Low LH and FSH. Advice and expectations.

daves52380

New Member
Been on TRT for 28 months. Prior to starting therapy, my wife and I conceived our two year old son during the first month of trying. So no fertility issue before TRT.

We have been trying for our second child for six months now without any luck. Dr started me two months ago on empower HCG 12,000iu with a dose of 2000/wk (675iu/3x week)
Got blood results this morning from DR.
LH less than .2 (1.4-7.7)
FSH .5 (1.5-14.0)
Prolactin is normal range (confirms prior fertility and secondary hypogonadism)

DR said he will call Monday with a plan to address low LH and FSH. His Suggestion is planning on adding between 25-50mg/daily clomid along with the current 2000iu/wk dose. He told me to continue my testosterone dosage of 60mg/3x week (180mg/wk). Anastrazol .5g/3x week

Do any of you guys have experience with a similar situation?

My main concern is being on HCG for over two months and LH is less than .2
I’m concerned I’m not responding to HCG or did I get a bad batch? Do I need to increase dosage?
 
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I fully understand that both are suppressed on trt. It was my assumption was that the HCG/LH and Clomid/FSH would signal sperm production.
According to your theory, what would I have to do to bring back production? Discontinue TRT until conceiving? Are there other hormones to supplement and what dosage schedule protocols?
 
Discontinuing TRT is pure hell on the body and shouldn't be considered an option, add FSH and sperm will likely increase and you can go on with your life uninterrupted.

Clomid, HCG and FSH are the only things I know of that stand a solid chance for fertility. FSH being the best option for success.
 
The best course of action is for a semen analysis. Everything verified good with your female partner for conceiving? Your Dr simply saying to address the LH and FSH being zero, you know why it's zero but the way that you've expressed it means your Dr is ignorant on the subject.
 
The best course of action is for a semen analysis. Everything verified good with your female partner for conceiving? Your Dr simply saying to address the LH and FSH being zero, you know why it's zero but the way that you've expressed it means your Dr is ignorant on the subject.
Hello Vince,
I’m convinced it’s from TRT. No sperm analysis yet, just blood work. We conceived our first child (pre/trt) the first month that we started trying. She’s a healthy 26 years old and Latina to add to that. Me, an old 38 year old male. Seems HCG/FSH will be my most promising option.
 
Someone please correct me but I was under the impression you don't take Clomid while you're on testosterone replacement. My knowledge is limited but I thought you took one or the other not both combined. However, I was told that by endocrinologist so take it for what it's worth
 
I dont think we see guys stacking it with Cypionate, for instance, but with fertility, maybe, we just don't get much topic of fertility and trying to conceive on this forum.
 

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Understanding Your Hormones

Estradiol (E2)

A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.

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Dihydrotestosterone is a potent androgen derived from testosterone. Affects hair growth, prostate health, and masculinization effects.

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The biologically active form of testosterone not bound to proteins. Directly available for cellular uptake and biological effects.

Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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