Post-TRT restart not going well - how long to wait for fertility to recover before going back on T shots?

[Hoodlum]

I was diagnosed with secondary hypogonadism in my early 30s (I'm 40 now), and went on TRT around the age of 32. Pre-TRT T level was 220 (although I probably crashed it lower than it should have been by cutting all fat out my diet, but even at age 27 I think it was only 300 or so). After some trial and error, got dialled in on a TRT regimen of shots + adex, with occasional HCG. Felt incredible by comparison, drive, motivation, libido good, although tailed off a bit in later years to just "ok".

Met a girl, got married, want kids next year, so thought I should come off to regain fertility. I'd barely been using HCG with any regularity, maybe 250IU once a week if I had any at the time, and my nuts were like raisins.

First 2 weeks of PCT I did 500IU HCG ED. Then the plan was to do clomid 25mg ED for 4 weeks. But I had to double the dose to 50mg as I felt utterly exhausted, listless, depressed. Felt slightly better after doubling the dose. But still constantly depressed, irritable, no motivation for anything. No twitch from the trousers department for nearly 4 weeks.

Been on the clomid 2.5 weeks now, so that's over a month since I stopped the T shots in total. Got a load of enclomiphene too, since my original plan was to use that as long term pill-only TRT - switching on to that now at 12.5mg ED, to see if the possible zuclomiphene-related sides clear up (mood etc).

I feel like I've had enough of this, and want to go back on TRT with shots again (except this time I would absolutely adhere to a 250IU HCG x2 week regimen to preserve fertility - that's enough to do so, right?). My nuts are back to full size, and my ejaculate volume seems to have gone up a lot.

My question is - should I wait longer until going back on, until I'm able to fully confirm that my fertility is restored? Or doesn't it matter too much, and I can still potentially fully restore it whilst on the T shots again in the future?

Thanks for any help guys. I guess I took how I felt whilst on TRT for granted, and now that it's gone... ha.

 

[Cataceous]

Your best fertility is going to be while using the SERM. If you go back on TRT with hCG then fertility will likely be reduced by some unpredictable amount. Taking 500 IU hCG per week is considered at the low end even for simply preventing testicular atrophy. It may or may not be enough to preserve fertility. I would definitely see where you stand on the SERM before making any changes. Then you could revert temporarily when you want kids if TRT plus hCG isn't doing it. Or if your fertility is good now and you have money to spare then you could bank some sperm as insurance, or to use in lieu of another HPTA restart.

As for how long it takes to regain fertility, that's variable and can be quite long in some cases—taking many months.

 

[Hoodlum]

Thanks for the response, understood.

I saw a study where 100% of the trial participants retained fertility after 1 year of TRT, using 500IU HCG EOD. However, I've also seen a lot of other forum posts of guys saying that's too high, and not that much is required. What is the recommended baseline amount HCG/week then please, if you know, for (attempting to) preserve fertility?

I guess using HCG and SERMS together whilst on TRT doesn't work, for an extra fertility boost without coming off?

 

[Cataceous]

According to at least one study the minimum dose of hCG needed to maintain normal intratesticular testosterone is around 250-300 IU EOD. I wouldn't go lower than this if fertility is the goal.

SERMs generally do not work with TRT because androgens directly suppress the hypothalamus—not just indirectly through estrogens.

 

[Hoodlum]

Got it, thanks again.