HCG Dosage for Primary Hypogonadism

[AdamYoung]

Hello Experts,
I am new to the group but have been doing small research for a long time.
I understand that the normal dosage for TRT is 75mg testosterone biweekly and 500iu HCG Biweekly for someone who wants to maintain fertility while on TRT (Assuming there testicles are working fine).
So, Now the question is, what if the testicles are not working properly. I mean, what if they working partially.
For eg: in my case, leydig cells are working 50% bcas my testosterone is 50% less than average while sertolli cells are working only 2% (Yes, based on the amount of sperm count).
So, to summarize,
Testicles are producing 50% testosterone and 2% sperms. So, how much HCG i have to use to maintain it. Is it ok if i just use 500iu twice a week bcas i am assuming, that no matter how much u give hcg, it will not produce more than that or you want me to increase it to say 1000iu or 1500iu biweekly bcas my LH and FSH is above normal range( you know what i mean, high FSH means High HCG, i have to mimic FSH right?)
Focus here is on HCG Dosage and to maintain sperm production.

 

[Nelson Vergel]

Best HCG Dose for Men on TRT: Two Studies That Used HCG with Testosterone

 

[gaz7718]

Age is clearly a factor too but for me a greater hcg dose combined with hmg appears to have worked EOD. I took 1500iu EOD for a week and am tapering this down towards 500EOD alongside 75iu hmg.

 

[AdamYoung]

Hi Nelson,
Thanks for the reply and the links. I read few of them earlier as i have been researching about it quite sometime now.
I am 40, primary hypogonadism, vericocele, low sperm count, low testosterone, High LH/FSH and ED to name a few.
Goal: increase testosterone and maaintain sperm( very low sperm count, 2 million)

So, my doctor has put me on mono hcg now to see if i can produce testosterone.
I am thinking to start TRT along with HCG(500 EOD). I can only check sperm count every 3 months. If sperm count decreases then i will add FSH to my protocol and decrease HCG to 500iu twice a week.
I was thinking what if i just use TRT and FSH? Has anyone tried this strategy bcas i get testosterone from TRT and FSH triggers sertoli cells to produce sperms but i guess it need intratesticular testosterone which will be produced by leydig cells. Let me know if anybody tried this.
So, another strategy is to use 75mg test+ 500iu hcg+ 150iu FSH from the start of TRT itself. What do u think? I know there is no side effects of trt+hcg but what if i add another exogenous hormone? Do u think it will increase PSA?

 

[AdamYoung]

Also i am assuming HMG is same as FSH right?

 

[slicktop]

Also i am assuming HMG is same as FSH right?

HMG or HCG? I think the answer is no either way, but "HMG" isn't ringing a bell.
Just out of curiosity, why the concern over sperm count at 40?
FSH is the most expensive option you mentioned, but a significant margin, and it may not be any more effective than HCG.
Lastly, don't walk in to this thinking there are "no side effects of trt + hcg"- there darn well could be.

 

[AdamYoung]

HMG or HCG? I think the answer is no either way, but "HMG" isn't ringing a bell.
Just out of curiosity, why the concern over sperm count at 40?
FSH is the most expensive option you mentioned, but a significant margin, and it may not be any more effective than HCG.
Lastly, don't walk in to this thinking there are "no side effects of trt + hcg"- there darn well could be.

I dont have kids yet and dont want to lose the opportunity to have one. I know its quit expensive thats y i am trying with HCG first to see if it improves sperm.
I read some article about the treatment with FSH+HCG incase HCG alone dint restore the fertility. Here is the link
Successful fertility treatment with gonadotrophin therapy for male hypogonadotrophic hypogonadism

 

[slicktop]

I dont have kids yet and dont want to lose the opportunity to have one. I know its quit expensive thats y i am trying with HCG first to see if it improves sperm.
I read some article about the treatment with FSH+HCG incase HCG alone dint restore the fertility. Here is the link
Successful fertility treatment with gonadotrophin therapy for male hypogonadotrophic hypogonadism

Well, again... HCG alone has a high potential to work on its own. I wouldn't spend the money on FSH unless HCG doesn't work for you after a month or so.

 

[AdamYoung]

Well, again... HCG alone has a high potential to work on its own. I wouldn't spend the money on FSH unless HCG doesn't work for you after a month or so.

I agree it works alone for people who has full testicle volume or for working testicles but in my case, My LH and FSH are already above normal and have low T n Sperm level and one of my testicle size is small compared to other one and i also have vericocele. Considering all these factors i doubt it will work but only time will tell and i need atleast 3 months to know whether it will work or not as sperm takes 3 months to fully develop.

 

[AdamYoung]

So, based on my understanding the solution lies in either HCG, FSH or clomid right. Is there anything else which is related to spermatogenisis.

 

[gaz7718]

HMG can be used instead of FSH. I found it to be more readily available and cheaper. I’m not aware of any material differences in side effects.

HCG alone from what I have read is unlikely to recover fertility once already adversely affected. I was taking HCG throughout my TRT which I started just over a year ago and lost my fertility at some point during that period.

I didn’t want to waste time on protocols that might not have worked so went straight with one that is proven to have been successful in a number of studies. Yes it’s dearer but if you are prepared to make that investment then I’d rather not waste time.

 

[AdamYoung]

Thanks gaz,
So did you use HCG right from the beginning or u added it in the middle of TRT.
What do u think i should be doing?
TRT(75mg/twice a week)+HCG(500iu/twice a week)+HMG(50iu/twice a week)
I have never done TRT and this is going to be my first time. I am using this protocal until i have kids and then switch to just TRT. Do u think its a best idea to start with this protocal.

 

[gaz7718]

I used hcg from the start at500iu every 3 days. I lost fertility at some point after starting TRT as I made my wife pregnant around the same time I started, but she suffered a miscarriage.

according to the studies shared on this forum 75iu minimum of FSH or HMG is that’s the option you are going with EOD plus hcg. If trying to recover fertility the studies included much higher hcg doses than 500iu but this carries a greater risk of disrupting your body.

generally it seems if kids are the priority you pursue that without starting TRT as that only further complicates matters.
Saying that I remained on TRT whilst on hcg and HMG.

 

[AdamYoung]

Thanks bro. I reason i dint start TRT all these years was that i was afraid that i will become infertile but now i need to start as i am 40 year old and getting married this year. TRT is a must for me as i am suffering from ED, high body fat, low muscle(inspite of going to gym), sleep disorder to name a few. So, I cant leave TRT at all. Sure, i will follow ur protocol, also its seems better to replace hormones that are suppressed( replacing Lh/FSH with HCG/HMG).

So, HMG 75iu EOD along with HCG/TRT seems bit high. I was thinking that dosage is for someone recovering from zero sperm.
Since i am using HMG from the beginning, I was thinking to use 75iu twice a week along with HCG 500iu twice a week and TRT(75mg twice a week).. what do u think?

 

[gaz7718]

Maintaining an already healthy fertility level is different in terms of dose. Hcg alone at 500iu every 3 days was the protocol I started TRT with and generally seems to work based upon what I read up on. Clearly it doesn’t work for everyone.
HMG is expensive and FSH more so, so why not start with just HCG and check your fertility after 3 months to ensure alls is still good. HMG is costing me £200 a month and that’s cheap.

 

[AdamYoung]

I was thinking the about the same to use TRT and HCG every 3 days but i read in this forum that did not work for few. I am totally getting confused after reading so many literature on the internet n this forum.
My current doctor is putting me on HCG alone 1250mg per week to see if i can increase my T levels and if it doesnt work after 3 months then he will use HCG along with TRT.
I thought that protocal doesnt make sense as i believe i already have above normal LH and FSH. So i am thinking to self medicate with TRT and HCG.
Sure, i am going back n forth, with TRT+HCG or TRT+HCG+HMG.
So, ok ill just stick to TRT+ HCG now and if it dint maintain sperm level then ill add HMG.
Yes money is important but i am only going to use it for 2 to 3 yrs max, After that ill just stick to TRT. Thanks