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Testosterone Replacement, Low T, HCG, & Beyond
Clomid for PCT, fertility or low T
How to Improve Sperm Quality, LH, FSH and Testosterone in Infertile Men
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<blockquote data-quote="DS3" data-source="post: 170110" data-attributes="member: 18514"><p>Here is my take on what has happened with your husband:</p><p></p><p>1. Why would his test DROP that much on a higher HCG dose? He said he feels decent (still lacks libido though), so we were both extremely surprised by this number.</p><p><span style="color: rgb(184, 49, 47)">This could be due to any number of things. (1) Timing of the assay (2) Desensitization of the LH receptors due to the dosage (3) E2 increase due to dosage increase (4) Sleep/diet/exercise/stress</span></p><p></p><p>2. Would adding the Clomid back help? He said he will do it if this will help his test and SA parameters.</p><p><span style="color: rgb(226, 80, 65)">If he felt bad on Clomid, as many men report that they do, then starting Clomid back would simply reduce quality of life while potentially adding to his sperm production. However, there is a better option (FSH or HMG). </span></p><p></p><p>3. Based on his bloodwork, would adding FSH or HMG give him the boost in sperm that he's looking for? At this point we would just like to regain enough to be able to be IUI candidates because at this point natural conception is pretty much impossible.</p><p><span style="color: rgb(226, 80, 65)">Adding FSH, according to Dr. Larry Lipschultz at the Baylor College of Medicine (one of the leading urologists in the US), is advisable at this point. </span></p><p></p><p><span style="color: rgb(226, 80, 65)"><a href="https://www.healio.com/endocrinology/reproduction-androgen-disorders/news/online/%7B027a4c7b-74f0-4f3a-a30f-0c24bd4365bd%7D/low-dose-hcg-can-prevent-sterility-in-men-prescribed-testosterone?page=2" target="_blank">https://www.healio.com/endocrinology/reproduction-androgen-disorders/news/online/{027a4c7b-74f0-4f3a-a30f-0c24bd4365bd}/low-dose-hcg-can-prevent-sterility-in-men-prescribed-testosterone?page=2</a></span></p><p></p><p><strong>-Strategy for clinicians (Excerpt from Dr. Larry Lipshultz) </strong></p><p></p><p>To maintain fertility in men with hypogonadism prescribed testosterone, Lipshultz said, clinicians should first insist on a semen analysis before beginning testosterone treatment.</p><p></p><p>“Patients need to realize that 2% of all men are sterile,” Lipshultz said. “We need to know where the individual is before we introduce testosterone because our endpoint may not be able to be any better than pre-treatment level.”</p><p></p><p>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.</p></blockquote><p></p>
[QUOTE="DS3, post: 170110, member: 18514"] Here is my take on what has happened with your husband: 1. Why would his test DROP that much on a higher HCG dose? He said he feels decent (still lacks libido though), so we were both extremely surprised by this number. [COLOR=rgb(184, 49, 47)]This could be due to any number of things. (1) Timing of the assay (2) Desensitization of the LH receptors due to the dosage (3) E2 increase due to dosage increase (4) Sleep/diet/exercise/stress[/COLOR] 2. Would adding the Clomid back help? He said he will do it if this will help his test and SA parameters. [COLOR=rgb(226, 80, 65)]If he felt bad on Clomid, as many men report that they do, then starting Clomid back would simply reduce quality of life while potentially adding to his sperm production. However, there is a better option (FSH or HMG). [/COLOR] 3. Based on his bloodwork, would adding FSH or HMG give him the boost in sperm that he's looking for? At this point we would just like to regain enough to be able to be IUI candidates because at this point natural conception is pretty much impossible. [COLOR=rgb(226, 80, 65)]Adding FSH, according to Dr. Larry Lipschultz at the Baylor College of Medicine (one of the leading urologists in the US), is advisable at this point. [/COLOR] [COLOR=rgb(226, 80, 65)][URL]https://www.healio.com/endocrinology/reproduction-androgen-disorders/news/online/%7B027a4c7b-74f0-4f3a-a30f-0c24bd4365bd%7D/low-dose-hcg-can-prevent-sterility-in-men-prescribed-testosterone?page=2[/URL][/COLOR] [B]-Strategy for clinicians (Excerpt from Dr. Larry Lipshultz) [/B] To maintain fertility in men with hypogonadism prescribed testosterone, Lipshultz said, clinicians should first insist on a semen analysis before beginning testosterone treatment. “Patients need to realize that 2% of all men are sterile,” Lipshultz said. “We need to know where the individual is before we introduce testosterone because our endpoint may not be able to be any better than pre-treatment level.” 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. [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Clomid for PCT, fertility or low T
How to Improve Sperm Quality, LH, FSH and Testosterone in Infertile Men
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