How can we predict efficacy of HCG plus testosterone on sperm production?

[Nelson Vergel]

TRT decreases the amount of intratesticular testosterone (ITT) needed for proper sperm production. This confusing fact may be due to the shut down of LH and FSH caused by the negative feedback loop in the hypothalamic-pituitary-testicular axis caused by TRT. ITT is needed for proper sperm production. Can HCG help increase it since it resembles LH?

As shown in several studies, HCG can increase sperm production in many men on TRT:

Best HCG Dose for Men on TRT: Two Studies That Used HCG with Testosterone

The investigators in the study below determined ITT (intratesticular testosterone- inside the testicles) concentration by testicular aspiration before and after treatment in men receiving exogenous testosterone to block endogenous gonadotropin (LH and FSH) production and randomly assigned to one of four doses of human chorionic gonadotropin (hCG) (0, 125 IU, 250 IU, 500 IU every other day) for 3 weeks.

Notice how at time zero, 17-hydroxyprogesterone and intratesticular testosterone are very low due to testosterone therapy.

This study shows that HCG increases not only intra-testicular testosterone (responsible for sperm production) but also 17-hydroxyprogesterone, androstenedione and DHEA.

Measuring blood levels of 17-hydroxyprogesterone may be a more practical way to measure ITT than performing an aspiration of testicles, a procedure that can be painful. ITT measurement can make it possible to adjust HCG dose to improve ITT so that sperm production can be restored while on TRT. Any dosage changes of HCG require at least 6 to 8 weeks wait time to measure sperm quality, so early ITT measurements can help improve the speed and accuracy of fertility enhancement of men using TRT using HCG.

NOTE: Normal ITT values for healthy men NOt on TRT ranges from 900-1200 nmol/L

Most men responded to HCG as their ITT increased with increased HCG dose. However, a few men did not respond well as seen in the white circle data points.

Is this part of the reason why men feel better on TRT + HCG?

Serum 17-hydroxyprogesterone strongly correlates with intratesticular testosterone in gonadotropin-suppressed normal men receiving various dosages of human chorionic gonadotropin

 

[Nelson Vergel]

I think HCG bennies play in to my own thoughts that its supposed to enable this downstream hormonal conversion just as LH does but in many many guys that just doesn't happen, its more like injecting straight water, and then there's the guys that seem to love HCG and have benefit to using it. Seems to me that there's some enzyme(?) activity, perhaps, that makes this a plus or minus for the individual. I mean if the downstream was working why are some many of us on Preg and/or DHEA, or Progesterone....????

You can see the different enzymes and paths affected by LH (and possibly hCG) in the hormone cascade in the figure below where the stars are. When we start TRT, LH is shut down and these enzymes are not activated. Does hCG (an LH analog) reverse that shut down of upstream hormones? Is this hCG-induced reactivation of neuro-hormones responsible for the improvement in mood and libido that some of us have on this analog? Only research will tell.

I am trying to get an investigator interested in studying the effect of HCG on these enzymes while having patients use our App on www.TRTdata.com before and through treatment to detect any improvements in libido and mood (it would have to be a placebo-controlled study).

By the way, I think that it takes a certain dosage of hCG to increase upstream hormones. I doubt that anything under 350 IU every other day work well.

I have coached over 150 guys and I have seen how introducing hCG to their TRT brings back pregnenolone and progesterone back to normal and in some cases it also normalizes DHEA. This reversal only happens when using 500 IU at least twice per week in combination with testosterone.

AS we know, TRT and anabolics can shut down those hormones:

Anabolic steroids and TRT decrease SHBG, DHEA, pregnenolone and progesterone in men.


Here are the enzymes and poteins affected by LH and their roles.

Some people may have deficiencies in one or several of them and they usually show hormone issues.

StAR: Steroidogenic acute regulatory protein

P450scc: Cholesterol side-chain cleavage enzyme

17,20 lyase

3 beta HSD

 

[Nelson Vergel]

More information about the blood test:

17 - OH Progesterone : HCG + TRT Efficacy Predictor

 

[Gianluca]

You can see the different enzymes and paths affected by LH (and possibly hCG) in the hormone cascade in the figure below where the stars are. When we start TRT, LH is shut down and these enzymes are not activated. Does hCG (an LH analog) reverse that shut down of upstream hormones? Is this hCG-induced reactivation of neuro-hormones responsible for the improvement in mood and libido that some of us have on this analog? Only research will tell.

I am trying to get an investigator interested in studying the effect of HCG on these enzymes while having patients use our App on www.TRTdata.com before and through treatment to detect any improvements in libido and mood (it would have to be a placebo-controlled study).

By the way, I think that it takes a certain dosage of hCG to increase upstream hormones. I doubt that anything under 350 IU every other day work well.

I have coached over 150 guys and I have seen how introducing hCG to their TRT brings back pregnenolone and progesterone back to normal and in some cases it also normalizes DHEA. This reversal only happens when using 500 IU at least twice per week in combination with testosterone.

AS we know, TRT and anabolics can shut down those hormones:

Anabolic steroids and TRT decrease SHBG, DHEA, pregnenolone and progesterone in men.


Here are the enzymes and poteins affected by LH and their roles.

Some people may have deficiencies in one or several of them and they usually show hormone issues.

StAR: Steroidogenic acute regulatory protein

P450scc: Cholesterol side-chain cleavage enzyme

17,20 lyase

3 beta HSD

View attachment 6267

@Nelson Vergel Do we have any new data about HCG as mimicker of LH assisting in the conversion of downstream hormones Pregnenolone/Progesterone/DHEA?

I'm thinking that might be a great cocktail to supplement with for those who don't use HCG or have trouble converting the downstream metabolites, although I know Dr Crisler always said Progesterone being a very feminizing hormone, and I tried that my self 2 years ago did not work well, I thought then

 

[Nelson Vergel]

@Nelson Vergel Do we have any new data about HCG as mimicker of LH assisting in the conversion of downstream hormones Pregnenolone/Progesterone/DHEA?

I'm thinking that might be a great cocktail to supplement with for those who don't use HCG or have trouble converting the downstream metabolites, although I know Dr Crisler always said Progesterone being a very feminizing hormone, and I tried that my self 2 years ago did not work well, I thought then

No. We only have anecdotal information from members on ExcelMale (including me). I have asked the Lipshultz group to measure pregnenolone and progesterone before and after a few weeks of adding hCG to TRT.

Having said that, this study shows some indication:

Serum 17-hydroxyprogesterone strongly correlates with intratesticular testosterone in gonadotropin-suppressed normal men receiving various dosages of human chorionic gonadotropin

 

[Nelson Vergel]

The Aging Leydig Cell: III. Gonadotropin Stimulation in Men
Nankin, H. R. ; Lin, T. ; Murono, E. P. ; Osterman, J.
Journal of Andrology, 08 July 1981, Vol.2(4), pp.181-189



To assess the capacity of aging human Leydig cells to respond to intramuscular injection of hCG, six healthy men, 68 to 86 years old, and eight healthy younger subjects, 25 to 42 years old, were studied. After two control specimens, each subject was given hCG (40 IU/kg of body weight intramuscularly) at 0900 hours. Blood specimens were then obtained hourly for 6 hours and at 24, 48, and 72 hours. The younger men had higher control concentrations of testosterone ( < 0.05). Both groups demonstrated biphasic elevations of circulating testosterone and 170H‐progesterone with a nadir at 5 hours and 6 hours separating the rises. The early (1–6 hours) and late (24, 48, and 72 hours) testosterone and 170H‐progesterone responses to hCG were significantly lower in older men. The older men demonstrated significant estradiol increases at 3, 4, and 6 hours, while the younger group had a significant 2‐hour rise. However, the peak (24‐hour) estradiol rises were significantly greater in the younger men. We conclude that the aged Leydig cell demonstrates altered early (1–6 hours) and late(24, 48, and 72 hours) responses to intramuscular injection of hCG, as assessed by circulating concentrations of testosterone, 17OH‐progesterone, and estradiol.

 

[Gianluca]

No. We only have anecdotal information from members on ExcelMale (including me). I have asked the Lipshultz group to measure pregnenolone and progesterone before and after a few weeks of adding hCG to TRT.

Having said that, this study shows some indication:

Serum 17-hydroxyprogesterone strongly correlates with intratesticular testosterone in gonadotropin-suppressed normal men receiving various dosages of human chorionic gonadotropin

thank you Nelson, reporting my experience, which I did in other posts, I was using 50mg Pregnenolone and 125IU HCG daily, 17-OH Progesterone low with that cocktail, and as I dropped the HCG I had the impression Pregnenolone would work better, I would feel it more, possibly for interrupting/decreasing its conversion to downstream hormones therefore leaving more Pregnenolone available

 

[Nelson Vergel]

The thing with your decision to drop hCG is that pregnenolone CANNOT convert into progesterone and most downstream hormones if you are on TRT without the help of LH as an enzyme activator. TRT suppresses LH, so hCG can take its place. We know that 500 IU HCG three times per week may work in 66% of men (older men and those on long term TRT may not respond as well).

 

[Gianluca]

The thing with your decision to drop hCG is that pregnenolone CANNOT convert into progesterone and most downstream hormones if you are on TRT without the help of LH as an enzyme activator. TRT suppresses LH, so hCG can take its place. We know that 500 IU HCG three times per week may work in 66% of men (older men and those on long term TRT may not respond as well).

I'm going for a blood work in 2/4 Weeks and checking Pregnonolone/Progesterone/DHEA, I will report my blood result here, I'm currently using 100mg Pregnenolone Rx from Empower along with TRT, let's see

 

[Nelson Vergel]

I'm going for a blood work in 2/4 Weeks and checking Pregnenolone/Progesterone/DHEA, I will report my blood result here, I'm currently using 100mg Pregnenolone Rx from Empower along with TRT, let's see

Thanks. That will help!

 

[Gianluca]

Thanks. That will help!

@Nelson Vergel here my blood result:

Pregnenolone, MS 59 ng/dL Reference Range: Adults: <151

DHEA-Sulfate 199.8 ug/dL 138.5 - 475.2 02

ACTH, Plasma 13.3 pg/mL 7.2 - 63.3

Progesterone 0.5 ng/mL 0.0 - 0.5


This is the result of taking 100mg PregnenoloneRX slow released, about 3hr prior the blood draw. As you can see without using HCG my Progesterone is at high end scale, my DHEA has been at that level since started 20mg of Hydrocortisone, actually it slighly improved on Pregnenolone.

I tested my LH two months ago and that was <0.2 Low mIU/mL 1.7 - 8.6

My Progesterone is at that level probably because I'm using Hydrocortisone as well

 

[Nelson Vergel]

Thanks for sharing! Remind us again what TRT protocol you are on (if any)

 

[Gianluca]

Thanks for sharing! Remind us again what TRT protocol you are on (if any)

I'm on 60mg 3 x week subQ, no AI, no HCG

what else does convert Pregnenolone to downstream hormones beside the need of LH?

 

[Gianluca]

@Nelson Vergel I try to ask this question again, what else beside LH can convert Pregnenolone to downstream hormones?

 

[Nelson Vergel]

ACTH can

The enhancement of pregnenolone production as the main mechanism of the prolonged stimulatory effect of ACTH on cortisol production by guinea-pig a... - PubMed - NCBI

https://www.sciencedirect.com/science/article/pii/0022473175903568

ACTH Action on StAR Biology

 

[Gianluca]

ACTH can

The enhancement of pregnenolone production as the main mechanism of the prolonged stimulatory effect of ACTH on cortisol production by guinea-pig a... - PubMed - NCBI

https://www.sciencedirect.com/science/article/pii/0022473175903568

ACTH Action on StAR Biology

View attachment 7138

@Nelson Vergel maybe I don't understand this well, but I see ACTH is involved in the conversion of Cholesterol into Pregnenolone, not Pregnenolone into downstream hormones such as Progesterone as so on,

 

[Omi7276]

The thing with your decision to drop hCG is that pregnenolone CANNOT convert into progesterone and most downstream hormones if you are on TRT without the help of LH as an enzyme activator. TRT suppresses LH, so hCG can take its place. We know that 500 IU HCG three times per week may work in 66% of men (older men and those on long term TRT may not respond as well).

So what shall be the HCG dose for men above 66 years age amd those on long term TRT ?

 

[Vince]

So what shall be the HCG dose for men above 66 years age amd those on long term TRT

My age is 69. I've been on TRT since I turned 60 and I inject 500 IU of HCG every third day. That was makes me feel my best. It also keeps my libido very strong.

HCG is not for everyone. You have to try it and see how it makes you feel.

 

[Omi7276]

My age is 69. I've been on TRT since I turned 60 and I inject 500 IU of HCG every third day. That was makes me feel my best. It also keeps my libido very strong.

HCG is not for everyone. You have to try it and see how it makes you feel.

Please explain e3d .
If I inject HCG on Mondays, e3d injection would be on Thursday ?

 

[Vince]

Please explain e3d .
If I inject HCG on Mondays, e3d injection would be on Thursday ?

Yes, after Monday the next day would be Thursday and then Sunday.