Fertility Recovery - Wife Unimpressed With Sterility

Been a while, but some news...

The two miscarriages we had last year were very frustrating, specially for my wife. Consequently, we decided to just take a break from 'trying'.

At some point around Jan 1st 2021, I also decided to stop taking clomid. It had been approx 14 months of consistent usage and I believe the stoppage was overdue. I am certain that during this time the floaters in my eyes increased markedly. During the earlier part of this year I had my share of 'what have I done?' moments - thinking that somehow I would be one of the guys who would never get back to 'normal'.

As of August, 2021 we found ourselves ready to dig in again. We started with a semen analysis. My wife found a proper at home test (sent to a lab, of course) so we submitted the sample. I think we both hoped the simple patience would pay off, however, initial results were quite disappointing:

Sampled on 8/12

Total Motile Count: 3.3 million. Normal is 20 mil+.
Concentration: 12.2 million/ml. Normal is 15 mil+
Motility: 13.5%. Normal is 40%
Morphology: 5%. Normal is 4%

A mixed bag - on one hand encouraging, my analysis during trt was totally zeroed out basically. On the other hand, it had been closer to two years since I had quit TRT, and 7-8 month since cutting the clomid. A bit discouraging. All the while I had been keeping an open line with an HCG/FSH supplier in India, telling my wife that if it came to it, that would be fine. Inside, however, I was not excited to mess with my hormones that much again. The obvious next step was some more tests:

Drawn on 9/22/21

Prolactin: 14.38 ng/mL (4.04-15.2)
LH: 6.61 mUI/mL (1.7-8.6)
FSH: 2.82 mUI/mL (1.5-12.4)
Estradiol: 35.1 pg/mL (15.5-63.3)
Progesterone: .49 ng/mL (.20-1.4)
Testosterone: 471 (249-836)

When I started TRT, I had had all results come back in the low 300 range. Seeing it up close to 500 was very exciting for me. Then seeing my LH and FSH both within range was like hearing TNT by AC/DC again for the first time. We decided to be patient and have some more labs done the following month:

Drawn on 10/26/21

Prolactin: 14.24 (4.04-15.2)
LH: 5.58 (1.7-8.6)
FSH: 2.91 (1.5-12.4)
Estradiol: 31.4 (15.5-63.3)
Progesterone: .56 (.20-1.4)
Testosterone: 510 (249-836)

Both of these draws were taken between 10:30-11 am. Also, bonus round - very positive for Covid antibodies 9 months after my infection. I have either had it again, without realizing it, or Fauci is a fool. Also, was very happy to see everything stable more or less and with T over 500. I do wonder if my FSH will continue to increase, my basic understanding is that it is slower to rebound than LH. New semen analysis was next:

Sampled on 11/16/21

Total Motile Count: 154.2 million. Normal is 20 mil+.
Concentration: 94.4 million/ml. Normal is 15 mil+
Motility: 81.7%. Normal is 40%
Morphology: 10%. Normal is 4%

It seems I am back to normal+. To be clear, I never did end up using FSH/HCG combo to restore my fertility, only HCG for a small window a couple years back to 'kick-start' (see details above). I will probably do some more labs, out of curiosity, around the new year and we will start trying.
 

hCG Mixing Calculator

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TRT Hormone Predictor Widget

TRT Hormone Predictor

Predict estradiol, DHT, and free testosterone levels based on total testosterone

⚠️ Medical Disclaimer

This tool provides predictions based on statistical models and should NOT replace professional medical advice. Always consult with your healthcare provider before making any changes to your TRT protocol.

ℹ️ Input Parameters

Normal range: 300-1000 ng/dL

Predicted Hormone Levels

Enter your total testosterone value to see predictions

Results will appear here after calculation

Understanding Your Hormones

Estradiol (E2)

A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.

DHT

Dihydrotestosterone is a potent androgen derived from testosterone. Affects hair growth, prostate health, and masculinization effects.

Free Testosterone

The biologically active form of testosterone not bound to proteins. Directly available for cellular uptake and biological effects.

Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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