No LH and very low fsh

[BigJahnny]

I’ve been on HCG( 2500 iu x 2 week) for 5 months and my doc just decided to add 25mg of clomid ed about a month and a half ago. Every time I’ve done bloodwork my LH level is always <.1 IU/L and my FSH is .2 IU/L.
Why can’t I get my LH and FSH up? Is it undetectable because I’m on hcg ??

 

[Cataceous]

Yes. HCG, particularly at those high doses, is suppressive of the HPTA. It's possible that the Clomid will help. However, depending on your goals you may see better results on Clomid alone, or better yet just enclomiphene.

 

[BigJahnny]

Ok, thanks. Do you think it would be worth lowering my hcg dose first? Or should I give the current protocol a few more months to see if it works? My main goal is to regain testicular size and fertility.

 

[Cataceous]

Yes, I think it would be worth lowering the hCG dose. There is a study showing the hCG/SERM combination therapy works, but it may be no more effective, and possibly less, than a SERM alone.

From Dr. Saya:

A *very* generalized ranking of relative fertilities (with top being most fertile):​

​

1. Clomid/SERM treatment​

2(A). HCG + HMG (or lyophilized FSH)​

2(B). Baseline no treatment (no HPTA suppression via TRT, AAS, HCG mono, etc) - assuming no significant degree of primary/secondary/tertiary dysfunction.​

3(A). HCG monotherapy (does in fact result in HPTA suppression, especially at higher doses, but *may* move up to #2 in select cases of SECONDARY/TERTIARY hypogonadism)​

3(B). TRT + HCG (as we know many men are still able to maintain adequate fertility to conceive)​

4. TRT/AAS with no concurrent HCG.​

[R]

 

[Nelson Vergel]

Evaluating the Combination of hCG + Clomid in Treatment of Male Hypogonadism - Excel Male Men's Health Forum

Background: In this study, we evaluated MHH patients who wished to preserve fertility, assessing the efficacy of a short course (12 months) of a combined hCG +clomiphene citrate. Materials and Methods: The cross-sectional study included 19 patients with hypogonadotropic hypogonadism who were...

www.excelmale.com

 

[Systemlord]

Why can’t I get my LH and FSH up?

HCG supresses the HPTA and therefore LH, it replaces it or rather mimics LH which is why it increases testosterone.

If you can't get FSH to increase, then you need clomid and or FSH injections.

If you are unable to get the LH and FSH to increase at all, you might try Clomid in isolation since HCG is having a suppressive effect on the pituitary gland.

If clomid doesn't increase LH after long-term of mid to high doses of clomid, that would signal your HPTA may be permanently shut down.