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    • Case Report: HCG Restores Spermatogenesis

      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/e...ea0050p373.htm

      This article was originally published in forum thread: Case Report: HCG Restores Spermatogenesis
      Comments 13 Comments
      1. frankwhite's Avatar
        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
      1. Vince's Avatar
        Vince -
        Quote Originally Posted by frankwhite View Post
        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...to-TRT-and-hCG
      1. frankwhite's Avatar
        frankwhite -
        Quote Originally Posted by Vince View Post
        Semen analysis results after adding FSH to TRT and hCG

        https://www.excelmale.com/showthread...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.
      1. Vince's Avatar
        Vince -
        Quote Originally Posted by frankwhite View Post
        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.
      1. DragonBits's Avatar
        DragonBits -
        Quote Originally Posted by frankwhite View Post
        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 have no idea until I run a blood test in the future.
      1. Weasel's Avatar
        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.
      1. Weasel's Avatar
        Weasel -
        Quote Originally Posted by frankwhite View Post
        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.
      1. DragonBits's Avatar
        DragonBits -
        Quote Originally Posted by Weasel View Post
        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.
      1. Weasel's Avatar
        Weasel -
        Quote Originally Posted by DragonBits View Post
        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.
      1. Vince's Avatar
        Vince -
        Quote Originally Posted by Weasel View Post
        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...erve-Fertility
      1. Weasel's Avatar
        Weasel -
        Quote Originally Posted by Vince View Post
        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...erve-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.
      1. DragonBits's Avatar
        DragonBits -
        Quote Originally Posted by Weasel View Post
        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.
      1. Weasel's Avatar
        Weasel -
        Quote Originally Posted by DragonBits View Post
        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.
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