Starting Fertility Journey After Long-Term TRT – Seeking Insights

Hey everyone,


I’m 3 weeks into adding HCG (1,000 IU, 3x/week) after being on TRT (150–200mg testosterone cypionate/week) for the last 9 years. I split my TRT dose twice weekly.


So far:


  • Sperm analysis came back at zero.
  • I’ve noticed a slight boost in energy and mood since starting HCG.
  • Testicular size has started to increase a bit.

I know this is a long road, but what’s weighing on me most is the psychological side—for both myself and my wife—as we try to conceive. A women’s fertility specialist told her there’s a “good chance” my fertility won’t return and that HCG would be a waste of time and money. That was tough to hear.


On Monday, I have my first appointment with a male fertility specialist. In the meantime, I’ve been considering next steps and weighing options:


  • Continuing current HCG protocol, possibly adjusting dose.
  • Exploring HCG monotherapy.
  • Adding Enclomiphene (already queued up through Defy Medical).

I’ve read plenty of mixed reports, but also success stories that give me hope. Right now, my instinct is to stay the course with HCG to give it a real chance before making bigger changes, like coming fully off TRT.


Has anyone been in a similar spot—zero count, long-term TRT, early into HCG—and seen recovery with persistence?
Any insights or experiences would mean a lot as I get started on this journey.


Thanks in advance.
 

hCG Mixing Calculator

HCG Mixing Protocol Calculator

TRT Hormone Predictor Widget

TRT Hormone Predictor

Predict estradiol, DHT, and free testosterone levels based on total testosterone

⚠️ Medical Disclaimer

This tool provides predictions based on statistical models and should NOT replace professional medical advice. Always consult with your healthcare provider before making any changes to your TRT protocol.

ℹ️ Input Parameters

Normal range: 300-1000 ng/dL

Predicted Hormone Levels

Enter your total testosterone value to see predictions

Results will appear here after calculation

Understanding Your Hormones

Estradiol (E2)

A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.

DHT

Dihydrotestosterone is a potent androgen derived from testosterone. Affects hair growth, prostate health, and masculinization effects.

Free Testosterone

The biologically active form of testosterone not bound to proteins. Directly available for cellular uptake and biological effects.

Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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