Fertility Restored While on TRT with hCG

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Hopeful Story

New Member
Hello everyone. These forums were very helpful to me on my fertility journey over the past 6 months, so I thought I would share more story. The more info people have, the better I think. If anyone wants more detail I'm happy to share. I don't know if I put this in the right forum so feel free to move it. I did not use clomid.

I'm 42 and been on testosterone gel for almost 15 years. Partner and I decided we want kids so we went straight to a fertility clinic. Our doctor is a reproductive endocrinologist. Did the semen analysis and 0 sperm, which I expected. At this point the doctor told me a few things turned out to not be accurate.

1) Insurance won't cover fertility meds for men. Out of pocket per month was gonna be around $1500 for hcg and fsh. Did a ton of research and Aetna will cover this as long as it's framed as the meds are needed for fertility due to hypogonadism. Not just for fertility. In essence, the diagnosis must be hypogonadism not infertility. Copays cost me $120/month.

2) You must go off testosterone or your sperm count won't go up. Even if I go off, the count will still be so low we'll almost certainly need IVF. I told her I want to try the meds while staying on testosterone. If after 6 months my count is still low, I will go off. She reluctantly agreed.

3) Take 10,000 units of hcg 1x week. I instead took 1000 EOD for 2 weeks. 750 EOD for 2 weeks. Then 500 EOD thereafter. I don't know if the higher doses at first were necessary or not, but my theory was my system needed a strong jumpstart after being shut down for 15 years. I also took between 75 and 125 units of fsh EOD the whole time. I played with the dose because it made me nauseous.

Did my second semen analysis 5 months in and the count went from 0 to a concentration of 24 million/ML. This test did concentration, not total. I'm guessing that would be somewhere around 75-100 million total in an average load. Never reduced the testosterone. My significant other got pregnant a couple weeks after that. Just hoping for a healthy pregnancy now! All I can say is what worked for me. Good luck to others that are trying!
 
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Vince

Super Moderator
So after 6 months of adding FSH to my TRT protocol I got a sperm analysis done.
A quick background. My fertility was normal before TRT and went to zero when I started TRT without HCG. Adding HCG 500 IU 2x a week my sperm analysis results were:


sperm count 2.1mm (normal >=20mm)
total sperm 7.2mm (normal >=40mm)


Subfertile with not great chances of getting my wife pregnant.

I tried to increase HCG to 500IU 3x a week but results were basically the same and it didnt make me feel good. So I asked Dr Saya if I could try FSH and he was ok with that. I have been taking 50IU 2x a week (less than the dosage prescribed... long story short my wife got pregnant and miscarried and we decided to hold off on another baby so i decided to use a much lower dosage just to save money and see if it would work).
So after 6 months on TRT with testosterone + HCG (500IU 2x a week) + FSH (50IU 2x a week) my new sperm analysis results are:


sperm count 15mm (normal >=20mm)
total sperm 52.5mm (normal >=40mm)


I am fertilile again! Thanks Dr Saya! The small FSH dosage worked!
So I am planning to keep using FSH in my protocol. At this dosage it is not that expensive.

Semen analysis results after adding FSH to TRT and hCG

Semen analysis results after adding FSH to TRT and hCG
 

Gonadotropica

New Member
Sorry for bumping this thread, hoping that the original author will chime in and be able to answer this question:

You said you used hCG and HMG (FSH) in combination with TRT and were able to restore fertility, which is fantastic. Were you able to increase your testicular size on this combination? If so, about how long did it take to see size increases?
 
Last edited:

KenLowT

Active Member
I need to get a hold of some FSH then. I've been doing 500iu's of HCG 3x per week, but I haven't done a sperm analysis yet. However, it seems to me that instead of going 3x per week I should go EOD with the HCG. It gets pricey though.
 

Hopeful Story

New Member
Sorry for bumping this thread, hoping that the original author will chime in and be able to answer this question:

You said you used hCG and HMG (FSH) in combination with TRT and were able to restore fertility, which is fantastic. Were you able to increase your testicular size on this combination? If so, about how long did it take to see size increases?
Sorry man, didn't realize it had been bumped. Testicles got to about 75% of their pre-testosterone size. It took probably 2-3 months to get there.
 

Hopeful Story

New Member
I need to get a hold of some FSH then. I've been doing 500iu's of HCG 3x per week, but I haven't done a sperm analysis yet. However, it seems to me that instead of going 3x per week I should go EOD with the HCG. It gets pricey though.
Worked like a charm for me. Definitely helped to have my insurance pay for it though. Would've cost me like $7500 otherwise.
 

sunnyksf

New Member
Hello everyone. These forums were very helpful to me on my fertility journey over the past 6 months, so I thought I would share more story. The more info people have, the better I think. If anyone wants more detail I'm happy to share. I don't know if I put this in the right forum so feel free to move it. I did not use clomid.

I'm 42 and been on testosterone gel for almost 15 years. Partner and I decided we want kids so we went straight to a fertility clinic. Our doctor is a reproductive endocrinologist. Did the semen analysis and 0 sperm, which I expected. At this point the doctor told me a few things turned out to not be accurate.

1) Insurance won't cover fertility meds for men. Out of pocket per month was gonna be around $1500 for hcg and fsh. Did a ton of research and Aetna will cover this as long as it's framed as the meds are needed for fertility due to hypogonadism. Not just for fertility. In essence, the diagnosis must be hypogonadism not infertility. Copays cost me $120/month.

2) You must go off testosterone or your sperm count won't go up. Even if I go off, the count will still be so low we'll almost certainly need IVF. I told her I want to try the meds while staying on testosterone. If after 6 months my count is still low, I will go off. She reluctantly agreed.

3) Take 10,000 units of hcg 1x week. I instead took 1000 EOD for 2 weeks. 750 EOD for 2 weeks. Then 500 EOD thereafter. I don't know if the higher doses at first were necessary or not, but my theory was my system needed a strong jumpstart after being shut down for 15 years. I also took between 75 and 125 units of fsh EOD the whole time. I played with the dose because it made me nauseous.

Did my second semen analysis 5 months in and the count went from 0 to a concentration of 24 million/ML. This test did concentration, not total. I'm guessing that would be somewhere around 75-100 million total in an average load. Never reduced the testosterone. My significant other got pregnant a couple weeks after that. Just hoping for a healthy pregnancy now! All I can say is what worked for me. Good luck to others that are trying!
 

sunnyksf

New Member
This is very encouraging! Thank you SO much for all of the information you shared. My husband also had a sperm count of 0 after being on testosterone injections for 4 years. He wants to remain on the testosterone. All fertility doctors we've talked to have said he's either a lost cause or that he'd have to definitely go off the trt. So we're trying to figure this out on our own. You said you stayed on the test the whole time, how much were you taking? Also, was the fsh called Ovidrel? We've found hmg and Ovidrel to be insanely expensive. We have good insurance but no doctors who will prescribe it :( Lastly, are Mom and baby healthy? Praying her pregnancy went smoothly with no issues. Looking forward to a response! :)
 

Systemlord

Member
This is very encouraging! Thank you SO much for all of the information you shared. My husband also had a sperm count of 0 after being on testosterone injections for 4 years. He wants to remain on the testosterone. All fertility doctors we've talked to have said he's either a lost cause or that he'd have to definitely go off the trt. So we're trying to figure this out on our own. You said you stayed on the test the whole time, how much were you taking? Also, was the fsh called Ovidrel? We've found hmg and Ovidrel to be insanely expensive. We have good insurance but no doctors who will prescribe it :( Lastly, are Mom and baby healthy? Praying her pregnancy went smoothly with no issues. Looking forward to a response! :)


You need to get FSH through compounding pharmacies, Empower Pharmacy. It's much cheaper.
 

Gman86

Member
Hello everyone. These forums were very helpful to me on my fertility journey over the past 6 months, so I thought I would share more story. The more info people have, the better I think. If anyone wants more detail I'm happy to share. I don't know if I put this in the right forum so feel free to move it. I did not use clomid.

I'm 42 and been on testosterone gel for almost 15 years. Partner and I decided we want kids so we went straight to a fertility clinic. Our doctor is a reproductive endocrinologist. Did the semen analysis and 0 sperm, which I expected. At this point the doctor told me a few things turned out to not be accurate.

1) Insurance won't cover fertility meds for men. Out of pocket per month was gonna be around $1500 for hcg and fsh. Did a ton of research and Aetna will cover this as long as it's framed as the meds are needed for fertility due to hypogonadism. Not just for fertility. In essence, the diagnosis must be hypogonadism not infertility. Copays cost me $120/month.

2) You must go off testosterone or your sperm count won't go up. Even if I go off, the count will still be so low we'll almost certainly need IVF. I told her I want to try the meds while staying on testosterone. If after 6 months my count is still low, I will go off. She reluctantly agreed.

3) Take 10,000 units of hcg 1x week. I instead took 1000 EOD for 2 weeks. 750 EOD for 2 weeks. Then 500 EOD thereafter. I don't know if the higher doses at first were necessary or not, but my theory was my system needed a strong jumpstart after being shut down for 15 years. I also took between 75 and 125 units of fsh EOD the whole time. I played with the dose because it made me nauseous.

Did my second semen analysis 5 months in and the count went from 0 to a concentration of 24 million/ML. This test did concentration, not total. I'm guessing that would be somewhere around 75-100 million total in an average load. Never reduced the testosterone. My significant other got pregnant a couple weeks after that. Just hoping for a healthy pregnancy now! All I can say is what worked for me. Good luck to others that are trying!

What brand of HCG did you use?
 

Weasel

Member
This is very encouraging! Thank you SO much for all of the information you shared. My husband also had a sperm count of 0 after being on testosterone injections for 4 years. He wants to remain on the testosterone. All fertility doctors we've talked to have said he's either a lost cause or that he'd have to definitely go off the trt. So we're trying to figure this out on our own. You said you stayed on the test the whole time, how much were you taking? Also, was the fsh called Ovidrel? We've found hmg and Ovidrel to be insanely expensive. We have good insurance but no doctors who will prescribe it :( Lastly, are Mom and baby healthy? Praying her pregnancy went smoothly with no issues. Looking forward to a response! :)
You can try just hcg. Hmg May or may not be necessary. It was not necessary for me. There are studies that show hcg also has some fsh activity. By adding just hcg at 500iu eod my number went to over 115mil.
 
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