He needs to suck it up and go get a semen analysis done. Period. It’s not exactly fun for you to go get pelvic exams and a whole crap ton of other tests that were done or will need to be done before you can start infertility treatments. Thankfully, my RE ordered a semen analysis when he ordered all of my tests. I told my husband that he had to get a SA and that we were doing IUI (your husband will obviously have to collect a sample for that too) . My husband said “Hell NO” at first, and I told him that he WILL be doing a SA and that was that! He voluntarily went on his own because he knew that I wasn’t playing. Like I said, it’s only fair considering that I had to do a very painful HSG, lots of exams and vaginal ultrasounds, plus take injections, get the IUI, deal with the side effect of the infertility meds, etc. Trust me, having a little rendezvous with a cup is the easy part!
Now to answer your question, my husband had low T and had a borderline low sperm count of 9 million sperm. My RE said that it was ok, but pregnancy rates were a bit lower with that count. I put my husband on a bunch of supplements that help increase count and quality (zing, magnesium, pycnogenol, red panax ginseng, l-carnitine, l-arginine, Macca root, flaxseed oil, vitamin c, b-12). He took the supplements for the 6 weeks we had until our IUI. I had him drink orange juice and eat foods high in vitamin c for 48 before the IUI (gives sperm energy to swim). His count jumped up to something like 65 million and our first IUI was successful.
The bad news for you is that the testosterone gel can permanently lower sperm count. It can also cause zero sperm count. Sperm count doesn’t always come back after the gel is stopped. It’s really important for your husband to get a SA done. If the clinic is close enough to your house (I think within an hour drive), your husband can collect at home. You can buy a special condom to use to collect the sample during sex if that’s easier for your husband. There is a drug store test (I think Amazon sells it too) that your husband can use to check his semen count at home. However, it’s honestly a waste of time and money. It only gives you a count. It doesn’t tell you if the sperm are formed correct or if they can swim correctly. Your husband could have 50 million sperm with 2 heads that swim in a circle. It’s really important to have all of the information that a real SA gives you, especiall since you already know for a fact that your husband has low T.
Lastly, I just want to warn you that TTC will most likely be very frustrating for you both. You will feel pressured (self imposed) to have sex several times during the week of ovulation. It seemed like the best day for us ovulation wise always ended up being the worst day for my husband to perform on. After 1 year of ttc, I was so tired and frustrated. The IUI cycle was honestly a relief because I knew that we for sure had the peak day of my cycle covered.
I understand that this is a sensitive subject for men. I knew to tread cautiously with my husband. However, I also knew that my husband was a grown man and mature enough to handle the truth. I was sensitive about the sex, and matter of fact when it came to infertility stuff. I had trouble with ovulation. We spoke candidly about testing and treatment options for my issue. Why should his low sperm count be treated any differently?