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3 Possible causes of fertility problems problems include testicular problems resulting in abnormal sperm parameters, hormonal conditions, and problems with sperm transport

The protocol typically involves starting HCG when beginning testosterone therapy, though some practitioners add it later if testicular atrophy becomes noticeable

[9] Bes F, Hofman W, Schuur J, Van Boxtel C

Their results suggested that a 37-mm needle, allowing for adequate penetration of the gluteal muscle, would not have reached IM depth in 54.7% of female subjects (81 of 148), in 14% of male subjects (21 of 150), or on average in 34.2% of the total sample