Case Report: HCG Restores Spermatogenesis

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    The questions are regularly posed here at Excelmale: Will HCG help me maintain fertility while on a TRT protocol? How much HCG must I use to remain fertile? This case report answers some of those questions.

    • A 40 year old man presented to an endocrine department in August 2015 with a 4-year history of tiredness, reduced libido and infertility. He was seen by the urologist in 2011 for right undescended testis and had an orchidectomy in January 2015.
    • In March 2014 he attended the fertility clinic and was found to be hypogonadal with azoospermia (repeat tests in 2015 and 2016 confirmed the same). An ultrasound revealed a small, well-perfused left testicle of 13 ml-size. His pituitary gland imaging was normal.
    • We commenced subcutaneous HCG 1500 IU three times a week until serum testosterone levels normalised. At month-3 subcutaneous rFSH 150 IU three times a week was commenced while the HCG dose was reduced to 1500 IU once a week.
    • Semen analysis at month-6 and month-9 has revealed progressive improvement in spermatogenesis (concentration, motility, and progressiveness).
    • Three-monthly assessment of testosterone levels, full blood count, prostate specific antigen and liver function tests have been normal. Combined therapy is being continued until appreciable levels of spermatogenesis have been achieved for non-assisted conception and/or for semen freezing and assisted conception treatment.

    Conclusion: In conclusion, we describe a man with hypogonadotropic hypogonadism, azoospermia, previous right orchidectomy and a remaining small left testicle, who is currently receiving gonadotropin therapy with subsequent stimulation of adequate spermatogenesis.

    “Successful stimulation of spermatogenesis in a man with hypogonadotrophic hypogonadism, azoospermia, previous right orchidectomy and a remaining small left testicle,” Endocrine Abstracts, 2017,http://www.endocrine-abstracts.org/ea/0050/ea0050p373.htm

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    frankwhite
    frankwhite

    Spermatogenesis was restored at month 3 when 150iu FSH 3 times a week was introduced. HCG does NOT restore spermatogenesis.

    https://youtu.be/Q9S-lDip86g

    Vince
    Vince

    Spermatogenesis was restored at month 3 when 150iu FSH 3 times a week was introduced. HCG does NOT restore spermatogenesis.

    https://youtu.be/Q9S-lDip86g

    Semen analysis results after adding FSH to TRT and hCG

    https://www.excelmale.com/showthread.php?13612-Semen-analysis-results-after-adding-FSH-to-TRT-and-hCG

    frankwhite
    frankwhite

    Semen analysis results after adding FSH to TRT and hCG

    https://www.excelmale.com/showthread.php?13612-Semen-analysis-results-after-adding-FSH-to-TRT-and-hCG

    Exactly. And yet there are supposedly knowledgeable people that keep putting out posts and Youtube videos saying HCG keeps you fertile. HCG is an LH analog. LH simply does not produce sperm. FSH does. But I guess sensational click bait titles are what’s important these days.

    Vince
    Vince

    Exactly. And yet there are supposedly knowledgeable people that keep putting out posts and Youtube videos saying HCG keeps you fertile. HCG is an LH analog. LH simply does not produce sperm. FSH does. But I guess sensational click bait titles are what’s important these days.

    We are all different. The only way you know is by getting your sperm checked.

    DragonBits
    DragonBits

    Exactly. And yet there are supposedly knowledgeable people that keep putting out posts and Youtube videos saying HCG keeps you fertile. HCG is an LH analog. LH simply does not produce sperm. FSH does. But I guess sensational click bait titles are what’s important these days. I did wonder why HCG alone should keep you fertile since FSH is required. BTW, when I went on Clomid by itself, both my LH and FSH went up quite high.9.4 and 15.1 pg/mL, above the top of their respective ranges. So maybe for me HCG would also cause an increase in FSH, I… Read more »

    Weasel
    Weasel

    Spermatogenesis was restored at month 3 when 150iu FSH 3 times a week was introduced. HCG does NOT restore spermatogenesis.

    https://youtu.be/Q9S-lDip86g

    Completely false statement.

    Weasel
    Weasel

    HCG alone can and does work awesome in many cases. HCG took my semen #’s from Zero to over 150 million in 6 months at 500iu 2x a week.

    So yeah, it does work.

    DragonBits
    DragonBits

    HCG alone can and does work awesome in many cases. HCG took my semen #’s from Zero to over 150 million in 6 months at 500iu 2x a week.

    So yeah, it does work.

    One unknown, since most men that go on TRT no longer measure their LH or FSH, they have no idea if FSH with or without HCG declines to near zero.

    Weasel
    Weasel

    One unknown, since most men that go on TRT no longer measure their LH or FSH, they have no idea if FSH with or without HCG declines to near zero.

    MY LH and FSH were basically zero.

    Vince
    Vince

    MY LH and FSH were basically zero.

    HCG only mimics the luteinizing hormone, it’s not LH.

    The Use of HCG to Prevent / Reverse Testicular Shrinkage and Preserve Fertility

    https://www.excelmale.com/showthread.php?435-The-Use-of-HCG-to-Prevent-Reverse-Testicular-Shrinkage-and-Preserve-Fertility

    Weasel
    Weasel

    HCG only mimics the luteinizing hormone, it’s not LH.

    The Use of HCG to Prevent / Reverse Testicular Shrinkage and Preserve Fertility

    https://www.excelmale.com/showthread.php?435-The-Use-of-HCG-to-Prevent-Reverse-Testicular-Shrinkage-and-Preserve-Fertility

    Understood. I took Dragonbits post as me not knowing my LH/FSH, and that this was the reason for the fertility instead of HCG, which was not the case.

    DragonBits
    DragonBits

    Understood. I took Dragonbits post as me not knowing my LH/FSH, and that this was the reason for the fertility instead of HCG, which was not the case.

    I know HCG won’t show up as LH, but if FSH is zero also, I have to wonder what is the pathway for Spermatogenesis to occur?

    Does anyone know the pathway? Just curious.

    Weasel
    Weasel

    I know HCG won’t show up as LH, but if FSH is zero also, I have to wonder what is the pathway for Spermatogenesis to occur?

    Does anyone know the pathway? Just curious.

    I remember reading some years back about HCG indeed affecting the FSH pathway to some extent but I cannot recall the actual pathway.