PCT & HCG Help

[itattoo]

My wife and I decided to have another child and for any man that has been on AAS for a significant amount of time...this is not the easiest process to come off and restart.

Any information is appreciated...here goes...

Ive been on AAS for a long time, I haven't come off AAS for maybe 2.5-3yrs. I typically ran 800mg of Test E and 400mg of Tren E for 10 weeks, then switch to 400mg Test Cyp and 200mg of Tren E for 10 weeks. In the past when I came off, I used Test Prop and Tren Acetate for 2 weeks while the Test Cypionate and Then Enanthate levels came down, then start PCT.

I started my PCT with 300mg of Clomid on day one followed by 100mg a day for 10 days, (usually) I would drop to 50mg of Clomid for another 10 days. However tomorrow ends my 20 days of 100mg of Clomid. I gave myself an HCG inter muscular injection this morning of 1500IU.

To sum it up, I've been on 100mg of Clomid for 20 days 300mg on day one of Clomid. on the 19th day of Clomid (today) I inter muscular injected 1500IU of HCG, then another 1500IU HCG EOD for a week.

what's the fastest you've seen recovery results?

 

[DS3]

Rule of thumb with Dr. Lipshultz and Dr. Ramasamy, two leading urologists in the US, is a 6-month lead time before desired pregnancy. So if you desire pregnancy in 6 months, do the approach that is suggested below. Dr. Lipshultz states that he has never once has a patient not return to baseline fertility on this protocol.

Your current PCT protocol is not conducive to achieving fertility. Clomid dosage is far too high and HCG should be used alongside Clomid, not in place of at the latter end of a PCT. Follow the PCT recommendations below and you can't go wrong. Monitor your E2.

Table 1
Summary of recommendations for maintenance of spermatogenesis with TRT or AAS use

Timing of desired pregnancy​	Treatment recommendation​
<6 months​	Stop TRT/AAS​
Start 3,000 IU hCG every other day ± clomiphene citrate 25 mg oral daily​
Semen analysis every 2 months​
No FSH response: discontinue clomiphene and add rhFSH 75 IU every other day​
6–12 months​	Continue TRT​
Start 500 IU hCG every other day ± clomiphene citrate 25 mg oral daily​
>12 months​	Continue TRT​
Cycle off TRT/AAS every 6 months with a 4-week cycle of 3,000 IU hCG every other day​

"Based off this evidence an algorithm was suggested for the simultaneous treatment of hypogonadism and preservation of fertility (14). All men wishing to preserve fertility while on TRT should have a baseline semen analysis (SA). Next it is important to determine the appropriate dosing regimen of hCG based off the timeline for desired pregnancy. For men who wish to obtain pregnancy within six months it was suggested to discontinue TRT and start 3,000 IU of hCG intramuscular, or subcutaneous every other day. SA should then be performed every two months. Clomiphene citrate 25–50 mg PO daily can be added or omitted to promote FSH production (15). We suggest including of clomiphene citrate in all men who are already oligospermic or azoospermic. It can be omitted in men who are initiating TRT and hCG simultaneously and have normal semen parameters."

"If Semen parameters fail to improve and FSH remains low, Gonal-f (recombinant FSH) 75 IU every other day can be added. In men who desire pregnancy within 6–12 months TRT can be continued with co-administration of 500 IU of HCG every other day ± clomiphene citrate can be used. When planning for pregnancy in greater than 12 months TRT should be cycled off every six months replaced by a four-week cycle of 3,000 IU of hCG every other day. For men who do not desire to preserve fertility testicular size can me maintained while undergoing TRT with 1,500 IU of HCG given weekly. Which is enough to maintain pre-TRT levels of intratesticular Testosterone (11). Table 1 summarizes recommendations for preserving spermatogenesis in men on TRT (16)."

Indications for the use of human chorionic gonadotropic hormone for the management of infertility in hypogonadal men