Why Men’s Fertility Is Declining: The Truth About Testosterone | Dr. Larry Lipshultz

**Dr. Gabrielle Lyon** (0:00)
Have you ever thought about male fertility as a man's final frontier? Not just sperm count or testosterone levels, but how modern life is quietly dismantling men's ability to create life, sustain energy, and age well? What if everything we thought we knew about male hormones and aging and virility was either outdated or flat wrong? Dr. Larry Lipshultz is one of the most respected male reproductive health experts in the world. For decades, he's been on the front lines of andrology, working with Olympic athletes, aging men, and everyday couples struggling to conceive. He doesn't just study testosterone, he wrote the rules for how it is treated.

**Dr. Larry Lipshultz** (0:50)
We are making such advances in female fertility and IVF, and we have nobody to take care of the men. So a light bulb went off.

**Dr. Gabrielle Lyon** (1:00)
Is it true that male fertility is declining?

**Dr. Larry Lipshultz** (1:04)
For sure.

**Dr. Gabrielle Lyon** (1:05)
Today, he breaks down the real cause of male infertility, the decline, how testosterone therapy impacts sperm, and what men can do to reclaim performance and purpose. From shocking truths about how male fertility is tested or often ignored, to why some of the most motivated men in the world are secretly burnt out, hopeless, or misdiagnosed with depression. Dr. Lipshultz exposes the blind spots in modern medicine that are quietly ruining men's lives and how we fix it. We talk libido, aging, legacy, and the emotional weight men often carry in silence. Dr. Larry Lipshultz, welcome to the show.

**Dr. Larry Lipshultz** (1:48)
Thank you so much.

**Dr. Gabrielle Lyon** (1:50)
I am very excited to have you on, and I want to tell you why.

**Dr. Larry Lipshultz** (1:54)
Why?

**Dr. Gabrielle Lyon** (1:55)
Right now, well, for many reasons, but right now, when people hear men's health, what they often think about is testosterone. However, what I have learned from you is there's so much more to men's health, and you have been an innovator when it comes to many things, whether it's environmental, infertility, erectile dysfunction. But I want to start with infertility, and I want to hear a little bit about your background, because at the time, I'm not so sure it was even a field, male infertility.

**Dr. Larry Lipshultz** (2:30)
Well, the whole thing wasn't a field. But should we go back to when this whole thing started?

**Dr. Gabrielle Lyon** (2:34)
Yes, sir, we should.

**Dr. Larry Lipshultz** (2:35)
So we go back to when I was an intern at the University of Pennsylvania, and I was rotating on OBGYN, and they had grand rounds like all specialty, and I was sitting there, and they had a lecturer, a PhD from New York whose basic science research was on sperm. Of course, it was OBGYN, it was appropriate. He started talking, and it was fascinating, things I never even thought about. At the end, the chairman, who was very early in the IVF world, said, that is such a fascinating lecture. He said, we are making such advances in female fertility and IVF, and we have nobody to take care of the men, right? So a light bulb went off. Hey, I'm an intern, I'm starting my residency, no one's doing infertility. What a great entree into an area that's been basically untouched.

**Dr. Gabrielle Lyon** (3:28)
Were you doing a residency? Was it obviously urology at the time? Or was it surgical?

**Dr. Larry Lipshultz** (3:34)
No, it was the internship. So then your PGY one year was called an internship, and then you went into, but you were already in the residency program. So I was in the urology program.

**Dr. Gabrielle Lyon** (3:46)
You heard about this male infertility. You thought it was amazing, very interesting, but you were only PGY one.

**Dr. Larry Lipshultz** (3:53)
Right.

**Dr. Gabrielle Lyon** (3:54)
How did you then go on to create arguably the first fellowship?

**Dr. Larry Lipshultz** (3:59)
Well, the fellowship's way later. The thing we had to first create was the area, the focus. I mean, there was zero focus.
In my program, we did PGY one, PGY two was a clinical year, PGY three, you went into the lab. I had one whole year and I decided I was going to devote that year to learning all I could about male infertility. There were two urologists in New York who were doing nothing but fixing varicose veins around men's testicles because that was felt to cause infertility, overheat the testicle, et cetera. So I went up and spend a day or two with them and realized it was very narrow. I then spent another day with a man in New York who was focused on anti-sperm antibodies which was hot at the time.