HCG discontinued (NOT) in the UK. Now what?

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Smoking_Krills

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I've read this forum from time to time over the years, but this is my first time posting here.
I'd value your thoughts on my little problem.

I have secondary hypo and my baseline testosterone was last measured at a whopping 239 ng/dl!!! Cut a long story short, everything else is in good order. Thyroid, weight, sleep etc etc.
I was put on a low dose of HCG because I am quite young and want to maintain my fertility. The HCG worked like a charm for the last couple of years. The problem is that HCG/Pregnyl has been discontinued in the UK, so I am not on anything at the moment.

With my doctor, we tried low dose Clomid but that gave me sore bloodshot eyes so we quickly abandoned that plan.
We then tried anastrozole. Problem is I already have very low estradiol, so although the anastrozole nicely increased my testosterone, my estradiol stayed too low and I got clicking joints and grumpy mood and so on.

So now I am asking myself "what next"?

I was thinking about a combination of Testim and anastrozole. I wondered if that combination would keep my fertility without driving my estradiol into the deck? It would be a fine balancing act if it worked at all.

Any other ideas?

My next doctors appointment is later this week and I was hoping to have a few ideas in place in case my doctor couldn't pull a rabbit out of the hat.
 
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Smoking_Krills said:
snip...

I was thinking about a combination of Testim and anastrozole. I wondered if that combination would keep my fertility without driving my estradiol into the deck? It would be a fine balancing act if it worked at all.

.
Click to expand...

Welcome to the forum. Neither Testim gel or anastrozole will keep you fertile. Testim gel will shut your natural T production and sperm production down and the AI will control your E2.
If you plan to be on TRT and remain fertile you pretty much need HCG since clomid doesn't work for you.
 
Is HMG available in the UK? Or recombinant LH and FSH? Problem here is the cost. But HMG or recombinant LH and FSH combined will work better than HCG to preserve your fertility.
 
Here is the full study under conclusion based on the evidence.

Nebido (shown in numerous studies to be an effective at impairing sperm production) was not used in the study.

When looking over the abstract is states in the interventions section that TU was administered at 120 mg/day which would be an oral form.

Reading through the full paper the TU used was the oral form Restandol at 40mg 3 times per day (due to short half-life).

http://www.fertstert.org/article/S0015-0282(97)81379-9/pdf
 
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madman said:
Here is the full study under conclusion based on the evidence. Nebido (shown in numerous studies to be an effective at impairing sperm production) was not used.

When looking over the abstract is states in the interventions section that TU was administered at 120 mg/day which would be an oral form.

Reading through the full paper the TU used was the oral form Restandol at 40mg 3 times per day (due to short half-life).

http://www.fertstert.org/article/S0015-0282(97)81379-9/pdf
Click to expand...

Many thanks.
 
CoastWatcher said:
I have seen that study and wondered about the conclusion. If anyone has ideas...
Click to expand...

This study may hold some insight as it is stated " the administration of androgen at a low dose does not compromise central and peripheral hormone secretion and might be appropriate for stimulating epididymal function independently of leydig cell activity and thus might improve sperm quality".

Also states "addition TU administration (40 mg t.i.d.) could result in marked increase in serum dihydrotestosterone (dht) without appreciable gonadotropin changes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3955339/
 
Thanks for your messages.

Yes, HMG is available here, but we have the same issue with price. It is prohibitively expensive for long term treatment.

I looked into Tamoxifen but it appears it can also cause ocular issues. After my sensitivity to Clomid, I don't want to risk it.

I've got a pharmacist acquaintance who I am going to speak with tomorrow and find out what alternatives he may know of to Pregnyl-HCG in the UK.
 
I heard from a friend in the UK and he uses Fertility2u.com .

Why are you taking anastrozole? It's a drug that is usually counterproductive.
 
HCG (pregnyl) is also discontinued in Portugal since some sometimes. WTF is happening I asked my GP and she replied " it most be a replacement coming in soon" I really hope so.
 
Nelson Vergel said:
I heard from a friend in the UK and he uses Fertility2u.com .
Click to expand...

Fertility2u no longer supply Pregnyl HCG to the UK

Why did HCG get discontinued in the UK?
Click to expand...

I don't know. The manufacturer stopped making it.

You got dry red eyes from clomid? How was your vision? I'm having vision issues and dry red eyes.
Click to expand...
I wasn't wanting to get into detail about it, but since you asked, it did cause various vision issues. Some short term, others long term/permanent.
 
madman said:
This study may hold some insight as it is stated " the administration of androgen at a low dose does not compromise central and peripheral hormone secretion and might be appropriate for stimulating epididymal function independently of leydig cell activity and thus might improve sperm quality".

Also states "addition TU administration (40 mg t.i.d.) could result in marked increase in serum dihydrotestosterone (dht) without appreciable gonadotropin changes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3955339/
Click to expand...


This is only true because of Tamoxifen:

"Available data has demonstrated that a low dosage of TU (40 mg t.i.d.) combined with tamoxifen can be used in treating idiopathic male infertility, does not reduce sperm quality and enhances the pregnancy rate more than when tamoxifen is used alone.2

Tamoxifen decreases IGF-1 and most guys on it hate it more than clomiphene.
 
Beyond Testosterone Book by Nelson Vergel
I ran into the same problem so here's my 2cents:
Pregnyl appears to be no longer available in most European countries. However, you can still get HCG via Ovitrelle, which seems to be available without issues in the UK as well:
https://www.medicines.org.uk/emc/medicine/14386
https://www.oxfordonlinepharmacy.co...dicines/ovitrelle-0-5ml-250mcg-pre-filled-pen

This is a bit messier than the cool vials US people have, what I do is this:
1) I put the contents of the Ovitrelle syringe into a 1ml insulin syringe
2) When I inject my T, I put a few drops from the Ovitrelle syringe (which I keep in the fridge) into the T syringe (which I typically prefill at room temperature, this is the one I inject into myself). When I do this, I need to use both hands and carefully look at the numbers of the syringe as it is easy to use too much HCG:

6500 IUs -> 0.50ml (Full contents of an Ovitrelle syringe)
650 IUs -> 0.05ml
520 IUs -> 0.04ml
390 IUs -> 0.03ml <-- what I am trying to inject now (but it's easy to throw 0.04ml+ if you are not careful)

Bottom line: Pregnyl is gone, HCG is still available via Ovitrelle. This seems commonly prescribed for women trying to conceive, so I don't think it will be gone from Europe any time soon.
 
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