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    • Blood Test to Measure HCG Efficacy: 17-Hydroxyprogesterone

      The use of testosterone replacement therapy (TRT) increases blood levels of testosterone but, surprisingly, it decreases the level of testosterone inside the testicles (Intratesticular testosterone or ITT). ITT is key for proper sperm production. This ITT decrease is due to the LH and FSH shut down that occurs with TRT. This shut down decreases ITT and sperm production in men on TRT. These two gonadotropins are required to maintain healthy levels of ITT and, thus, sperm production. Some men on TRT become infertile because of this issue. ITT levels are usually ten times higher than regular blood levels.


      Several studies have found that using human chorionic gonadotropin (HCG) while on TRT can normalize ITT and sperm production in some men (older age and longer pre-exposure to testosterone predicted poorer response). However, the optimum dose and frequency of HCG vary in every man. Fortunately, there are several ways to determine if the dose/frequency of HCG while on TRT is effective: Performing a sperm count/quality test (which requires a 3 month wait period) and/or measuring an upstream hormone to testosterone called 17-hydroxyprogesterone (17OH-P) (which can be measured within 2 weeks of starting HCG). TRT decreases 17OH-P and other upstream hormones due to the shut down of LH (LH is needed to activate the production of these hormones- See figure below). Since HCG mimics LH, using HCG plus TRT may normalize upstream hormones like 17OH-P.


      Several studies have found that 17OH-P blood level is correlated to ITT, so testing for this hormone could save time in optimizing HCG dose while waiting for a required 3-month sperm test. The 17OH-P test can also eliminate the need to perform testicular aspirations to measure ITT, which is a very difficult procedure to do and which is reserved to research settings. A study found that a 17OH-P level greater than 6.5 nmol/L (or 215 ng/dL) was found to normalize ITT while using HCG doses of 500 IU every other day plus testosterone enanthate injections given at 200 mg/week. However, only testing sperm count/quality at after 3 months of HCG initiation makes it possible to know for sure if HCG is effective. As men get older and as they are exposed to longer time on TRT, their response to HCG may decrease. These men may need combination approaches using clomiphene and/or FSH (follicle stimulating hormone).









      References:
      Amory et al. Serum 17-hydroxyprogesterone strongly correlates with intratesticular testosterone in gonadotropin suppressed normal men receiving various dosages of human chorionic gonadotropin. Fertility and Sterility. Vol. 89, No. 2, February 2008





      For more information on the use of HCG to prevent/reverse testicular atrophy, infertility, and improve libido in men on TRT, please click here


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      This article was originally published in forum thread: Blood Test to Measure HCG Efficacy: 17-Hydroxyprogesterone
      Comments 5 Comments
      1. Straffaren's Avatar
        Straffaren -
        New to the group and I understand the intricacies of the forum. Im a 46 year old male born with one testical that stopped doing what I needed in my early twenties. I've been on Dr prescribed cypionate, 200mg per wk for almost 10 yrs. Worthless gels before that. I started off well. Injections got my levels up to the high 700's Felt great actually for the first time in a long time I had a feeling of contentment. No longer. My testical of course has shrunk and the 200mg only gets my levels to 323. I want or should I say need to start a weekly hcg regimine along with my test but, how the hell does one do so affordably?
      1. Vince's Avatar
        Vince -
        Quote Originally Posted by Straffaren View Post
        New to the group and I understand the intricacies of the forum. Im a 46 year old male born with one testical that stopped doing what I needed in my early twenties. I've been on Dr prescribed cypionate, 200mg per wk for almost 10 yrs. Worthless gels before that. I started off well. Injections got my levels up to the high 700's Felt great actually for the first time in a long time I had a feeling of contentment. No longer. My testical of course has shrunk and the 200mg only gets my levels to 323. I want or should I say need to start a weekly hcg regimine along with my test but, how the hell does one do so affordably?
        I get my HCG from Empower Pharmacy through Defy Medical, 12,000 vial of HCG $70.00 plus shipping. I usually buy 2 vial to save on shipping. We also have a thread you may like to read.

      1. CSI007's Avatar
        CSI007 -
        Quote Originally Posted by Straffaren View Post
        New to the group and I understand the intricacies of the forum. Im a 46 year old male born with one testical that stopped doing what I needed in my early twenties. I've been on Dr prescribed cypionate, 200mg per wk for almost 10 yrs. Worthless gels before that. I started off well. Injections got my levels up to the high 700's Felt great actually for the first time in a long time I had a feeling of contentment. No longer. My testical of course has shrunk and the 200mg only gets my levels to 323. I want or should I say need to start a weekly hcg regimine along with my test but, how the hell does one do so affordably?
        When do you test and how often do you inject?
      1. Straffaren's Avatar
        Straffaren -
        Sorry not very tech savy and I just figured out how to get back to this. Thank you for responding.To answer your question. I inject once a week. My blood tested every 6 months or so. I can tell you that 5 years ago I had a level of 830 and felt great! By great I mean totally content with life. Libido was good was losing bodyfat getting back lost strength etc... Now its reversing on me. Memory isnt as sharp as it should be anymore. I shouldn't feel this damn old. Never a whole lot of feed back from the my Dr. when my tests would come back. Its like my first test loss all over again. In my late 20's I dropped to a level of around 128. Causes major depression. I feel like test has saved my life and I dont want to go back there and Im afraid of it not working anymore.
      1. Straffaren's Avatar
        Straffaren -
        Also I always had my draw done around 9am fasting.
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