28 year old male. I got my blood work done after the typical low test symptoms came back at sub 300. Probably due to some military/natural causes prior.
I was a little ignorant when I first started and my trt clinic never got LH/FSH on my bloods. I’m currently 3 weeks into 150mg test a week over 3 doses as well as HCG at 1500iu a week over 3 doses on days I don’t take my test. I’ve scheduled a “fertility” test with my doc which will probably end up being a semen analysis if I had to guess. As most people recommend getting one prior to starting TRT, will the fact that I’ll take one a month after starting show any decrease in sperm production?
Any other recommendations as far as fertility support during this? Are most of you having success with hcg? Will probably start looking to have kids within the next 2-3 years.
Thanks gents
Unfortunately you would always need a baseline before jumping on exogenous T to see where such markers truly sit.
Any doctor in the know who understands this would get a baseline SA before any man interested in maintaining fertility starts exogenous T.
Your doctor is out to lunch here.
There will be a strong suppression LH/FSH within the first few weeks and near undetectable levels 4 weeks in as the hpta will be shutdown.
Semen parameters (concentration, count, motility) will begin to decline within 2-4 weeks of starting T with significant suppression 6-12 weeks in.
Full effect on spermatogenesis takes longer due to the ~64-74 day sperm cycle.
Your starting dose 150 mg T (split 3x weekly) with hCG thrown in to boot is overkill.
Such dose will most likely have your trough FT too high off the hop which is going to have a big impact on driving up your hematocrit and hammering the s**t out of your dopamine and CNS!
Making a big mistake here jumping in head first.
Last thing you want to do here is drive up your trough FT too high off the hop.
Most of those dime a dozen run of the mill T-clinics are notorious for overmedicating men on T from the get-go.
The standard starting dose across the board by those in the know is 100 mg T/week or 50 mg T twice-weekly.
There will always be time to increase your dose or add hCG if need be.
Most men on TTh are injecting 100-200 mg T/week whether once weekly or split into more frequent injections.
The majority of men can easily achieve a healthy/high trough FT injecting 100-150 mg T/week especially when split into more frequent injections.
Some can achieve stellar levels injecting <100 mg T/week especially when split into more frequent injections.
Yes there will always be those outliers who may need the higher-end dose 200 mg T/week but its far from common as in rare!
Such dose would have the majority easily overmedicated.
Complete overkill here.
Always best to start low and go slow on a T-only protocol you can see how your body reacts to testosterone and where said protocol has your trough TT and more importantly FT, estradiol let alone critical blood markers RBCs, hemoglobin and hematocrit.
Blood work will be done 6 weeks in once you have reached steady-state (4-6 weeks TC/TE).
We always want to test at the true trough (lowest point) before your next injection.
All that should really matter here is the dose one needs to achieve a healthy trough FT which will result in relief/improvement of low-T symptoms and overall well-being.
Yes symptom relief is what truly matters but when it comes to what FT level is needed one needs to keep in mind the overall goal would be to use the least amount in order to feel well while at the same time minimizing sides and keep blood markers healthy long-term.
If one feels great overall blood markers are healthy/minus any sides then I see no issue running a higher trough FT level (within reason).
Nelson's Excel kicking facts here!
Dr. Bernie dropping gems!
Something everyone needs to keep in mind here!
* There are very few large RCTs comparing theses strategies in the fertility-seeking hypogonadal male!
Limitations/Future Directions
Key Takeaways
Fertility Preservation in Hypogonadal Men (2018)
Robert J. Carrasquillo and Ranjith Ramasamy
Introduction
Testicular failure is defined as the impairment or loss of both the endocrine functions of the testis (production of testosterone, or T) and exocrine function (production of spermatozoa). Testicular failure can result from the pathology of the testis itself or disorder at any point in the hypothalamic-pituitary-gonadal axis. Primary testicular failure is characterized by normal/low T in the presence of the elevated follicle-stimulating hormone...
Hot off the press!
25th Annual Fall Scientific Meeting of SMSNA!
Grapevine, Texas!
Great presentation!
1:29:40-1:43:30
Conclusions
Introduction Androgens play a crucial role in the development and maintenance of: Male reproductive and sexual functions Body composition Erythropoiesis
www.thebloodproject.com
Introduction
- Androgens play a crucial role in the development and maintenance of:
- Male reproductive and sexual functions
- Body composition
- Erythropoiesis
- Muscle and bone health
- Cognitive function
- Testosterone falls progressively with age and a significant percentage of men over the age of 60 years have serum testosterone levels that are below the lower limits of young...
