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Testosterone Replacement, Low T, HCG, & Beyond
Clomid for PCT, fertility or low T
Fertility help...again
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<blockquote data-quote="Cataceous" data-source="post: 177519" data-attributes="member: 38109"><p>For most guys, exogenous testosterone negates the desired effects of SERMs and AIs on the HPTA. Refer to this illustration:</p><p></p><p><img src="https://asih.net/images/hpta-feedback-loop.gif" class="bbImage" alt="" data-url="https://asih.net/images/hpta-feedback-loop.gif" style="width:150px;" /></p><p>What is desired is to stimulate natural LH and FSH production. SERMs such as tamoxifen block the negative feedback of estradiol at both the hypothalamus and pituitary. An AI like anastrozole does something similar by reducing the total amount of estradiol. The problem is that there's also negative feedback by testosterone at the hypothalamus. This limits the necessary GnRH output, which in turn stops production of LH and FSH. If your husband is highly motivated then it is possible to bypass the hypothalamus by injecting GnRH directly. But it requires frequent administration or an infusion pump. It's unclear if this would significantly improve fertility. The large doses of hCG are already equivalent to massive amounts of LH. So it's a question of whether adding native FSH to the modest injected doses would help. In the end it might be easier to bite the bullet and stop everything except a SERM, which typically provides the best fertility.</p><p></p><p>Per Dr. Saya:</p><p style="margin-left: 20px"><em>A *very* generalized ranking of relative fertilities (with top being most fertile):</em></p> <p style="margin-left: 20px"></p> <p style="margin-left: 20px"><em>1. Clomid/SERM treatment</em></p> <p style="margin-left: 20px"><em>2(A). HCG + HMG (or lyophilized FSH)</em></p> <p style="margin-left: 20px"><em>2(B). Baseline no treatment (no HPTA suppression via TRT, AAS, HCG mono, etc) - assuming no significant degree of primary/secondary/tertiary dysfunction.</em></p> <p style="margin-left: 20px"><em>3(A). HCG monotherapy (does in fact result in HPTA suppression, especially at higher doses, but *may* move up to #2 in select cases of SECONDARY/TERTIARY hypogonadism)</em></p> <p style="margin-left: 20px"><em>3(B). TRT + HCG (as we know many men are still able to maintain adequate fertility to conceive)</em></p> <p style="margin-left: 20px"><em>4. TRT/AAS with no concurrent HCG.</em></p></blockquote><p></p>
[QUOTE="Cataceous, post: 177519, member: 38109"] For most guys, exogenous testosterone negates the desired effects of SERMs and AIs on the HPTA. Refer to this illustration: [IMG='width:150px; width="150px"']https://asih.net/images/hpta-feedback-loop.gif[/IMG] What is desired is to stimulate natural LH and FSH production. SERMs such as tamoxifen block the negative feedback of estradiol at both the hypothalamus and pituitary. An AI like anastrozole does something similar by reducing the total amount of estradiol. The problem is that there's also negative feedback by testosterone at the hypothalamus. This limits the necessary GnRH output, which in turn stops production of LH and FSH. If your husband is highly motivated then it is possible to bypass the hypothalamus by injecting GnRH directly. But it requires frequent administration or an infusion pump. It's unclear if this would significantly improve fertility. The large doses of hCG are already equivalent to massive amounts of LH. So it's a question of whether adding native FSH to the modest injected doses would help. In the end it might be easier to bite the bullet and stop everything except a SERM, which typically provides the best fertility. Per Dr. Saya: [INDENT][I]A *very* generalized ranking of relative fertilities (with top being most fertile):[/I][/INDENT] [INDENT][/INDENT] [INDENT][I]1. Clomid/SERM treatment[/I][/INDENT] [INDENT][I]2(A). HCG + HMG (or lyophilized FSH)[/I][/INDENT] [INDENT][I]2(B). Baseline no treatment (no HPTA suppression via TRT, AAS, HCG mono, etc) - assuming no significant degree of primary/secondary/tertiary dysfunction.[/I][/INDENT] [INDENT][I]3(A). HCG monotherapy (does in fact result in HPTA suppression, especially at higher doses, but *may* move up to #2 in select cases of SECONDARY/TERTIARY hypogonadism)[/I][/INDENT] [INDENT][I]3(B). TRT + HCG (as we know many men are still able to maintain adequate fertility to conceive)[/I][/INDENT] [INDENT][I]4. TRT/AAS with no concurrent HCG.[/I][/INDENT] [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Clomid for PCT, fertility or low T
Fertility help...again
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