On HRT a long time. Possible to have kids?

Hi everyone,

New to the forum and it looks a fantastic resource.

I'm looking for some advice. A bit if background first. I'm currently 34, was diagnosed with secondary hypogonadism when I was 21 and was put on Sustanon. This helped to get puberty moving for me as it was very slow and at 21 I still hadn't fully developed due to lack of testosterone. Sustanon worked well for me and I lead a normal life. In 2008 our health service (I'm in Europe) stopped supplying sustanon and I was moved to Nebido. This also worked well for me. In total i've been on TRT for about 13 years.

Roll on to the present and at 34 I now want to have kids. I was told all along at my yearly check ups that to have kids should be possible and that it would simply involve moving me on to a different injection. I was always happy enough with that and never really looked into it further, until recently.
After reading this and other forums it appears I should probably have been taking HCG with my nebido if I wanted to preserve my fertility. Is this true? It was never given as an option to me. Is it likely that taking HCG now will kickstart my testes into producing sperm given I have been on HRT for such a long time?

lg1234 said:

Hi everyone,

New to the forum and it looks a fantastic resource.

I'm looking for some advice. A bit if background first. I'm currently 34, was diagnosed with secondary hypogonadism when I was 21 and was put on Sustanon. This helped to get puberty moving for me as it was very slow and at 21 I still hadn't fully developed due to lack of testosterone. Sustanon worked well for me and I lead a normal life. In 2008 our health service (I'm in Europe) stopped supplying sustanon and I was moved to Nebido. This also worked well for me. In total i've been on TRT for about 13 years.

Roll on to the present and at 34 I now want to have kids. I was told all along at my yearly check ups that to have kids should be possible and that it would simply involve moving me on to a different injection. I was always happy enough with that and never really looked into it further, until recently.
After reading this and other forums it appears I should probably have been taking HCG with my nebido if I wanted to preserve my fertility. Is this true? It was never given as an option to me. Is it likely that taking HCG now will kickstart my testes into producing sperm given I have been on HRT for such a long time?

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You are probably infertile. But get a semen analysis done to make sure. Then you have two options. Stop TRT and use clomid or add HCG + FSH to your regimen. 500IU HCG + 75IU FSH 3x a week should be enough to get you going. Then once your wife get ls pregnant you could reduce dosage. I am currently taking 500IU HCG + 50IU FSH twice a week and my fertility is ok (i am not planning to have kids now but if i decide to have more kids in the near future this regimen will kept me fertile).
Of course consult with your doctor. I had a similar problem to yours and HCG + FSH added to TRT fixed my issue. Best of luck

lg1234 said:

Hi everyone,

New to the forum and it looks a fantastic resource.

I'm looking for some advice. A bit if background first. I'm currently 34, was diagnosed with secondary hypogonadism when I was 21 and was put on Sustanon. This helped to get puberty moving for me as it was very slow and at 21 I still hadn't fully developed due to lack of testosterone. Sustanon worked well for me and I lead a normal life. In 2008 our health service (I'm in Europe) stopped supplying sustanon and I was moved to Nebido. This also worked well for me. In total i've been on TRT for about 13 years.

Roll on to the present and at 34 I now want to have kids. I was told all along at my yearly check ups that to have kids should be possible and that it would simply involve moving me on to a different injection. I was always happy enough with that and never really looked into it further, until recently.
After reading this and other forums it appears I should probably have been taking HCG with my nebido if I wanted to preserve my fertility. Is this true? It was never given as an option to me. Is it likely that taking HCG now will kickstart my testes into producing sperm given I have been on HRT for such a long time?

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I brought this up with my Urologist over a year back, enquired if my wife could come off the pill now that I am on TRT, his reply was absolutely NOT; it is still possible and likely that she could become pregnant and that I must not consider TRT as part contraception.

Thanks for the replies.

My girlfriend came off the pill about 9 months ago so I'd be fairly sure Im firing blanks at the moment. My big concern is that ive been on HRT for so long, 13 years, without any HCG that my testes will really struggle to make sperm again as they've been shut down for so long.

Ive also noticed im at the very early stages of gyno and taking HCG will probably accelerate this. From reading these boards I see I need to have the ultra sensitive estrogen lab done, but chances are my endo wont know this or this test wont be available to him. Taking anastrozole appears to be the answer if my levels are high but Im reluctant to take this after reading some peoples accounts.

lg1234 said:

Thanks for the replies.

Ive an appointment with my endo on Monday so Ill see what he says, its good to go into the meeting with all this information.​

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Wishing you well on Monday, it is very refreshing to read that you are doing things the correct way
I mean this by researching as much as you can, and then most importantly seeking the full medical advice of your doctor & Endo, rather than going it alone like so many do.
.
I sure hope all works out well for you and your good lady.

Semen analysis results after adding FSH to TRT and hCG

https://www.excelmale.com/forum/sho...lysis-results-after-adding-FSH-to-TRT-and-hCG

Thought I'd update everyone on my appointment with my Endo this morning.

He wants me to come off test altogether and start HCG on it's own. Then we'll do sperm analysis in 4 months and see how I'm getting on. He said we will add FSH further down the road if it's needed.

I was concerned about coming off nebido but he said the HCG alone should have me making enough test to be ok while i try get my girlfriend pregnant.

He didn't want to give me anything for my gyno, he said there's very little gyno there and coming off the nebido should help reduce what I had developed. Personally I don't really want to go messing with ai's unless it gets pretty bad.

I've to go back in two weeks with my HCG as pregnyl is no longer available in Europe and he needs to show me how to extract what I need from the HCG pens (think they're called Ovitrelle pens)

Also got bloods taken for fsh, lh, e2, shbg and test.

Happy with that. Concerned about coming off the nebido (most posts I read here it seems people just add HCG but keep on the taking the testosterone) but he knows what he's talking about, he's always been right to date so happy to trust it's the right decision.

Stopping TRT just to start HCG is a bit dramatic, who's to say adding HCG won't be enough to get the wife pregnant?

user_joe said:

Not saying the Dr is wrong but I'd personally want to try adding hcg to the trt for a while. Depends on how patient you are I guess. No guarantee how you will feel with the hcg only. Could go either way.

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Ye this is what I wanted as I had read up on it but my Endo insisted I drop the test and do HCG only, adding FSH a few months down the road if needed. He said HCG will give me enough test but I'm worried it won't and I'm in for a tough few months.

Is it likely coming off the test and using HCG only will help reduce gyno?

Just an update. In going back to my Endo next week to be shown how to use the HCG shot.

It's now 14 weeks since my last nebido shot (was getting a shot every ten weeks previously) and I feel like total crap now. I've no energy, very irritable and feeling pretty depressed about everything. I don't want to keep feeling like this.

When I start taking the HCG I presume it will take a while to kick start my own testosterone production, especially as I'm on trt 13 years? I really want him to prescribe me more nebido to take along with the HCG so I feel normal for the next few months but he was adamant the HCG would be enough testosterone for me. Is anyone aware of any studies which say you should take testosterone along with HCG when trying for children that I can show him? Or any other tips on how I can convince him test+HCG is the protocol he should put me on?

lg1234 said:

Just an update. In going back to my Endo next week to be shown how to use the HCG shot.

It's now 14 weeks since my last nebido shot (was getting a shot every ten weeks previously) and I feel like total crap now. I've no energy, very irritable and feeling pretty depressed about everything. I don't want to keep feeling like this.

When I start taking the HCG I presume it will take a while to kick start my own testosterone production, especially as I'm on trt 13 years? I really want him to prescribe me more nebido to take along with the HCG so I feel normal for the next few months but he was adamant the HCG would be enough testosterone for me. Is anyone aware of any studies which say you should take testosterone along with HCG when trying for children that I can show him? Or any other tips on how I can convince him test+HCG is the protocol he should put me on?

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lg1234 said:

Just an update. In going back to my Endo next week to be shown how to use the HCG shot.

It's now 14 weeks since my last nebido shot (was getting a shot every ten weeks previously) and I feel like total crap now. I've no energy, very irritable and feeling pretty depressed about everything. I don't want to keep feeling like this.

When I start taking the HCG I presume it will take a while to kick start my own testosterone production, especially as I'm on trt 13 years? I really want him to prescribe me more nebido to take along with the HCG so I feel normal for the next few months but he was adamant the HCG would be enough testosterone for me. Is anyone aware of any studies which say you should take testosterone along with HCG when trying for children that I can show him? Or any other tips on how I can convince him test+HCG is the protocol he should put me on?

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HCG mono is not optimal for fertility either (your HPTA will still be supressed). Clomid should be a better choice for fertility and can also help bringing up testosterone levels. However most don’t feel subjectively good with clomid.

Thanks for the replies. I'm aware HCG mono isn't the best option, my Endo said he'd add FSH a few months down the line if we need it (why not just add it now!?). But I can wait. My main concern is how I feel, I feel like crap and don't want to spend months like this

Thought I'd post an update on where I'm at now. I added FSH to my protocol in October, so now I'm taking 75iu FSH X3 weekly and 800 HCG x3 weeky. I feel good bit libido isn't great. Getting blooss done next week.

Anyway I did a sperm test at the end of January, 4 months after starting the HCG, and the results came back today. The results show a very low number of sperm. I didn't get the exact figure, was just told it's very very low. There's no motility in the sperm and the endo said they're immature.

After 14 years on trt I'm relieved that there's some sperm there, as I was terrified my body wouldn't be able to make any. Disappointed there's not more and there's no motility, but I hope that will come a few months further down the road.

As I just started on FSH in October and it takes around 3 months for the body to make sperm, and my sperm test was late January, I'm hoping it's just my body taking a while to kick-start sperm production. Fingers crossed.

lg1234 said:

Thought I'd post an update on where I'm at now. I added FSH to my protocol in October, so now I'm taking 75iu FSH X3 weekly and 800 HCG x3 weeky. I feel good bit libido isn't great. Getting blooss done next week.

Anyway I did a sperm test at the end of January, 4 months after starting the HCG, and the results came back today. The results show a very low number of sperm. I didn't get the exact figure, was just told it's very very low. There's no motility in the sperm and the endo said they're immature.

After 14 years on trt I'm relieved that there's some sperm there, as I was terrified my body wouldn't be able to make any. Disappointed there's not more and there's no motility, but I hope that will come a few months further down the road.

As I just started on FSH in October and it takes around 3 months for the body to make sperm, and my sperm test was late January, I'm hoping it's just my body taking a while to kick-start sperm production. Fingers crossed.

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During these 14 years you never used HCG? Hopefully with a bit more time things will get back on track. Do you have the details of your sperm analysis?

No never used HCG. Never knew anything about it to be honest. Was put on TRT to get puberty started and was happy with the results so had no reason to even know what HCG was at the time. Was told during my yearly endo visits that everything was fine, I felt fine and that if I wanted kids to let him know. So presumed my prescribed meds were all I needed.

I only first heard of HCG when I found these forums a couple of years ago.

I'll get the full breakdown of my sperm analysis when I see my endo in person next week

If you could get that info and share with us would be helpful. An aggravating fact is that you stayed a very long time with both LH and FSH supressed. Data shows that it takes longer for sperm production to resume the longer you are on TRT (in this specific study patients simply quit TRT). I would assume this is also true if you are just adding HCG and FSH to your TRT regimen. Hypothetically there are two things in play: the time the HPT axis takes to “wake up” and start producing LH and FSH again + the time your HPT axis was shut down and your sertoli and leydig cells were “dormant”. By adding HCG + FSH to TRT you will eliminate the first component so in theory sperm production should resume sooner than what shown in studies where patients simply quit TRT (that assuming proper dosages and application intervals of HCG and FSH are being used). In this study, if i am not mistaken, the longest it took for men to become fertilite again was 2 years.
So you just recently added FSH (2-3 months) so give it at least a few more months. My sperm count went back to “normal” 6 months after adding FSH (however I didn’t have a sperm analysis done in the 3 months mark to compare).
If I were you I would keep your protocol for at least 3 more months and retest (maybe just change one thing. Inject FSH EOD instead of 3x a week due to its short half life).
After 3 months get another sperm analysis done and go from there. An increase in FSH dosage might be warranted if sperm count hasn’t significantly improved by then. Also make sure you are getting your meds from a reputable source.
Best of luck and keep us posted

And just to make sure. Your keep both HCG and FSH refrigerated right?

I didn't refrigerate my HCG for the first couple of months. I was told at the time I didn't have to. I do now though.

That's encouraging to hear other men took up to two years to produce sperm again. I'd imagine with me it will take a while to get sperm producing again given I've been on trt for 13 years, so I'm not too concerned about the very low count and no motility just yet, im just glad something is happening. I can wait.

Also it's worth noting that my endo took me off nebido (test) and put me on HCG monotheraphy for a few months and then put me on FSH too. After reading these boards i see the normal procedure is to stay on test and add HCG and FSH. I asked for this but it was a definite no. But to be honest Ive never felt better than I have these last few months. I'll be getting my sperm results tomorrow so I'll post up here what they are.