Starting Fertility Journey After Long-Term TRT – Seeking Insights

[EnlightenedViking]

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.

 

[Cataceous]

That doctor is way too pessimistic. The studies suggest that a significant majority of men can regain fertility. It can take as long as one or two years, however. If you're wanting to hang onto the cypionate as long as possible then you might be interested in this speculative treatment. Basically you would just add in the enclomiphene and some cistanche extract. Alternatively, I have demonstrated that enclomiphene along with gonadorelin injections can restart LH/FSH production under TRT. If you go this route then I would throw in kisspeptin-10 to encourage the resumption of endogenous GnRH production. In the end these might just be ways to soften the blow by getting some or all of the HPTA going before you drop the endogenous testosterone—although in the best-case scenario you may regain fertility beforehand, as I did in a borderline fashion. As I recall, in the research the men just stopped TRT cold-turkey and eventually most recovered.

 

[FunkOdyssey]

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

You can also consider adding FSH to the hCG for better results.

Enclomiphene is unlikely to do anything useful while you maintain an injectable TRT dosage of 150+ mg weekly. If you want enclomiphene to help in a significant way, that TRT dosage needs to come way down.