Have questions on what to do about no sperm and using HCG

[giants23]

Need Help. Trying for 1st baby...ON HCG but not working yet to bring up my motility. Nelsen I have read a lot of what you have posted on about HCG. I am new on here and frustrated. I don't smoke or drink. I was on TRT for quite a few yrs when a doctor told me I had a low T back in late 20's early 30's.. they measured my T in 2 ways...Normal range 400-800 roughly and 10-59 on a different number test..Not sure what milligrams or metric measure they used...I kept falling between 50-200 or 8-27....I was prescribed 2 CC's every 2-3 weeks that put me at around 780 peak....I liked injections so much better than gels due to transfer in contact and it made my arms hairy where they were not before on gels. 2 different women over that time period. I got both pregnant(both were there first pregnancies) both miscarried after a little over 1-2 months...NONE of these doctors told me TRT would affect my Sperm counts....My current wife was pregnant 4yrs ago after she was on the pill and I still got her pregnant while on TRT to boot! In the last yr n half I have not done any TRT due to after going to fertility center they said I had 0 Sperm! I was prescribed HCG shots with Clomid 2500 IU per shot every 3 days and clomid once a day for about 5 months....Then I went off for 4 months to check to see if my sperm and testosterone kicked in more....It had my testosterone levels in the high 200's low 300's...but still no sperm..I then went to a new doctor DR Sher who is pretty famous and has been on talk shows. I now have been taking for 4 months 5000IU's per shot every 3 days and is expensive as hell! 550.00 for 1 month supply! I keep seeing much cheaper prices on SAFEMEDS and other online pharmacies but keep getting worried if its going to be the real thing like here in USA. Neither of us have kids and both want them bad.

 

[Vince Carter]

I wouldn't say, what my experience tells me from your post, that you haven't been treated in good conscience, none of what you describe is how we approach TRT. 2cc's every 2-3 weeks....that's just archaic. 5000iu HCG every 3 days...an enormous dose. I'd hazard a guess on the reckless treatment you received for years, maybe the end game was sterility. It's not hard to induce organ failure of the testes if you're on TRT for "quite a few years" and not using HCG regularly.
You need to get down to the root cause of your obvious sterility. You're showing zero on more than one test. You might just have to accept it. I'd suggest there could be some malpractice involved. But if you're now sterile, I'm no Dr, but I don't think you come back from that.

 

[giants23]

Do u know what the regular amount of Testosterone replacement therapy should be? I felt way better on 2 CCs every two weeks? Is that normal dose? When the doctor prescribed that hormone replacement they never told me that it lowers your sperm count or shut your own system down. They were just treating me for low T. The first fertility place told me to take a shot every 3 days of HCG 2500 IU to see if that would boost my count back up when I discovered I had zero sperm showing up on the test. I read it could take up to two years. After three months it hadn't improved so they said I need to do surgery to extract it but how do you know if you have any if it's not showing up on the test? It seems like it would be a waste of money so I went somewhere else. I tested my levels and it did bring my testosterone level up but only in the two to three hundred range so the new doctor prescribed 5000 Pro Shot and it doubled my testosterone. Sperm count was 12 million but not motile. I tried fertilaid, countboost, proceptin and nothing helped yet. Do I give it more time? If it doesn't come back do I even need to take HCG and or should I take a combo of that and testosterone still?

 

[ERO]

State of the art TRT means T injections every 3.5 days or even more often. Once every two weeks is like a decade or two out of date. Test Cyp has an effective half life of about 6 days, so its pretty obvious that a shot every two weeks is a disaster.

My 2-cents: Give Defy Medical a call and get a consult at least. It will be money well spent as many of us here use and highly recommend them. They do great work and they can get you an up-to-date protocol.

 

[giants23]

Ok thank you very much

 

[Nelson Vergel]

Giants23

Just tell your doctor to put you on 150 mg T cypionate and 500 IU HCG every other day per Lipshultz protocol. Do a sperm test 8 weeks after. If you got good sperm, have it frozen! No need to panic.

Get HCG cheap at Empowerpharmacy.com

 

[Re-Ride]

5000 Pro Shot eh? Only available with the the Platinum or Elite membership I suspect. With any luck that's just a marketing name and not the # of IU in the dose. So you took this Pro shot MWF and your serum T doubled to about 600 after only achieving 200-300 on 2500 IU MWF? Might be worthwhile to try a branded product like APP or Novarel or trusted compounded EOD or E3rdD for a month at 350 to 500 IU and re-testing including E2 sensitive. Perhaps you are making T but aromatizing. You need a new doc.

"Surgery to extract it"
I'm visualizing a micro vacuum pump implant, Bluetooth controlled from your eyephone. This really means aspiration with a needle.

I don't want to make light of a condition which is causing angst. You looked for sperm four months AFTER going off the hCG 2500 IU MWF? When using hCG as a male fertility booster the semen is tested the morning after. In hCG naive individuals an old fertility protocol was one massive dose up to 10k IU. You can try this before you go back on TRT to preserve your health. Staying healthy with good serum levels of T along with other hormones in range would be my primary goal.

150 mg T-cyp per week with up to 500 IU hCG twice a week is a standard TRT protocol for men trying to preserve healthy testicular tissue. Using hCG EOD as Nelson mentions might help. Worth a try I suppose. There is no "regular amount" of T only a bell curve. Your dose needs to be dialed in with serum monitoring.

Threads here explain why we speak of T in mg per week rather than doses in cc's. When using a 200 mg/ml preparation the weekly total volume is 0.75 cc in the above protocol or 0.375 of one ml ( one cc ) with each of the two weekly injections. Easy to draw precisely with an insulin syringe.

Wishing you success with fertility treatment. Don't compromise your health pursuing it over TRT though.

 

[giants23]

Thanks alot guys...I was never told that taking TRT would stop sperm production. I tested sperm while taking HCG and the volume went up but no motility. After 4 months of 2500 IU per shot the doctor told me to go off of it for 5 months. Retest in 3 months to see if my own body kicks back in. It did not. It did bring my T level up but not to normal so he doubled the dose to 5000 IU and it got my T in the 400's...On reg TRT my okd doc had me in the 700s and I felt much better...I have only recently read about doing HCG and TRT. I hope it comes back as I am too afraid to go back soley on TRT as I want to have a child. I will try empower pharmacy instead of going thru these super expensive specialty pharmacies...just worried online if its the real hcg and not a fake....What does Aromatizing mean? I just want to get back to normal but nobody knows why my levels are low...Im pretty healthy n dont drink, dont smoke and never did any kind of drugs

 

[Re-Ride]

The pursuit of endocrine health in the absence of patient education is an exercise in futility as you've already learned with TRT. Your priority Giants is fertility. Regardless of what anyone here says it appears this isn't gong to change. 5,000 IU of hCG MWF is nuts. Continuing a pt on a protocol which only achieves serum tot T of 400 while leaving him feeling unwell is bad medicine.

Many of us including myself arrived here in a dire condition after relying, often for years, on poorly trained docs or those with agendas. Rethink the advice given by Nelson,ERO and Vince Carter.

 

[CoastWatcher]

You asked what "aromatizing" meant. It is the physiological process in the male body whereby testosterone is converted to estrogen.

 

[CoastWatcher]

The pursuit of endocrine health in the absence of patient education is an exercise in futility...Continuing a pt on a protocol which only achieves serum tot T of 400 while leaving him feeling unwell is bad medicine...Many of us including myself arrived here in a dire condition after relying, often for years, on poorly trained docs or those with agendas.

You have learned a very painful lesson - it is imperative that we become our own advocates. That means we have to self-educate in regard to whatever cards we are dealt as far as our health goes. You have bounced through the system and all you have to show for it is a mishandled TRT protocol and possible/likely sterility. No, it isn't fair. Please reconsider the approach you are taking, consult with a competent doctor, and see what can be salvaged from the way you have been treated. I do wish you success.

 

[giants23]

Thanks alot guys. I really really appreciate the feedback....so frustrating as Im still young, have the right woman in my life finally just not the right doctor from what I am seeing...All I want is the right Testosterone level and the sperm count to get to normal. Each doctor is different but all fertility doctors have said dont do TRT as it shuts your own body down to 0 sperm. HCG is supposedly used to bring it back up and kick start your system. I have been off the TRT for exactly 17months. Tried HCG 2500 IU's per shot 3 times a week from Feb 2016 until June with clomid 1 a day prescribed. Next fertility doctor I sought out said get off everything and test in 3 months. My T was low 167 but it was higher than what I tested out before using HCG so it kicked me in some what and no sperm. From July 2016 to Nov 2016 I took nothing. Then that new fertility doctor said lets try 5000 IU per shot n see if ur T level kicks in higher (which it did to the 400's) but sperm still a problem. Didnt give me clomid or any Estrogen blocker as he said thats not good to stay on that but what if it turns to Estrogen?..Is it possible its too much HCG over killing the sperm to be able to produce vs helping it produce? I am 5'9 200lbs where i used to be ripped 180lbs.. I have read that if hcg is too high a dose it shuts ur Leydig Cells down or burns them out....seems to me self analyzing it, Ideally have your T at 600-700 and sperm count 20 mill or more....I dont know how to get there. I tried countboost, fertilaid, proceptin....The odd thing is before I ever heard of HCG, my wife was on the pill, I was on T shot but running and working out. She got pregnant and miscarried 7 weeks later. We thought she had the problem so when we went to a fertility doctor and they did a sperm count on me it showed zero and that's where I learned about HCG in Dec 2015 so I stopped taking T shot. HCG has increased the volume amount but not motility etc....I dont know if endocrinoligist is better or fertility or combo of both....somehow i gotta get the T normal and the sperm there

 

[Vettester Chris]

Why not focus on the FSH analog and look at HMG (encompasses both LH & FSH)? The sertoli cells should be more of the focus IMO ...

 

[giants23]

I have been told HMG injections are thousands of dollars? I am looking at my last test results in January after taking 5000 per shot or 2 shots per bottle.

Testosterone 468. Was 167 while having no shot
FSH is high at 9.1
LH 3.1 a little low
Prolactin 6.2
TSH 3.09
Estradiol while off shot was 19 but wasnt tested on this recently after HCG 5000 a shot
DHT or Dihydrotestosterone in Aug 2015 was 11L but normal range says 16-79. That was also after i quit HCG in July and was on nothing...T went down
Semen analysys
- 7.4 mL Volume up from 3.4 on last test
Concentration: 0
Motilility 1% 2-3 sperm
Im wondering if it's working n just takes time to come back or too much is being given stifling progress?

 

[Re-Ride]

HCG is supposedly used to bring it back up and kick start your system.

Wrong. hCG is similar to LH and capable of stimulating the Leydigs to producing T. Just like exogenous T though your hormonal axis will be be shut down or impaired. You doc should have put you on a post cycle therapy aka "restart". The next doctor, for fertility purposes might have tried one or two high doses of hCG but then should have concluded that you are at least partially primary hypogonatic (testicular failure) and discontinued or reduced hCG dose. It seems your testes have some function so they should be maintained at the minimum hCG dose which is effective for you. Taking more than that is wasteful and likely will result in unwanted estrogen produced within the testes themselves.

Another reason to take hCG is that in small doses LH receptors in the central nervous system benefit which can translate to less pain and better mood, perhaps better cognition.

I agree that you should avoid aromatase inhibitors whenever possible and you likely can. Arimidex can be a valuable to when carefully used. I don't know what you can do about the fertility issue if anything. Read the new pt intake at Defy and get those labs done then consult with Drs. Saya or Crisler. They can help you with a proper restart if appropriate and/or get you on proper HRT which you are very likely going to need. Nelson suggested a protocol that might help both your sperm count and your your low T. Discuss that with your new doc.

I would consider contacting Nelson about the coaching he offers.

 

[giants23]

Man all of you are a great help. You seem to be more in tune than the actual doctors...I will contact Defy Medical...

 

[giants23]

Thanks for everything Nelson I really really appreciate it!

 

[Dr Justin Saya MD]

For OPTIMAL fertility you have two options:

On TRT: HCG + HMG (HMG doesn't cost thousands but is relatively expensive)

Usually *adequate* fertility can be achieved while on TRT with HCG alone, but you're case sounds like it would call for a more aggressive approach.

Off TRT: Clomid -> this would likely give you the BEST chance at regaining fertility, but would be more challenging to dial you in to feel your best.

**If your sperm count remains zero after being on an appropriate Clomid regimen for a few months, you are indeed sterile.

Hope to talk/help you soon if you get in touch with us. Best of luck!

 

[giants23]

So your saying try clomid all by itself for a few months without any HCG or THT? How often would be the clomid dosage? Is there cheaper places to buy HMG? I saw safemeds.com but have no idea if its legit..empowerpharmacy is another that Nelson suggested. I was told it was extremely expensive for HMG even way more than HCG...right now Pregnyl on 1 months supply at 5000IUs a shot is costing me 574.00 and Novarel was 700...I liked what I read on your findings at using 500 a shot instead with combo of TRT. Could this 5000IU's also cause Leydig Cells to be desensitized rather than help since its so much? Is my case better off not touching the TRT yet and just stick to HCG/HMG/Clomid? Very frustrating as if I would have been told yrs ago TRT would lower sperm I wouldnt have taken. I even got my wife pregnant 3-4 yrs ago while i was on TRT, she was on the pill and had no clue about HCG but she miscarried... all of these doctors try 3 months with HCG and then say nothing they can do or suggest extracting right from scrotum for over 20K...if i have none on semen analysys then why waste money doing that until I see some results from HCG... on the forums it says it could take up to two years for that to come back to normal on HCG. You know you guys in just two days have been more help than I've had in 2 years from any professionals that I have spoken with. Some of them are renowned in their industry, been on talk shows and have not come up with anything or maybe just not spent enough time looking for an answer...I am my dads only son. Wife only daughter to her parents. We desperately want a baby as it stops with us in our family tree....wife is testing perfect although miscarried due to fibroid back then..she is 30 and I just turned 40...past relationships had kids already n tubes tied so never knew anything bad could come of TRT shutting me down...even when i was younger my gf miscarried and I got her pregnant first time we did it....

 

[Dr Justin Saya MD]

If you are going to use HCG + HMG you need to get it from a compounding pharmacy for MUCH CHEAPER than the brand name (Pregnyl).

If FERTILITY alone is your top priority, as it clearly sounds from your posts, then Clomid is the BEST and CHEAPEST option for you assuming that your pituitary is capable of producing adequate LH+FSH - this would be determined with f/u testing (note you cannot be on TRT while taking the Clomid - it will not work as intended).

For your fertility purposes, basically a "last resort", your Clomid dosing would likely be in the 25-50mg per day range with follow-up testing and semen analyses' to titrate.

You should work with a qualified physician for this. My heart breaks for you based on your experiences up to this point.