TRT and Fertility

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JayLay777

Member
Is TRT basically a guarantee for not keeping fertility? I started TRT due to low normal free T and high SHBG with some low t symptoms but I am concerned about fertility since I am 28 years old. I do not want to take HCG as it makes me feel bad and basically makes TRT not work for me. Is there any chance I can keep my fertility while just taking testosterone ? Or is there another option or anything else I can take besides HCG to stay somewhat fertile on TRT?
 
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Vince

Super Moderator
Is TRT basically a guarantee for not keeping fertility? I started TRT due to low normal free T and high SHBG with some low t symptoms but I am concerned about fertility since I am 28 years old. I do not want to take HCG as it makes me feel bad and basically makes TRT not work for me. Is there any chance I can keep my fertility while just taking testosterone ? Or is there another option or anything else I can take besides HCG to stay somewhat fertile on TRT?
Chances are pretty low, the only way to know for sure is by getting you sperm tested.
 

madman

Super Moderator
Is TRT basically a guarantee for not keeping fertility? I started TRT due to low normal free T and high SHBG with some low t symptoms but I am concerned about fertility since I am 28 years old. I do not want to take HCG as it makes me feel bad and basically makes TRT not work for me. Is there any chance I can keep my fertility while just taking testosterone ? Or is there another option or anything else I can take besides HCG to stay somewhat fertile on TRT?


The hpta will be shutdown when using exogenous testosterone and the only option to maintain fertility would be through the addition of hCG which will maintain ITT (intra-testicular testosterone).






*High intratesticular testosterone (ITT) levels maintain the spermatogenic process and prevent germ cell death. Low ITT levels result in an impaired blood-testis barrier permitting immune cells to enter the seminiferous tubules and attack autoantigenic germ cells. Low intratesticular testosterone levels also block the conversion of round spermatids to elongating spermatogonia and prevent spermiation, leading to phagocytosis of spermatids
by Sertoli cells.



*It is well established that exogenous testosterone therapy causes azoospermia in the majority of men. Exogenous testosterone’s contraceptive effect occurs through its suppression of the HPG axis, preventing LH and FSH release and their respective gonadal functions. Studies examining the reproductive outcomes and rates of azoospermia development of various testosterone treatment modalities show less detrimental effects with testosterone patches [24% rate of azoospermia] compared to intramuscular injections of testosterone enanthate, which result in up to a 98% rate of combined azoospermia and oligozoospermia (≤3 million/cc) after 1 year of therapy.




Novel methods of treating hypogonadal symptoms and keeping men fertile include the use of nasal testosterone and resetting the HPG axis with TRT and controlled administration of HCG. While preliminary results suggest that these methods may increase success for fertility treatments, more extensive research is needed to demonstrate the efficacy and safety of these therapies. The most recent evidence provides hope for the future of male fertility in patients that require TRT.





Alternatives to trt would be Natesto or clomid/enclomiphene.

You could look into Natesto as you have already tried Clomid/Enclomiphene which you did not like...
 

madman

Super Moderator
Adding to what @Vince stated.....Chances are pretty low, the only way to for sure is by getting your sperm tested.




Every man should have a semen analysis pre-trt.




Strategy for clinicians

To maintain fertility in men with hypogonadism prescribed testosterone, Lipshultz said, clinicians should first insist on a semen analysis before beginning testosterone treatment.


Patients need to realize that 2% of all men are sterile,” Lipshultz said. “We need to know where the individual is before we introduce testosterone because our endpoint may not be able to be any better than pre-treatment level.”
 
Dr Saya told me, you can just start the HcG 2 months before you are planning to conceive.
how is your TRT journey so far?

Edit:I am not sure for the exact time frame but he definitely told me you can skip the hcg for now and start it once you are planning to conceive.
 

buckeye22

Member
Is TRT basically a guarantee for not keeping fertility? I started TRT due to low normal free T and high SHBG with some low t symptoms but I am concerned about fertility since I am 28 years old. I do not want to take HCG as it makes me feel bad and basically makes TRT not work for me. Is there any chance I can keep my fertility while just taking testosterone ? Or is there another option or anything else I can take besides HCG to stay somewhat fertile on TRT?

You’re young to be on TRT. What is your idea of low normal values???
If u have concerns about fertility then you should NOT take Exogenous testosterone. you can do more harm then good. Get your semen analysis done then go from there. Then maybe get on Clomid or Hcg or both as either one will keep fertility alive and well. Sounds like you’ve received some terrible advice in past.
 

JayLay777

Member
My free t is always low normal range most of the time on blood test and I had a low t symptoms.Are you saying come off TRT and add Clomid or HCG Or add both to TRT?
 

Cips1975

Active Member
Is TRT basically a guarantee for not keeping fertility? I started TRT due to low normal free T and high SHBG with some low t symptoms but I am concerned about fertility since I am 28 years old. I do not want to take HCG as it makes me feel bad and basically makes TRT not work for me. Is there any chance I can keep my fertility while just taking testosterone ? Or is there another option or anything else I can take besides HCG to stay somewhat fertile on TRT?
I started TRT ( Test Cyp and HcG ) at 42 1/2 years old. Turned 45 2 months ago. Anyway been on the entire time. I took HcG 50 units a week the entire time to preserve fertility while on test. Just found out wife is pregnant. We are doing IVF so having fertility issues was a concern of mine when we started taking about a baby while I was on TRT. Anyway, HcG seems to do the trick for me.
 

JayLay777

Member
I started TRT ( Test Cyp and HcG ) at 42 1/2 years old. Turned 45 2 months ago. Anyway been on the entire time. I took HcG 50 units a week the entire time to preserve fertility while on test. Just found out wife is pregnant. We are doing IVF so having fertility issues was a concern of mine when we started taking about a baby while I was on TRT. Anyway, HcG seems to do the trick for me.
You got away with only taking 50 iu a week or did you mean 500iu a week?
 

Kimpe

Member
Dr Saya told me, you can just start the HcG 2 months before you are planning to conceive.
how is your TRT journey so far?

Edit:I am not sure for the exact time frame but he definitely told me you can skip the hcg for now and start it once you are planning to conceive.
I got a semen analysis done after 2 months of HCG and the count was almost zero.
The fertility clinic doctor told me that it takes at least 3 months for fertility to recover at all, since the lifespan of semen is around that time.
 

Nelson Vergel

Founder, ExcelMale.com
 
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