TRT - Trying to Conceive and Looking for Direction

I have Post TBI Hypothalamic Pituitary Dysfunction and my wife and I have been trying to start a family for about 6 years. Up until my TBI (Traumatic Brain Injury), she had been on a ton of fertility medications because of her own fertility issues. Then I was in an accident, gained about 70 lbs... lost all motivation, sex drive, became depressed, among many other issues. I lived like this for 2 years before my wife convinced me to go into the doctor because my situation was impacting our marriage.

The doctor started me on HCG cream twice daily on my wrists because we are worried about the effects of TRT on sperm count. Which, prior to my accident I was getting a sperm count of roughly 50million post wash... now I'm lucky if I get 20million post wash. Granted this is still within a range they consider to be normal, but with her decreased fertility we need all the help we can get.

My main concern is this HCG not working quickly and TRT decreasing my sperm count even further. I was wondering if any of you have any experience with a method or combination of medications that will counteract the effects of TRT on sperm count?

I've read some things on using HCG with TRT to prevent sperm count from dropping. But I am not 100% on the effectiveness of this protocol.

It's hard because I am no longer able to please my wife between the ED and lack of motivation I feel like a really huge burden on her. I know she isn't satisfied with our life together right now even though she is doing her best to hide the lack of satisfaction. So I want to start TRT to make her happy again, but all in the same I want to be able to give her the family I know she has so desperately wanted for the last 6 years.

Thanks.

Tough situation. If fertility is the top concern in the next few months, I would stay off of TRT and lean more towards clomid. If fertility is a longer range concern, then go on TRT with HCG and you can always taper off TRT and keep the HCG. If your wife is unhappy now I can't imagine bringing a kid into the situation is going to make it better, so if I were in your shoes, I would get myself in order first.

Here are some articles on TRT with HCG...
https://www.ncbi.nlm.nih.gov/pubmed/27855957
https://www.ncbi.nlm.nih.gov/pubmed/25904023
https://www.ncbi.nlm.nih.gov/pubmed/25337850


Good luck!

KSPhD said:

Tough situation. If fertility is the top concern in the next few months, I would stay off of TRT and lean more towards clomid. If fertility is a longer range concern, then go on TRT with HCG and you can always taper off TRT and keep the HCG. If your wife is unhappy now I can't imagine bringing a kid into the situation is going to make it better, so if I were in your shows, I would get myself in order first.






Good luck!

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Thank you for your response.

I do agree that my health is the main priority. I am just trying to find a way that we can balance both sides of the spectrum. We have to do IUI with a lot of medications or IVF in order for her to achieve a pregnancy. Our plan prior to getting this diagnosis was to start trying again next year. But it seems as if most options to jump start sperm production again take 6-12 months on average after stopping TRT. So it seems counterproductive to not be focusing on my sperm count now in conjunction with my testosterone.

Plus it sounds like if I were to start TRT to get our marriage back in check that once I stopped the TRT the symptoms of low T would return and we would be in the same position we are now with our marriage and be trying for a baby. So it seems to be that either way we will be dealing with the stress, it's just a matter of when. I have no doubts that our marriage will make it through all this, especially now that she understands it isn't her fault that I am uninterested in sex.

I will definitely be taking a look at those links you provided me.

Then I would seek a urologist or fertility expert willing to treat you with clomid. This will raise your T and increase your sperm. Also I believe defy medical would be an option. If you search pubmed for Clomid male hypogonadism, you should stumble upon a few articles of interest.

Thank you. We are going in to see our Reproductive Endocrinologist on Monday. I will bring up Clomid, HCG, and TRT. See what kind of ****tail we can come up with.

I really appreciate your knowledge. PubMed seems to have a lot of information on it as well.

Perhaps I missed it, but can you tell us how old you and your wife are? And, as importantly, you were not injecting HCG? You were using a cream?

I would suggest that while you're trying to conceive just HCG, injections, and see how you do. I think if you tear it all down with TRT it takes a good amount of time to reach a good spot and I'd avoid trying to do too much. HCG is where's it at with fertility, cream is unusual, we all inject.

brian.coggins1969 said:

I have Post TBI Hypothalamic Pituitary Dysfunction and my wife and I have been trying to start a family for about 6 years. Up until my TBI (Traumatic Brain Injury), she had been on a ton of fertility medications because of her own fertility issues. Then I was in an accident, gained about 70 lbs... lost all motivation, sex drive, became depressed, among many other issues. I lived like this for 2 years before my wife convinced me to go into the doctor because my situation was impacting our marriage.

The doctor started me on HCG cream twice daily on my wrists because we are worried about the effects of TRT on sperm count. Which, prior to my accident I was getting a sperm count of roughly 50million post wash... now I'm lucky if I get 20million post wash. Granted this is still within a range they consider to be normal, but with her decreased fertility we need all the help we can get.

My main concern is this HCG not working quickly and TRT decreasing my sperm count even further. I was wondering if any of you have any experience with a method or combination of medications that will counteract the effects of TRT on sperm count?

I've read some things on using HCG with TRT to prevent sperm count from dropping. But I am not 100% on the effectiveness of this protocol.

It's hard because I am no longer able to please my wife between the ED and lack of motivation I feel like a really huge burden on her. I know she isn't satisfied with our life together right now even though she is doing her best to hide the lack of satisfaction. So I want to start TRT to make her happy again, but all in the same I want to be able to give her the family I know she has so desperately wanted for the last 6 years.

Thanks.

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HCG cream is a new one on me. Never heard of it and I'm skeptical it would be effective. HCG injections are SOC. In terms of fertility, see also:

http://www.brinkzone.com/general-he...ty-how-to-get-the-best-of-both-worlds-part-1/

CoastWatcher said:

Perhaps I missed it, but can you tell us how old you and your wife are? And, as importantly, you were not injecting HCG? You were using a cream?

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My wife and I are both only 25. Very young to be dealing with these issues.

Yes I am using the HCG cream, not injections.

I hadn't ever heard of the Cream for HCG until we picked it up at the pharmacy. And my wife when she used HCG for fertility she used IM injections. So this is all new to us.

Does the HCG eventually improve the way I feel though? We did one injection of testosterone when I was diagnosed prior to hearing about the effects on fertility, and boy let me tell you, I haven't felt that good in years. I had energy, sex drive, and I was in a great mood for a few days. But once we found out about the fertility thing we quickly switched to HCG. When we saw our doctor he stated we would be doing injections but then when we picked it up from the pharmacy it was in a cream so it was quite the surprise to us.

brian.coggins1969 said:

Does the HCG eventually improve the way I feel though? We did one injection of testosterone when I was diagnosed prior to hearing about the effects on fertility, and boy let me tell you, I haven't felt that good in years. I had energy, sex drive, and I was in a great mood for a few days. But once we found out about the fertility thing we quickly switched to HCG. When we saw our doctor he stated we would be doing injections but then when we picked it up from the pharmacy it was in a cream so it was quite the surprise to us.

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You need far better medical direction than either of you are receiving. TRT and HCG injections are regularly prescribed - testosterone levels rise and fertility is maintained. This isn't new, nor is it exotic. There are plenty of success stories here on the Forum of men who, while taking HCG and testosterone achieved their hope of fatherhood. Examples of sound protocols can be found in the appropriate folders. Does it work for every man, is it a guarantee? No, of course not. But a good doctor, one experienced with both testosterone replacement and HCG, should be a priority for you. As for HCG cream...well, it's probably a good moisturizer. To keep your testicles functioning...

CoastWatcher said:

You need far better medical direction than either of you are receiving. TRT and HCG injections are regularly prescribed - testosterone levels rise and fertility is maintained. This isn't new, nor is it exotic. There are plenty of success stories here on the Forum of men who, while taking HCG and testosterone achieved their hope of fatherhood. Examples of sound protocols can be found in the appropriate folders. Does it work for every man, is it a guarantee? No, of course not. But a good doctor, one experienced with both testosterone replacement and HCG, should be a priority for you. As for HCG cream...well, it's probably a good moisturizer. To keep your testicles functioning...

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I didn't realize it was that common to combine HCG and Testosterone to maintain fertility. I received the diagnosis from our family doctor so I know he is no specialist on the matter. I am waiting on my insurance to approve the referral he gave us to go to an endocrinologist considering the route of the problem here isn't just low testosterone. Most of my hormones are nearly completely non existent due to the brain injury I had.

Monday we are going in to see our Reproductive Endocrinologist because we don't need a referral since we pay him out of pocket for all treatments. But as you can imagine that is a pretty expensive option. I will look to see if I can find some discussions on here in regards to using HCG with TRT.

Thanks again for your insight, I appreciate it considering I am so new to all this.

brian.coggins1969 said:

My wife and I are both only 25. Very young to be dealing with these issues.

Yes I am using the HCG cream, not injections.

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What is yours and her BMI?

Will Brink said:

What is yours and her BMI?

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My BMI is awful... it's about 36. Hers about normal at 26.

Start with this thread on HCG and fertility w/TRT.

https://www.excelmale.com/forum/sho...e-Testicular-Shrinkage-and-Preserve-Fertility

brian.coggins1969 said:

My BMI is awful... it's about 76. Hers about normal at 26.

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High BMI (too high or too low BTW) is associated with fertility issues and other obvious health related issues as well as low T in men, etc. Improve your nutrition, get some regular exercise, throw in some key supplements, and one, or both of you, may see a radical improvement in fertility and of course over all health.

People often don't wanna hear that, and look for a magic pill/shot from a doctor. Not directed at you, just a general statement of fact;

TBI is associated with major disruption of hormones in men, something very few docs currently aware of and could certainly be a major part of your issue:

https://www.excelmale.com/forum/showthread.php?9774-TBI-and-PTSD-what-s-the-connection&highlight=TBI

So it looks like in theory HCG should help me because I have secondary HG. But it seems I risk increasing my estrogen levels which I have a feeling are already high. The doctor attempted to check my E2 levels but apparently the lab misread his handwriting or he checked the wrong box because they checked E3. Which doesn't really give us answers.

Thanks for this link I appreciate it. It's hard to weed through all the posts on here to find information.

brian.coggins1969 said:

So it looks like in theory HCG should help me because I have secondary HG. But it seems I risk increasing my estrogen levels which I have a feeling are already high. The doctor attempted to check my E2 levels but apparently the lab misread his handwriting or he checked the wrong box because they checked E3. Which doesn't really give us answers.

Thanks for this link I appreciate it. It's hard to weed through all the posts on here to find information.

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You came to the right place. Don't be surprised at all if even the specialist looks at you like you're crazy when you attempt to discuss some of this with them. So, be prepared for that.

brian.coggins1969 said:

So it looks like in theory HCG should help me because I have secondary HG. But it seems I risk increasing my estrogen levels which I have a feeling are already high. The doctor attempted to check my E2 levels but apparently the lab misread his handwriting or he checked the wrong box because they checked E3. Which doesn't really give us answers.

Thanks for this link I appreciate it. It's hard to weed through all the posts on here to find information.

Click to expand...

You realize that there is only one appropriate test for measuring estradiol in men, the sensitive (LC, MS/MS) test (which may be called ultrasensitive at certain labs)? And that e2 can be brought under control?