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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Side Effect Management
Regaining Fertility; TRT+HCG+FSH
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<blockquote data-quote="Sides" data-source="post: 143387" data-attributes="member: 31749"><p>You are definitely on the right track with test + HCG + FSH, and it worked for me. I have been on testosterone for over 27 years now, and had a zero sperm count in November of 2017 when my wife and I embarked on our fertility journey. Over the course of 11 months, my sperm count went from zero to 35 million by the time my wife and I had IVF done in October, and my wife is now pregnant with our child.</p><p></p><p>As your sensitive estradiol is already comparatively low (18.8 according to your labs), I would not add anastrozole as it might drive your E2 too low and crush your libido, although admittedly the low E2 might result in a higher sperm count. My fertility doctor had me try letrozole when we were going through the fertility process, but even a small dose (.5mg) crushed my E2 to less than 5 and also crushed my libido and energy. I would only suggest adding a small dose of anastrozole if further labs show that your E2 increases due to possible increased aromatization from the HCG, but then be cautious and only add a very small dose to see how you respond to it.</p><p></p><p>Also, as HealthMan mentioned, although twice-weekly injections of FSH will work, I would advise increasing injection frequency to EOD or if possible small daily injections for optimal results. Personally I did small twice-daily injections just to have as stable levels as possible. The half life of FSH is fairly short (20 hours if injected subcutaneously), so small frequent injections will probably give you better results than larger less-frequent injections.</p><p></p><p>From the Empower Pharmacy website regarding FSH:</p><p></p><p><strong>Pharmacokinetics: </strong>Urofollitropin is administered subcutaneously or intramuscularly. Based on the steady state ratio of the peak plasma concentration (Cmax) and the area under the plasma concentration-time curve (AUC), subcutaneous (SC) and intramuscular (IM) administration of urofollitropin are not bioequivalent. Metabolism of urofollitropin has not been studied in humans.</p><p></p><p><strong>Route-Specific Pharmacokinetics: </strong><em>Intramuscular Route</em>: Multiple doses of urofollitropin IM resulted in Cmax and AUC of 77.7% and 81.8% compared to multiple doses of urofollitropin SC. Peak blood concentrations after 150 IU daily injections for 7 days was 11.5 IU/L for IM administration. The maximum plasma concentration was obtained at approximately 10 hours following intramuscular administration. The elimination half-life is roughly 15 hrs after 7 days of IM administration.</p><p></p><p><em>Subcutaneous Route</em>: Peak blood concentrations after 150 IU daily injections for 7 days was 14.8 IU/L for SC administration. The maximum plasma concentration was obtained at approximately 10 hours following SC administration. The elimination half-life is roughly 20 hrs after 7 days of SC administration.</p><p></p><p><a href="https://www.empowerpharmacy.com/drugs/fsh-injection.html" target="_blank">FSH INJECTION | Compounding Pharmacy - Empower Pharmacy</a></p><p></p><p>Best of luck to you on your fertility journey! If it worked for me after 27 years of testosterone use, I am sure it will work for you as well. If you have any questions, I am happy to try to help as much as I can.</p></blockquote><p></p>
[QUOTE="Sides, post: 143387, member: 31749"] You are definitely on the right track with test + HCG + FSH, and it worked for me. I have been on testosterone for over 27 years now, and had a zero sperm count in November of 2017 when my wife and I embarked on our fertility journey. Over the course of 11 months, my sperm count went from zero to 35 million by the time my wife and I had IVF done in October, and my wife is now pregnant with our child. As your sensitive estradiol is already comparatively low (18.8 according to your labs), I would not add anastrozole as it might drive your E2 too low and crush your libido, although admittedly the low E2 might result in a higher sperm count. My fertility doctor had me try letrozole when we were going through the fertility process, but even a small dose (.5mg) crushed my E2 to less than 5 and also crushed my libido and energy. I would only suggest adding a small dose of anastrozole if further labs show that your E2 increases due to possible increased aromatization from the HCG, but then be cautious and only add a very small dose to see how you respond to it. Also, as HealthMan mentioned, although twice-weekly injections of FSH will work, I would advise increasing injection frequency to EOD or if possible small daily injections for optimal results. Personally I did small twice-daily injections just to have as stable levels as possible. The half life of FSH is fairly short (20 hours if injected subcutaneously), so small frequent injections will probably give you better results than larger less-frequent injections. From the Empower Pharmacy website regarding FSH: [B]Pharmacokinetics: [/B]Urofollitropin is administered subcutaneously or intramuscularly. Based on the steady state ratio of the peak plasma concentration (Cmax) and the area under the plasma concentration-time curve (AUC), subcutaneous (SC) and intramuscular (IM) administration of urofollitropin are not bioequivalent. Metabolism of urofollitropin has not been studied in humans. [B]Route-Specific Pharmacokinetics: [/B][I]Intramuscular Route[/I]: Multiple doses of urofollitropin IM resulted in Cmax and AUC of 77.7% and 81.8% compared to multiple doses of urofollitropin SC. Peak blood concentrations after 150 IU daily injections for 7 days was 11.5 IU/L for IM administration. The maximum plasma concentration was obtained at approximately 10 hours following intramuscular administration. The elimination half-life is roughly 15 hrs after 7 days of IM administration. [I]Subcutaneous Route[/I]: Peak blood concentrations after 150 IU daily injections for 7 days was 14.8 IU/L for SC administration. The maximum plasma concentration was obtained at approximately 10 hours following SC administration. The elimination half-life is roughly 20 hrs after 7 days of SC administration. [URL="https://www.empowerpharmacy.com/drugs/fsh-injection.html"]FSH INJECTION | Compounding Pharmacy - Empower Pharmacy[/URL] Best of luck to you on your fertility journey! If it worked for me after 27 years of testosterone use, I am sure it will work for you as well. If you have any questions, I am happy to try to help as much as I can. [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Side Effect Management
Regaining Fertility; TRT+HCG+FSH
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