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How to get your Dr. to prescribe something they are reluctant to.
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<blockquote data-quote="Gene Devine" data-source="post: 3233" data-attributes="member: 4"><p>Published research is usually your best option. </p><p></p><p>Studies like this one can help:</p><p></p><p>The efficacy for hCG for both Primary and Secondary Hypogonadism has been documented. For those whose Doctor refuse to prescribe HCG as part of your TRT protocol print this study abstract and force them to read it:</p><p></p><p>Tung-Chin Hsieh, Alexander W. Pastuszak, Kathleen Hwang and Larry I. Lipshultz*,&#8224;</p><p>From the Division of Urology, University of California-San Diego (TCH), San Diego, California, Scott Department of Urology, Baylor College of Medicine (AWP, LIL), Houston, Texas, and Department of Urology (KH), Brown University School of Medicine, Providence, Rhode Island</p><p> </p><p><strong>Purpose:</strong> Testosterone replacement therapy results in decreased serum gonadotropins and intratesticular testosterone , and impairs spermatogenesis, leading to azoospermia in 40% of patients. However, intratesticular testosterone can be maintained during testosterone replacement therapy with co-administration of low dose human chorionic gonadotropin , which may support continued spermatogenesis in patients on testosterone replacement therapy.</p><p></p><p><strong>Materials and Methods:</strong> We retrospectively reviewed the records of hypogonadal men treated with testosterone replacement therapy and concomitant low dose human chorionic gonadotropin (HCG ). Testosterone replacement consisted of daily topical gel or weekly intramuscular injection with intramuscular human chorionic gonadotro- pin (500 IU) every other day. Serum and free testosterone, estradiol, semen parameters and pregnancy rates were evaluated before and during therapy.</p><p> </p><p><strong>Results:</strong> A total of 26 men with a mean age of 35.9 years were included in the study. Mean followup was 6.2 months. Of the men 19 were treated with injectable testosterone and 7 were treated with transdermal gel. Mean serum hormone levels before vs during treatment were testosterone 207.2 vs 1,055.5 ng/dl (p <0.0001), free testosterone 8.1 vs 20.4 pg/ml (p = 0.02) and estradiol 2.2 vs 3.7 pg/ml (p = 0.11). Pretreatment semen parameters were volume 2.9 ml, density 35.2 million per ml, motility 49.0% and forward progression 2.3. No differences in semen parameters were observed during greater than 1 year of followup. No impact on semen parameters was observed as a function of testosterone formulation. No patient became azoospermic during concomitant testosterone replacement and human chorionic gonadotropin therapy. Nine of 26 men contributed to pregnancy with the partner during follow-up.</p><p></p><p><strong>Conclusions:</strong> <u><strong>Low dose human chorionic gonadotropin appears to maintain semen parameters in hypogonadal men on testosterone replacement therapy. Concurrent testosterone replacement and human chorionic gonadotropin use may preserve fertility in hypogonadal males who desire fertility preservation while on testosterone replacement therapy.</strong></u></p><p></p><p>We also have a good link in here in the stickies on HCG as well.</p></blockquote><p></p>
[QUOTE="Gene Devine, post: 3233, member: 4"] Published research is usually your best option. Studies like this one can help: The efficacy for hCG for both Primary and Secondary Hypogonadism has been documented. For those whose Doctor refuse to prescribe HCG as part of your TRT protocol print this study abstract and force them to read it: Tung-Chin Hsieh, Alexander W. Pastuszak, Kathleen Hwang and Larry I. Lipshultz*,† From the Division of Urology, University of California-San Diego (TCH), San Diego, California, Scott Department of Urology, Baylor College of Medicine (AWP, LIL), Houston, Texas, and Department of Urology (KH), Brown University School of Medicine, Providence, Rhode Island [B]Purpose:[/B] Testosterone replacement therapy results in decreased serum gonadotropins and intratesticular testosterone , and impairs spermatogenesis, leading to azoospermia in 40% of patients. However, intratesticular testosterone can be maintained during testosterone replacement therapy with co-administration of low dose human chorionic gonadotropin , which may support continued spermatogenesis in patients on testosterone replacement therapy. [B]Materials and Methods:[/B] We retrospectively reviewed the records of hypogonadal men treated with testosterone replacement therapy and concomitant low dose human chorionic gonadotropin (HCG ). Testosterone replacement consisted of daily topical gel or weekly intramuscular injection with intramuscular human chorionic gonadotro- pin (500 IU) every other day. Serum and free testosterone, estradiol, semen parameters and pregnancy rates were evaluated before and during therapy. [B]Results:[/B] A total of 26 men with a mean age of 35.9 years were included in the study. Mean followup was 6.2 months. Of the men 19 were treated with injectable testosterone and 7 were treated with transdermal gel. Mean serum hormone levels before vs during treatment were testosterone 207.2 vs 1,055.5 ng/dl (p <0.0001), free testosterone 8.1 vs 20.4 pg/ml (p = 0.02) and estradiol 2.2 vs 3.7 pg/ml (p = 0.11). Pretreatment semen parameters were volume 2.9 ml, density 35.2 million per ml, motility 49.0% and forward progression 2.3. No differences in semen parameters were observed during greater than 1 year of followup. No impact on semen parameters was observed as a function of testosterone formulation. No patient became azoospermic during concomitant testosterone replacement and human chorionic gonadotropin therapy. Nine of 26 men contributed to pregnancy with the partner during follow-up. [B]Conclusions:[/B] [U][B]Low dose human chorionic gonadotropin appears to maintain semen parameters in hypogonadal men on testosterone replacement therapy. Concurrent testosterone replacement and human chorionic gonadotropin use may preserve fertility in hypogonadal males who desire fertility preservation while on testosterone replacement therapy.[/B][/U] We also have a good link in here in the stickies on HCG as well. [/QUOTE]
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How to get your Dr. to prescribe something they are reluctant to.
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