: -0.4%; P = .805).
While semen volume improvements were more common in the control group, they were not observed in the GLP-1 RA group (AR: -4.6%; P = .001).
The improvements in sperm count, provide hope that these medications can offer more than just metabolic benefits. By controlling for BMI, diabetes, and other health factors, the study strengthens the link between GLP-1 exposure and enhanced sperm count, suggesting a potential therapeutic role for GLP-1s in male infertility management.
The Best Strategy for Strong Results: GLP-1s Plus Lifestyle Changes
A study presented at the AUA 2024 meeting4 and published in the Journal of Urology explored the effects of GLP-1 receptor agonists on male reproductive health and impact of diet and lifestyle. On their own, GLP-1s produced modest gains: small improvements in sperm concentration, stable testosterone levels, and limited changes in total motile sperm count.
However, when researchers compared these findings to lifestyle-driven interventions, the contrast was striking. Men who achieved weight loss through structured diet and exercise saw larger and more sustained improvements in sperm concentration, motility, and hormonal balance. Importantly, when GLP-1 therapy was combined with lifestyle changes, outcomes were stronger than either strategy alone.
The combined approach delivers:
Greater improvements in sperm concentration and motility than GLP-1s or lifestyle changes alone.
Sustained weight loss supported by medication while reinforced through diet and exercise.
Higher testosterone and gonadotropin levels, helping restore hormonal balance.
Superior reproductive outcomes5 for overweight men struggling with infertility.
The evidence shows that while GLP-1s RA like semaglutide provide an important metabolic foundation, the best fertility results occur when they are paired with healthy lifestyle choices. Together, medication and lifestyle factors make up an all-inclusive path toward stronger sperm health, better hormone regulation and long-term reproductive enhancement.
FAQS
Do GLP-1s improve testosterone in men?
Yes. Research, including meta-analyses and systematic reviews, found that GLP-1 receptor agonists such as semaglutide can significantly increase total testosterone levels. These drugs also improve gonadotropins (LH and FSH), which play a key role in hormone regulation. By addressing obesity and metabolic dysfunction, GLP-1s indirectly help restore testosterone balance in men with weight-related hormonal issues.
Can GLP-1 therapy improve sperm count and motility?
Yes. Evidence shows GLP-1 therapy can improve sperm count in some obese men. In the AUA 2025 study, 3% of GLP-1–treated men achieved normal sperm counts versus none in the control group. While motility gains were limited, combining GLP-1s with diet and exercise produced stronger improvements in motility and overall semen health.
What is the best strategy for improving male fertility with GLP-1s?
The best fertility results occur when GLP-1 therapy is combined with lifestyle changes. Medication supports weight loss, while diet and exercise enhance hormone balance and sperm quality. Together, they improve testosterone, sperm count, and motility, offering the most effective approach for men with obesity-related infertility.
Is semaglutide safe for men concerned about fertility?
Yes. Semaglutide is generally safe and well-tolerated for diabetes or obesity. Studies show it does not harm natural testosterone production and may support reproductive health indirectly by improving metabolism. Men should consult a healthcare provider, as fertility effects are modest and can vary individually.
References:
1- Salvio G, Ciarloni A, Ambo N, Bordoni M, Perrone M, Rossi S, Balercia G. Effects of glucagon-like peptide 1 receptor agonists on testicular dysfunction: A systematic review and meta-analysis. Abstract 166. Presented at: 2025 ICS Annual Meeting; 2025 Sep 19-22; Paris, France.
2- Raheem O, Deameh M, Rowaiee R, Ramez M. Effects of GLP-1 Receptor Agonists on Testosterone Levels and Semen Parameters in Men: A Systematic Review. Urology. 2025 Sep;6:14. DOI: 10.1111/andr.70022
3- AUA 2025: GLP-1 RAs Could Improve Sperm Count in Overweight Men. Urology Times. 2025 May; 53(5). Presented at: 2025 AUA Annual Meeting; 2025 May 18-21; San Diego, CA.
4- Salvio, G., Ciarloni, A., Ambo, N., Bordoni, M., Perrone, M., Rossi, S., & Balercia, G. (2025). Effects of glucagon-like peptide 1 receptor agonists on testicular dysfunction: A systematic review and meta-analysis. Andrology, 13(2), 263-272.
5- Du Plessis SS, Omolaoye TS, Cardona Maya WD. Potential impact of GLP-1 receptor agonists on male fertility: a fable of caution. Frontiers in Physiology. 2024 Nov;15:1496416. Presented as: Front Physiol. 2024 Nov 18;15:1496416. doi: 10.3389/fphys.2024.1496416.
