I was azoospermic after a year on pellets, no HCG. I have a better physician now and doing great on IM Test Cyp and HCG. Testicle size full recovered. Anyone know if I must stop TRT completely to restart spermatogenesis or can HCG be enough while continuing TRT? The idea of stopping is dreadful.
Azoospermia: No Sperm on Testosterone Pellets
- Thread starter Jntsrgn
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What dose of HCG are you currently on?
To answer your question, the chances are pretty high that you don’t need to stop the testosterone while trying to regain fertility. I wasn’t even trying to get anyone pregnant, and knocked up my ex girlfriend while being off of HCG for two months. Was on test and HCG for years, then stopped HCG and kept using testosterone, and got her pregnant 2 months later. Have a boy coming in December.
I would imagine that fertility can be improved even further if you’re actually trying and implement Clomid, FSH and/ or HMG. But 1000iu’s/ week of HCG was enough for me while using testosterone propionate.
I've been on testosterone for over 27 years, and I was able to bring back my fertility over the course of a year, from zero sperm count (azoospermia) to 31 million/ml, using HCG and later HMG and FSH, without ever coming off of testosterone. My wife is currently 6 months pregnant and we are expecting our healthy baby daughter in November.
As long as you didn't have any underlying fertility issues before you started TRT, you should be able to restore your own fertility using HCG, and if necessary HMG or FSH.
It worked for me and others, and hopefully it will work for you as well.
As long as you didn't have any underlying fertility issues before you started TRT, you should be able to restore your own fertility using HCG, and if necessary HMG or FSH.
It worked for me and others, and hopefully it will work for you as well.
Thanks for sharing your experience. Do you mind posting your doses for each compound?
Well, my fertility program evolved over the course of a year, trying to find doses that worked best for me personally, and always depending on what my doctor would agree to prescribe (initially he refused to prescribe HMG or FSH), and what I could find access to on the black market that he wouldn't prescribe. People can search my old posts for more details, as the program changed as I went along. I used Clomid, Proviron, and Letrozole as well as HCG, HMG, and FSH, but I don't feel the other compounds added much if anything to the program. My doses went up or down depending on how the side effects effected me.
But to sum it all up, if I had to do it all over again, I would have stuck with:
200mg Testosterone per week (or whatever TRT dosage works best for you.)
500iu HCG every other day
30-60iu HMG or FSH per day (60iu would be in divided doses, 30iu in the morning and 30iu in the evening, because of the short half life of FSH.)
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Much appreciated! I guarantee this info is going to help a lot of guys in the future.
Thanks, I hope so. Too many doctors, including fertility and TRT doctors, are still stuck in the past and want guys to come off testosterone when fertility becomes a priority. But that leads to low libido, and the health issues which were why we all started testosterone therapy in the first place.
If only more doctors would read the work of pioneering doctors like Larry Lipschultz, John Crisler, and others who have advocated the use of HCG to maintain or regain fertility while staying on testosterone. And if only more doctors would be willing to prescribe HMG or FSH to men who need it for fertility reasons. The studies are out there that show that it works, and there are plenty of guys like me who have successfully used Test + HCG + HMG/FSH to regain their fertility, even after decades of testosterone use.
3 months until my little baby daughter is due to be born, and plenty of changing diapers in my future LOL.
Haha, same here. Got my first son coming in 3 months, which was conceived just using testosterone and HCG. Didn’t even need HMG or FSH, and was actually off HCG for two months during the time of conception. Unless you have some type of medical condition that causes you to have fertility issues prior to starting HRT, fertility should not be much of a concern while on HRT, imo
Thank you very much. I have not rechecked a count since starting HCG 3 months ago but I will soon. My understanding is that Clomid has zero effect if you are taking any exogenous testosterone.
Regarding Clomid, it is the consensus of many experts, and it certainly was my experience, that Clomid doesn't do much, if anything, positive, and only has negative side effects for men taking exogenous testosterone.
I used Clomid at 50mg per day because my fertility doctor insisted on it, and he initially refused to prescribe HMG or FSH. But after seven months on Clomid and HCG (and Proviron), my sperm count had only come up from zero to 7 million/ml.
All that Clomid seemed to do for me was make me moody, miserable, and increase my SHBG to ridiculously high levels (112 nmol/L at the highest point measured, as compared to 40 on my latest blood test.)
Once I added in HMG, and later FSH, my sperm count rapidly rose over the next few months to 31 million/ml at the time of our IVF procedure. I'm sure that it would have continued to rise much higher, but that was all we needed. My sperm successfully fertilized my wife's eggs, and gave us 3 embryos that survived to become 5-day blastocysts, of which one is our healthy baby girl now growing bigger every day in my wife's uterus, and due to be born in November.
So if I had to do it all over again, I would have stayed away from the Clomid, and stuck to Test + HCG + HMG, or Test + HCG + FSH. My advice to you is to do the same. And if your fertility doctor refuses to prescribe HMG or FSH, find a new doctor. Too many doctors are still stuck in the past, using antiquated methods, when there is plenty of research out there showing that newer methods work better.
HCG is still necessary if you can get HMG? My impression was that HMG gave both the LH and FSH effect. I’m not having much luck finding HMG.
HCG is still necessary, even when using HMG. HMG is a mix of FSH and LH, but there is not enough LH to maintain high enough intra-testicular testosterone levels. And the half-life of injected LH is very short, while the half-life of HCG is much longer, which makes HCG much more user-friendly. You will need to use HCG, along with either HMG or FSH, to have high enough ITT levels for optimal sperm production. Use the HMG for its FSH content, and use HCG as a replacement (analogue) for the body's naturally occurring LH.
Recovery of spermatogenesis following testosterone replacement therapy or anabolic-androgenic steroid use
"FSH given alone or in combination with testosterone has proven unsuccessful at inducing spermatogenesis or maintaining spermatogenesis in those previously induced with hCG/FSH (hCG 1500 IU and HMG 150 IU both subcutaneous and 3 times per week), confirming the need for maintenance of elevated ITT.46 However, long-term use of hCG alone can induce spermatogenesis in up to 70% of patients, with a greater effect seen in men with initial testis length >4 cm, but further improvement is appreciated with the addition of FSH (HMG) suggesting a timelier recovery with both gonadotropins.47 The success of inducing spermatogenesis with a combination of hCG and FSH is supported by several studies (Table 1).41,42,45,48,49,50,51,52,53 In these data, most begin by stimulating endogenous testosterone production with trial of hCG alone with doses ranging from 1500 to 5000 IU 2–3 times per week titrated according to serum testosterone levels. Most experts treat with hCG alone for 3–6 months after which a certain number of cases will result in spermatogenesis induction. In those without adequate spermatogenesis induction, treatment proceeds with the addition of FSH with doses ranging from 75 to 400 IU 2–3 times per week titrated according to semen analysis results. Success defined as induction of spermatogenesis with >1–1.5 × 106 ml-1 sperm was reported to occur in 44%–100% of patients treated for 6–144 months.52 "
My doctor refused to prescribe HMG, and initially refused to prescribe FSH, so I had to find my own black market sources, imported from overseas. For HMG, I used both Menopur by Ferring in Portugal, and Merional by IBSA in Turkey, both were excellent. Try searching for both from online pharmacies, and if you need any help finding them, feel free to message me.
Best option is if you can get your doctor to prescribe FSH or HMG from Empower Pharmacy right here in America, as that is the least expensive FSH I have found from a domestic US pharmacy. But they require a doctor's prescription, and sometimes it is hard to find a doctor who will do the right thing for you. So we have to do what we have to do to accomplish the goal. But at least try to get your doctor to legitimately prescribe it, and if that's not possible, then there's always a way to get the job done.
MENOTROPINS (HMG) INJECTION | Compounding Pharmacy - Empower Pharmacy
FSH INJECTION | Compounding Pharmacy - Empower Pharmacy
Maximus220rr
Member
Were u doing 500ius eod or just twice a week? Od u did a true eod it would be like 1500ius a week for hcg.Did u use an ai? Any high e2 sides? What dose of test did u do or doing?
By the end of the program, I had settled on 500iu of HCG every other day, which is what I would recommend to others, and what worked best for me. I used different doses of HCG over the 11 months I was on the fertility program, from as little as 100iu every day, to as much as 3000iu EOD at the direction of my doctor, which was way too much and gave me very bad side effects. 500iu EOD seemed to give me the best compromise of increased sperm count with a minimum of side effects.
I did have high E2 side effects, especially when I was on higher amounts of HCG, so my doctor prescribed me Letrozole. But I react badly to AI's, and even as little as a quarter tab of Letrozole every other day crashed my E2 to less than 5 pg/mL, leaving me with low E2 side effects and poor libido. If I had to do it all over again, I would keep the amount of HCG reasonable, no more than 500iu EOD, and I would avoid the use of the AI altogether.
I used 200-300mg of Test Cypionate per week throughout the program, and never went off Test. I've been using Testosterone for over 27 years now, and it has always been very good to me.
StillPushin
New Member
This is very promising news! I am currently in the baby making struggle. I didn’t start using HCG until very recently after being on TRT for about 5 years. I’m delighted to read that you were able to continue using testosterone along with the HCG and HMG. I see that you were on a fertility program for 11 months. At what point in those 11 months did you add the HMG? And how long were you on the HMG before you were fertile? And would it have been possible with just HCG in your case? I realize that everyone different. Many thanks!
I never used HCG either, for 25 years, until I married my new wife, and we started trying for a baby. In November of 2017 I had a zero sperm count, and I started using HCG, Clomid, and Proviron. But when I did a semen analysis in May, my sperm count was only up to 4 million/ml, with very poor motility. In June of 2018, it was only up to 7 million, after 7 months of using HCG, and my wife and I were approved by insurance to do IVF.
But starting in July, I started using HMG, first Menopur by Ferring, then Merional by IBSA. I used the HMG through July, August, and September, and in October of 2018, when my wife and I did our IVF procedure, my sperm count was up to 31 million per ml, with much improved motility.
So I did regain some amount of fertility just using HCG, but the HMG did make a huge difference. A sperm cycle is about 2.5 months, so the HMG I was using in August paid off for me in October.
If I could do it all over again, I would have used HMG or FSH from the beginning, and I am sure I would have had even better results. But my doctor refused to prescribe either for me, so I was limited to what I could get from the black market.
It all worked out in the end, and I am grateful for that. I hope that it works out for you as well.
But starting in July, I started using HMG, first Menopur by Ferring, then Merional by IBSA. I used the HMG through July, August, and September, and in October of 2018, when my wife and I did our IVF procedure, my sperm count was up to 31 million per ml, with much improved motility.
So I did regain some amount of fertility just using HCG, but the HMG did make a huge difference. A sperm cycle is about 2.5 months, so the HMG I was using in August paid off for me in October.
If I could do it all over again, I would have used HMG or FSH from the beginning, and I am sure I would have had even better results. But my doctor refused to prescribe either for me, so I was limited to what I could get from the black market.
It all worked out in the end, and I am grateful for that. I hope that it works out for you as well.
StillPushin
New Member
Absolute gold! Your posts along with healthman’s thread answered so many of my questions. Congratulations, and thanks for the encouragement! I’m also leaning toward HMG as soon as possible.
@Sides it’s crazy to think that your posts might be the single best source of information, in regards to TRT and fertility, on the internet today, no exaggeration. Best I’ve seen at least, by far! Thanks so much for your contribution! Guarantee your anecdotal experience and advice will help more men than you can imagine in the years to come.
xqfq
Active Member
Anyone interested in learning more should check out this video by Dr. Thomas O'Connor on fertility on testosterone (& steroids):
It's a wealth of knowledge and first-hand experience!
@Gman86 thanks, I really appreciate that, and I've learned so much from your posts as well. I had to do a tremendous amount of research on fertility back in 2017-18 so that my wife and I could have our baby. I made a lot of mistakes, but also got a lot of things right, and I learned a great deal from the experience. Now that we've been blessed with a child I know that I am responsible for passing on what I've learned, so that it's easier for other people in the future.
Now if only someone would volunteer to come help me change diapers... ;-)
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