On HRT a long time. Possible to have kids?

[Systemlord]

If you feel better on HCG monotherapy, maybe you could stay on it. Your endo should be on board with keeping your testicles in a functioning state.

 

[lg1234]

So I was with my endo today, she said to continue the current protocol of 800 HCG and 75iu X3 times weekly for now. My test levels were good, Estrogen, LH, FSH were fine.

The sperm test result said zero sperm count, but then a note saying that some sperm were visible. So it looks like we're talking about very very low numbers. My endo says he's happy there's some sperm there and we'll restest in another three months and see where we're at. So it's a waiting game for now. Fingers crossed.

 

[lg1234]

I thought I would update on my progress.

I had a sperm count done in May, which would be 10 months since I went on HCG mono and 6 months since I went on FSH (no test during that period) and my sperm count has gone from virtually 0 in January to 3 million in May. So although it's still very low numbers I'm making progress and heading in the right direction. I'm very happy with this as although my numbers are low I was worried I wouldn't be able to make sperm at all as I went on test originally to induce puberty which never started naturally and have been on it ever since, about 15 years.

I'm currently taking 800iu of HCG and 75iu of FSH 3 times a week and I feel good on this protocol, much better than when I was on Nebido. My test levels are still quite low at only 12.4, which is the very low end of the range (12-32). My endo wants to increase HCG to 1100iu 3 times per week and FSH to 100iu to try boost my numbers and we'll do another sperm test in 4 months time. I'd like to stay on my current protocol as I feel good but I need to get that sperm count up.

 

[HealthMan]

I thought I would update on my progress.

I had a sperm count done in May, which would be 10 months since I went on HCG mono and 6 months since I went on FSH (no test during that period) and my sperm count has gone from virtually 0 in January to 3 million in May. So although it's still very low numbers I'm making progress and heading in the right direction. I'm very happy with this as although my numbers are low I was worried I wouldn't be able to make sperm at all as I went on test originally to induce puberty which never started naturally and have been on it ever since, about 15 years.

I'm currently taking 800iu of HCG and 75iu of FSH 3 times a week and I feel good on this protocol, much better than when I was on Nebido. My test levels are still quite low at only 12.4, which is the very low end of the range (12-32). My endo wants to increase HCG to 1100iu 3 times per week and FSH to 100iu to try boost my numbers and we'll do another sperm test in 4 months time. I'd like to stay on my current protocol as I feel good but I need to get that sperm count up.

Is that 3 million per ml? How are the other parameters? Morphology, forward progression etc?

 

[lg1234]

Yes 3 million per ml, 9 million total. We didn't get into the specifics of the other parameters but the endo said all other parameters were ok and in range.

 

[HealthMan]

Yes 3 million per ml, 9 million total. We didn't get into the specifics of the other parameters but the endo said all other parameters were ok and in range.

If the goal is to get your partner pregnant then these numbers are not bad (assuming all other parameters are normal) and you should start trying.

 

[lg1234]

Hi folks I thought I would update on my journey.

After 2.5 years on HCG and FSH my sperm numbers are still way to low to conceive naturally.

The results of my latest sperm test are very poor. In a previous post about I said it was 3 million per ml but this is incorrect it was 3 million total at the time.

A semen test in April last year showed 4.5 million total sperm and then in August it showed 9 million total. Although still extremely low it was heading in the right direction.

However, my latest results are terrible. See below:

Motility:

(a) 46 % Progressive motility (PR) (32%)

(a) 5 % Non-Progressive (NP)

(a+b) 51 % total Motility (PR+NP) (40%)

(a) 49 % Immotile

Vitality: 51 % live (58% live)

Concentration: 2.3 million / ml (15

million/ml)

Total sperm per ejaculate: 5.75 million (39 million)

MAR Test: Insufficient motile sperm for test (50%)

MICROSCOPY – STAINED PREPARATION

Morphology (normal forms)

3 % normal (4%)

97 % abnormal

Total sperm in ejaculate: 5.75 Million

As you can see these results are very poor. I'll be going to speak with my endo about the results next week. After 2.5 years I'm resigned to the fact IVF might now be the only option.

My current protocol is FSH 150iu x3 weekly and HCG 900iu x3 weekly.

Is there anything else that I can look into or consider? I like to do my research before I see him but I think at this stage I might begin to turn my attention to IVF

 

[Cataceous]

It looks as though you still haven't tried #1 on Dr. Saya's fertility list, a SERM, also recommended by @HealthMan above. I suggest enclomiphene if you can get it. Clomid might work, but it's common to not feel good with it.

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.​

HCG Monotherapy to Clomid Ratio For Fertility

HCG Monotherapy to Clomid Ratio For Fertility

www.peaktestosterone.com

 

[lg1234]

I wouldn't mind not feeling good for a while if it improved my numbers. I'll speak with my endo about it and see what he thinks.

 

[Kev101]

Hi everyone,

New to the forum and it looks a fantastic resource.

I'm looking for some advice. A bit if background first. I'm currently 34, was diagnosed with secondary hypogonadism when I was 21 and was put on Sustanon. This helped to get puberty moving for me as it was very slow and at 21 I still hadn't fully developed due to lack of testosterone. Sustanon worked well for me and I lead a normal life. In 2008 our health service (I'm in Europe) stopped supplying sustanon and I was moved to Nebido. This also worked well for me. In total i've been on TRT for about 13 years.

Roll on to the present and at 34 I now want to have kids. I was told all along at my yearly check ups that to have kids should be possible and that it would simply involve moving me on to a different injection. I was always happy enough with that and never really looked into it further, until recently.
After reading this and other forums it appears I should probably have been taking HCG with my nebido if I wanted to preserve my fertility. Is this true? It was never given as an option to me. Is it likely that taking HCG now will kickstart my testes into producing sperm given I have been on HRT for such a long time?

Definitely man! Lots of massive pro bodybuilders have kids after heavy duty use. I had my son after Tren, Anadrol and Test for 16 weeks.

There is a protocol where you takes lots of HCG, I forget now but I can find it for you if you like?

 

[lg1234]

Hi Kev,

Thanks for the reply. If you read further down you'll see I've tried the protocol with HCG and it's not working well enough to get my partner pregnant after over 2 years. So I need to see if there are other options before I look into IVF

 

[Kev101]

Sorry, I should have read it all! I'll take note of what you have tried and see if I can find any other options.

 

[Dr Justin Saya MD]

It looks as though you still haven't tried #1 on Dr. Saya's fertility list, a SERM, also recommended by @HealthMan above. I suggest enclomiphene if you can get it. Clomid might work, but it's common to not feel good with it.

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.​

HCG Monotherapy to Clomid Ratio For Fertility

HCG Monotherapy to Clomid Ratio For Fertility

www.peaktestosterone.com

Indeed. As we all know, however, a SERM is only #1 on the fertility list when used without the HPTA suppression of TRT.

 

[jc2c]

It looks as though you still haven't tried #1 on Dr. Saya's fertility list, a SERM, also recommended by @HealthMan above. I suggest enclomiphene if you can get it. Clomid might work, but it's common to not feel good with it.

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.​

HCG Monotherapy to Clomid Ratio For Fertility

HCG Monotherapy to Clomid Ratio For Fertility

www.peaktestosterone.com

Where would TRT + hCG + urofollitropin be on this list? I'm guessing above 3(a) or 3(b)?

 

[Vince]

Hi everyone,

New to the forum and it looks a fantastic resource.

I'm looking for some advice. A bit if background first. I'm currently 34, was diagnosed with secondary hypogonadism when I was 21 and was put on Sustanon. This helped to get puberty moving for me as it was very slow and at 21 I still hadn't fully developed due to lack of testosterone. Sustanon worked well for me and I lead a normal life. In 2008 our health service (I'm in Europe) stopped supplying sustanon and I was moved to Nebido. This also worked well for me. In total i've been on TRT for about 13 years.

Roll on to the present and at 34 I now want to have kids. I was told all along at my yearly check ups that to have kids should be possible and that it would simply involve moving me on to a different injection. I was always happy enough with that and never really looked into it further, until recently.
After reading this and other forums it appears I should probably have been taking HCG with my nebido if I wanted to preserve my fertility. Is this true? It was never given as an option to me. Is it likely that taking HCG now will kickstart my testes into producing sperm given I have been on HRT for such a long time?

How to Improve Sperm Quality, LH, FSH and Testosterone in Infertile Men

Improving Testosterone, LH, FSH and Sperm Quality in Men Who Stopped TRT or Anabolic Steroids? Main Therapies. Note: AI's are not recommended due to extreme decreases in estradiol that may have negative health consequences in men. hCG plus FSH doses used in several studies: Reference...

www.excelmale.com

 

[Cataceous]

Where would TRT + hCG + urofollitropin be on this list? I'm guessing above 3(a) or 3(b)?

That would be my guess as well. I'd lean towards above 3(a) because having the FSH in there might override the drawbacks of TRT when compared to hCG monotherapy. If he's around it would be informative to see what @Dr Justin Saya MD thinks.

 

[lg1234]

I thought I would give a quick update here. In July 2021, 5 months after my last post in Feb 21, when my total sperm was only 5.75, my wife became pregnant. We had a healthy boy in early 2022. I remained on the same HCG and FSH protocol following his birth. 9 months later, my wife got pregnant again, and now we have 2 happy healthy kids.

Thanks to everyone that contributed. I'm back on Nebido thesedays, 2 is plenty!!

 

[Gman86]

I thought I would give a quick update here. In July 2021, 5 months after my last post in Feb 21, when my total sperm was only 5.75, my wife became pregnant. We had a healthy boy in early 2022. I remained on the same HCG and FSH protocol following his birth. 9 months later, my wife got pregnant again, and now we have 2 happy healthy kids.

Thanks to everyone that contributed. I'm back on Nebido thesedays, 2 is plenty!!

Awesome to hear man! Congratulations! Was ur second one a girl? I’ve had two kids on TRT with HCG. Both boys. So I’m jc lol. Well had one boy 4 years ago, and then my girl is pregnant with a boy currently. Due in February