One of the biggest crises in health right now is the low levels of sperm count and fertility in young men, and the question of what the clinical community can do about it. Why are we experiencing such a decline in the reproductive potential of men who should be in their prime? Does testosterone therapy need to be at super-therapeutic levels all the time? How can men on testosterone therapy still maintain their fertility? On this episode, I’m joined by the Director of Male Reproductive Medicine and Surgery at the University of Miami, Dr. Ranjith Ramasamy, who talks about how to improve the reproductive health of men.  Four Takeaways  The reasons we’re experiencing low sperm count in young men are obesity, environmental influences, stress, and social media.  Short-acting testosterone is better for fertility and reproductive potential because it mimics the body’s natural pulsativity.  The reason testosterone therapy affects fertility and blocks metagenesis is because if it’s used over a long term, it blocks FSH and LH.   The restorative protocol for people who took supra-physiological doses of testosterone for long periods of time is HCG and clomiphene to jumpstart testosterone and sperm production.    At the start of the show, Dr. Ramasamy shared how he got started, and what’s causing the crisis in male fertility right now. Next, we talked about why the biggest battle in the clinical optimization space is misinformation, and why it’s equally important to educate consumers as much doctors. We also talked about why faster-acting testosterone is better for improving fertility, and why the insurance-attached prescribing community is so afraid of testosterone.    We also discussed:  Where the fear of men taking estrogen comes from  How to restore sperm and testosterone production  Why doctors should not be dismissive  Risks of phlebotomy    For the last few decades, testosterone therapy has opted for long-acting preparations, but the problem is that it has impacted the reproductive potential of many men. When it comes to fertility, maintaining testicular size, and reproductive potential, the pendulum has to swing back to a shorter acting form to mimic the body’s natural physiology. That way, we can help men boost fertility and improve their health.