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"The Use of hCG in Men with or Without Testosterone Replacement: Overview and Emerging Data"
Human chorionic gonadotropin (hCG) plays a critical role in maintaining progesterone production during pregnancy.
- hCG is a glycoprotein composed of 237 amino acids with two subunits, alpha and beta, the latter being unique to hCG.
- The lecture will review the current practices and data on the use of hCG in men, beyond fertility, for testosterone supplementation therapy.
HCG in combination with testosterone may prevent fertility loss and testicular atrophy.
- Testosterone supplementation may reduce fertility and cause testicular atrophy.
- HCG mimics luteinizing hormone to stimulate testicular cells, but requires close monitoring for potential side effects.
HCG plus TRT can prevent testicular atrophy and loss of fertility
- HCG dosing and timing varies among clinics and needs monitoring for variables when used with testosterone
- HCG is used for FDA approved and off-label purposes such as treating undescended testicles, low testosterone, infertility, and as an adjunct for anabolic steroid use
HCG in combination with testosterone has added benefits for libido and mood.
- HCG acts similarly to LH and may replace the effects of LH on the body when providing testosterone replacement.
- The non-gonadal expression of LH and HCG receptors suggests potential effects beyond just testicular function.
HCG may reactivate the hormone path affected by testosterone supplementation.
- Testosterone supplementation shuts down LH, which may lead to a decrease in prol and progesterone.
- HCG, an LH mimicker, may reactivate the hormone path and normalize the Cascade.
HCG decreases sex hormone binding globulin and increases free testosterone.
- Potential reasons for increased libido in men on testosterone replacement therapy plus HCG.
- Effect of testosterone therapy plus HCG on intratesticular testosterone and sperm production.
HCG with testosterone prevented decrease in sperm count, motility, and morphology.
- Study demonstrated effectiveness of low dose HCG in maintaining spermatogenesis.
- However, not effective for older men with longer exposure to testosterone.
Using hCG and TRT to preserve testicular function and sperm count
- Recommended protocol for men desiring to maintain fertility while starting testosterone supplementation therapy
- Different approaches based on the desired timing of pregnancy and the use of HCG, Clomiphene, and FSH
Use of hCG and TRT can help prevent testicular atrophy and loss of fertility.
- Recovery of spermatogenesis can range from 50% to 100% based on factors like population, hCG dose, and injection frequency.
- Higher doses of hCG lead to increased and sustained beta HCG levels, which is relevant for comparison with normal luteinizing hormone concentrations.
HCG can complicate assessment of cancer remission in men receiving treatment for testicular cancer.
- Men with testicular cancer may require testosterone replacement and/or HCG which can make it difficult to assess HCG levels for cancer recurrence.
- Higher doses of HCG can lead to increased estradiol levels, and there may be desensitization with prolonged use.
Lack of data on hypothalamic pituitary access normalization protocols for former and current users of anabolic androgenic steroids.
- Stopping hCG usage affects libido and testicular atrophy prevention.
- More information on this topic will be covered in another webinar.