HCG and Fertility post TRT

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Pipster

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I am a 40 year old male with no health issues. I was on TRT for about 18 months at a dosage of ~150mg split into 2x weekly sub Q injections- near the end I went to 7 daily even divided injections.

My lady and I want to have a kid so my doc introduced 1000iu HCG EOD. Waited a few months did a sperm test and basically had nothing there. I stopped TRT (12 weeks ago) and doc told me to go to 2000iu HCG EOD for 8 weeks. I did it for ~9.5 weeks and then stopped. The e2 swings were crazy. I was using .125 anastrozole 2x a week and that was too little. But .18mg 2x a week was too much over time. I could never get it balanced, but I stuck with it. I do think I am very sensitive to estrogen as even though I felt great when on TRT once I stopped I really leaned out (at a BW of 235 @ 6'2) so clearly I was carrying water weight even I felt very good and didn't think I was carrying excess water at the time. I could especially see the difference in my abs and face.

Fast forward to having stopped HCG all together 9-10 days ago. I've been having major fatigue and muscle recovery issues and sweating chills etc. My workouts are are weak compared to what they were. Not the strength portion so much but my energy for harder conditioning is just crap. I probably should have done a sperm analysis immediately but haven't booked it yet. After about 6 weeks on the 2000IU HCG my testicles do now seem much bigger and heavier than before and I am producing more ejaculate. However, since stopping the HCG my sex drive is mostly gone and my morning wood is weak or missing. My testicles may be a hair smaller but it's hard to tell. They are certainly bigger than before the 2000iu of HCG EOD.

I am ASSUMING that the HCG was keeping my T higher and now that I've stopped it's low. I'm scheduling some blood work for next week. I also take .1mg 2x daily of ipamorelin/CJC 1295 without DAC 4 days a week. I've read nothing that it states it harms fertility but if I have to I will stop taking it, although it really made me feel vital when I introduced it and it seems to help keep me lean. Also, I was smoking the occasional bit of marijuana to help deal with the e2 symptoms (like insomnia) until I learned that it can impact fertility (felt pretty stupid) . Then I stopped cold turkey a week ago. I don't drink (at all) or do any recreational or RX drugs. I do drink a cup of folgers a few times a week.

My question are the following:

1) Do you guys think that 500iu of HCG every day would be a good way of both helping fertility and increasing T or should I go to 1000iu EOD? My thinking was every day would produce better e2 control (just like with daily TRT) but I've also read that I may need a higher one time load of HCG to increase fertility.

2) Any advice on what panel to run? I'd like to see where my FT and TT are and also add IGF-1 to make sure the peptides are doing their thing. But not sure what else I should be looking at.

3) Could stopping MJ be causing any my symptoms like the fatigue or muscle recovery issues?

3) Finally, should I do a sperm analysis asap or wait until I've given the lower HCG dose a chance to do it's thing.

Thank you guys ahead of time for the advice, it's always appreciated and I am grateful for this forum.
 
Defy Medical TRT clinic doctor
 
post#6

If the man desires a future pregnancy, the clinician should prescribe hCG concurrent with testosterone therapy, typically at 500 U subcutaneous three times per week or 1,500 U once weekly if the patient wishes only to prevent testicular atrophy. The patient should cycle off of testosterone twice yearly, at a rate of 3,000 U three times per week for 4 weeks, adding 25 mg daily clomiphene therapy during that period, Lipshultz said. However, for men desiring a pregnancy, 3,000 U hCG three times per week should be prescribed in addition to clomiphene therapy. Clinicians should check the patient’s follicle-stimulating hormone (FSH) level and conduct a semen analysis after 4 months for men desiring pregnancy; if the FSH level is not sufficiently elevated, the clinician should discontinue clomiphene and instead introduce FSH concurrent with the hCG, he said.
 
Lipschultz would be considered one of the leading experts when it comes to male infertility.






Table 1. Studies on HCG on testosterone and fertility parameters
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