Fertility help!!

[Hopeful1]

So my husband has been on trt for about 2 and a half years with no hcg. I am unsure of the dose, but he takes it once a week. We wanted to try for another child so his doc had him take clomid every day starting this past February along with his weekly test shot. Had a semen analysis done beginning of June and not surprising the results were 0 sperm. His doc put him on hcg 3x a week, I dont know the dosage in iu’s, but hes using I think an insulin syringe and taking .3ml or .5ml. He cut his test shot in half from what he was originally taking, not sure the dose, and still using the clomid.
I have read on several sites that using test, Hcg, and clomid is not good and the clomid and test will actually work against each other. He has been doing that regime since approximately July. He finally had blood drawn and his LH levels were 0.1, they didn’t include the FSH level for some reason but the doc said it was going to be low anyway. I am assuming with LH levels so low he still isn’t producing sperm? Could it be a possibility he is producing sperm since the HCG mimics LH and won’t be detected on bloodwork? He doesn’t want to come off the test bc of the crash, and the doc didn’t seem to want to prescribe FSH and said it would be very expensive. I would assume it would be pointless to do another semen analysis with such low LH numbers. Is there anything help you guys could provide as to what we could try next to restore fertiliy?
Prior to trt, he had a great semen analysis and we had a child.

 

[Nelson Vergel]

Have him try TRT (dosage 50 to 75 mg twice per week) plus HCG 500 IU every other day. Get him to do a semen analysis after 6 weeks. If that does not work, drop the TRT and bring in 25 mg per day of Clomid. Test again 6 weeks later. If that does not work, his doctor can fax a script of FSH to Empower Pharmacy and use it with HCG every other day.

 

[Nelson Vergel]

Fertility Restored While on TRT

 

[Nelson Vergel]

Semen analysis results after adding FSH to TRT and hCG

 

[Nelson Vergel]

Fertility Archives - ExcelMale

 

[Hopeful1]

Have him try TRT (dosage 50 to 75 mg twice per week) plus HCG 500 IU every other day. Get him to do a semen analysis after 6 weeks. If that does not work, drop the TRT and bring in 25 mg per day of Clomid. Test again 6 weeks later. If that does not work, his doctor can fax a script of FSH to Empower Pharmacy and use it with HCG every other day.

Thank you for the reply, Nelson.
He said he dropped from 1.4 of test to 1.0 once a week starting this past July. I apologize I dont know the units its measured in. He is taking .5ml of hcg mwf.
Am i correct to assume given his current regime of t+hcg+clomid and his lh level only being at 0.1 that it would be pointless to do a semen analysis? And do you think that the clomid along with test and hcg is causing more problems of not producing sperm?

 

[HealthMan]

Best course of action if fertility is the priority is stop the testosterone injections and use clomid only. If he does not want to stop tbe testosterone injections use both HCG and FSH (no need to use clomid in this case). Testosterone + HCG only is suboptimal for fertility restoration but it might work. The problem is it will take you weeks to find out. If money is not an issue I would go testosterone + HCG + FSH right away and skip the testosterone + HCG.

 

[Hopeful1]

Best course of action if fertility is the priority is stop the testosterone injections and use clomid only. If he does not want to stop tbe testosterone injections use both HCG and FSH (no need to use clomid in this case). Testosterone + HCG only is suboptimal for fertility restoration but it might work. The problem is it will take you weeks to find out. If money is not an issue I would go testosterone + HCG + FSH right away and skip the testosterone + HCG.

Thanks Healthman.

I remember reading your post a while back and armed with that information, I told the husband to ask the doc this past Thursday while going over blood results about dropping the clomid and doing the test +hcg + fsh, but the doc said fsh was very expensive and what hes on now will do the trick to bring sperm back, which clearly it hasn't worked. On an average, how much does fsh cost?

 

[Vince Carter]

Thank you for the reply, Nelson.
He said he dropped from 1.4 of test to 1.0 once a week starting this past July. I apologize I dont know the units its measured in. He is taking .5ml of hcg mwf.
Am i correct to assume given his current regime of t+hcg+clomid and his lh level only being at 0.1 that it would be pointless to do a semen analysis? And do you think that the clomid along with test and hcg is causing more problems of not producing sperm?

LH will be 0 while he's using Testosterone, LH at this point has no bearing on semen or any thing else, just indicates HPTA shutdown which started as soon as he went on Test.

 

[HealthMan]

Thanks Healthman.

I remember reading your post a while back and armed with that information, I told the husband to ask the doc this past Thursday while going over blood results about dropping the clomid and doing the test +hcg + fsh, but the doc said fsh was very expensive and what hes on now will do the trick to bring sperm back, which clearly it hasn't worked. On an average, how much does fsh cost?

Empower has the cheapest FSH. Around $350 for 1200 IU. If you want to speed up things without breaking the bank consider 75IU 3x a week plus 500 IU HCG. That will cost a bit less than $300 a month. After you get pregnant it would he wise to keep this protocol until you have the baby just in case you have a miscarriage. After that if you guys decide no more babys he can go back to his old protocol. I personally dont plan in having more kids but you never know. So i take a small dosage of HCG and FSH just to keep things running at a minimum level amd ready to get back to full steam if and when i decide to

 

[Hopeful1]

Empower has the cheapest FSH. Around $350 for 1200 IU. If you want to speed up things without breaking the bank consider 75IU 3x a week plus 500 IU HCG. That will cost a bit less than $300 a month. After you get pregnant it would he wise to keep this protocol until you have the baby just in case you have a miscarriage. After that if you guys decide no more babys he can go back to his old protocol. I personally dont plan in having more kids but you never know. So i take a small dosage of HCG and FSH just to keep things running at a minimum level amd ready to get back to full steam if and when i decide to

Well that's not too bad, I was thinking it was going to be in the thousands for a vial considering I keep seeing posts saying how expensive it is. He gets his test shot every monday so I will get him to talk to his doc again next monday to persuade him to order a vial of fsh and drop the clomid. I just hope his doc will agree to it...

 

[HealthMan]

Well that's not too bad, I was thinking it was going to be in the thousands for a vial considering I keep seeing posts saying how expensive it is. He gets his test shot every monday so I will get him to talk to his doc again next monday to persuade him to order a vial of fsh and drop the clomid. I just hope his doc will agree to it...

Fingers crossed!

 

[Hopeful1]

Fingers crossed!

Will keep everyone posted incase anybody else is combing through the forums for the same reason.

 

[Sides]

Well that's not too bad, I was thinking it was going to be in the thousands for a vial considering I keep seeing posts saying how expensive it is. He gets his test shot every monday so I will get him to talk to his doc again next monday to persuade him to order a vial of fsh and drop the clomid. I just hope his doc will agree to it...

Your doctor probably doesn't know that Empower Pharmacy is offering FSH for such a reasonable price. My fertility doctor had no idea until I showed him the printout off the Empower website, and I convinced him to write a prescription for 75iu FSH every other day.

Go to the Empower website and print out the information on FSH at the following link, and have your husband bring it with him when he goes to the doctor:

FSH INJECTION | Compounding Pharmacy - Empower Pharmacy

That should help convince your doctor that there is real FSH out there for a reasonable price. The HCG and FSH from Empower Pharmacy are the best bargain in the fertility world, at least here in the USA.

It worked for me and my wife, and I have been on testosterone for 26 years. We successfully had IVF done back in October. I hope for the best for you guys as well!

 

[Hopeful1]

Your doctor probably doesn't know that Empower Pharmacy is offering FSH for such a reasonable price. My fertility doctor had no idea until I showed him the printout off the Empower website, and I convinced him to write a prescription for 75iu FSH every other day.

Go to the Empower website and print out the information on FSH at the following link, and have your husband bring it with him when he goes to the doctor:

FSH INJECTION | Compounding Pharmacy - Empower Pharmacy

That should help convince your doctor that there is real FSH out there for a reasonable price. The HCG and FSH from Empower Pharmacy are the best bargain in the fertility world, at least here in the USA.

It worked for me and my wife, and I have been on testosterone for 26 years. We successfully had IVF done back in October. I hope for the best for you guys as well!

Thank you! I will print this out along with a couple fsh success stories I've seen on here. The hubby briefly talked to the doc that gives him his weekly test shot and their "plan" is to lower the amount of his test shot, continue with the hcg 3x a week, continue with clomid, and add in igf-1 to help fertility. I have not seen anybody taking igf-1 to help fertility. He told me it helps to stimulate the sperm production, I don't know how accurate that information is. He also mentioned starting on Deca too. That just seems like way too many things to take.
I was hoping the fertility center would do another semen analysis since he's been on the hcg shots since the end of July to see if there are at least some sperm present, as he had a 0 count back in May (prior to test he had a great SA). They wont due the analysis since his blood work came back last week with 0.1 lh levels and low fsh levels. Very frustrating.
Does anybody know anything about igf-1 for fertility?

 

[Sides]

There's a few studies that show a benefit to taking HGH or IGF-1 to help with fertility, both in animals and humans, and in both males and females. You can Google "growth hormone male fertility" and you will see studies like these:

Growth hormone in male infertility
Growth hormone treatment of subfertile males. - PubMed - NCBI
Growth hormone improves semen volume, sperm count and motility in men with idiopathic normogonadotropic infertility | ECE2008

HGH does seem to help with male fertility, sperm count, and motility, at a dose of 1.5iu per day. IGF-1 would work through the same mechanisms.

Personally, I used HGH at 2-4iu per day all the way through my 11 month fertility protocol until my wife and I had success with our IVF procedure. So I do recommend it.

I can't imagine any reason to take Deca, as it is more suppressive of the HPTA and fertility than testosterone, and nandrolone decanoate has a long half-life and the metabolites stay in your body for a long time after use. I think your husband would be much better off staying on a higher dose of testosterone, rather than cutting the testosterone and adding in Deca. That doesn't make any sense to me from a fertility aspect, although I do understand the use of Deca in bodybuilding to build muscle.

 

[Hopeful1]

So a little bit of a silver lining. A couple months back I had bought a cheapie kids microscope and had been putting a drop of semen on a slide to check for sperm. I hadn't seen any the many times I checked and was getting frustrated so stopped doing it since it was stressing me out. It's been maybe 3-4 weeks since the last time I did it. Well I decided to do it again today and to my surprise found sperm! There definitely wasn't many in the "sample", maybe a dozen or so, but it was for sure sperm. They were actually easy to spot right away due to their movement. I'm sure his count is super low, but gives me a glimmer of hope his fertility is starting to come back, now we just need to get the numbers up to a good count.

 

[daves52380]

I am in the same situation as your husband. Before starting TRT my wife and I were very fortunate and conceived our first child the first month that we started trying, conceived March 2016, born Dec 16, 2016.

I started TRT May of 2017 with a Testosterone and anastrozole protocol. No HCG.

As we planned to conceive a second child I was prescribed HCG in July 2018, with dose of 2000iu per week split up in 650iu MWF injections. We have been trying to conceive without success since July 2018 and to our concern we had my Dr run LH, FSH and Prolactin in my labs in Oct 2018. Results, FSH 0.5 (1.5-14.0 range) LH <0.2 (1.4-7.7 range) Prolactin 8.5 (2.6-13.1 range).
LH and FSH were non-existent. I was concerned about why LH was so low for being on a moderate HCG dose for 3-4 months.

My DR decided to order FSH from empower pharmacy 1200iu vial with next day delivery, (exceptional customer service and product).
Since November I have continue taking HGC 700iu 3x/wk MWF and the added FSH 80iu 3x/wk MWF. I had labs done 1/16/19 and just got my labs with results.
FSH increased from .05 to 2.0 (1.5-14 range) and LH is now .02 from <0.2 (1.4-7.7 range) so no real increase in LH. Again to my surprise considering being on HCG 700iu 3x/wk (2100iu/wk) for almost 7 months. I am not sure why I am not responding to HCG or if I need a much larger dose.
I will keep you updated with any progress and best of luck to you and your husband. I will be looking out for an update when you have one.

 

[Nelson Vergel]

hCG is an LH analog but it is NOT detected as LH in blood tests. In fact, it shuts down LH.

I think your protocol is a good one. Please let us know what your semen values are in a few weeks.

 

[Hopeful1]

I was just going to post what Nelson said, the lh wont be detected on the bloodwork.

My husbands lh and fsh levels were pretty much non existent on his last bloodwork done in October or November. He is still taking clomid and hcg shots 3x a week (300 or 500 iu, I cant remember). He started his hcg shots around July too. Prior to starting that, he was on test plus clomid since February, but his semen analysis in May came back with 0 sperm. From reading these forums, It seems as the clomid and Test work against one another, but I think the reason his doc prescribed him the clomid was to help raise the fsh while the hcg would raise testicular lh. His doc didn't want to prescribe the FSH, I'm not sure why.
The fertility clinic refuses to do another semen analysis since the numbers on his bloodwork are so low and they told me it would be pointless. As weird as it may sound, I am glad I bought a little microscope and looked for myself to monitor for any progress. When I first started looking, there indeed was no sperm to be found, however when I checked again this past December after taking a break from checking, there were definitely sperm present. Of course I dont know how high the count is but just bought and received today a Micra sperm test. This is a microscope designed to test count and motility.
He has just cut his test shot down by half again, and plans on cutting it down further in a couple weeks in hopes of weaning himself off the test in order to fully restore sperm production. He plans on getting new bloodwork done within the next few weeks to see if the lower Test shots along with hcg shots and clomid have produced any positive results. I'm also going to see if the doc that gives him his Test shot is able to write him a script to get another semen analysis done at Labcorp so we can bypass the fertility clinic and get a true count.
I will definitely update this thread with whatever updates I have, including the results from the Micra microscope test.