What to watch with SHBG and fertility?

SHBG (sex hormone-binding globulin) influences the bioavailability of free testosterone and estradiol, both critical for fertility. In men, elevated SHBG can reduce free testosterone, potentially impairing spermatogenesis. In women, low SHBG is often linked to PCOS and may disrupt ovulation. However, SHBG alone is not a direct fertility marker; interpretation requires clinical context (age, cycle, semen analysis, other hormones). The evidence is moderate: associations exist but causality is not firmly established. Caution: a single SHBG value from a home test does not replace a full fertility workup. If abnormalities arise, consult an endocrinologist or reproductive specialist.