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Testosterone Replacement, Low T, HCG, & Beyond
Clomid for PCT, fertility or low T
Support for HMG during TRT to restore count
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<blockquote data-quote="Sides" data-source="post: 163420" data-attributes="member: 31749"><p>Well, while I always learn a lot from your posts, I have to disagree with you there. Yes, HMG is LH + FSH. However, there is not sufficient LH in HMG to achieve optimal levels of intra-testicular testosterone and optimal fertility, at least not without spending a small fortune, as HMG is usually an expensive product.</p><p></p><p>Most preparations of HMG are 75/75iu or 150/150iu of LH and FSH. This amount of LH is useful, but comparatively little compared to the 500iu of HCG or more suggested every-other-day or twice a week in most fertility protocols.</p><p></p><p>And HCG is actually preferred to LH in fertility protocols, due to the much longer half-life of HCG compared to injected LH (30-36 hours compared to only 30 minutes or so), and the increased LH receptor activity of HCG.</p><p></p><p>The bottom line is that the most effective (and cost-effective) fertility protocols are going to include some combination of HCG to optimally stimulate the Leydig cells to produce high enough levels of intra-testicular testosterone, and HMG or FSH to optimally stimulate the Sertoli cells for spermatogenesis.</p><p></p><p>"Human chorionic gonadotropin (hCG) is a naturally occurring protein produced by the human placenta with a serum half-life of approximately 36 h. Structurally, hCG shares an identical α-subunit with LH and FSH. However, hCG has a unique β-subunit that is virtually identical to the LH β-subunit except that it has an additional 24 amino acid tail at the amino terminus of the protein, which is highly glycosylated and leads to both a longer circulating half-life of hCG (~36 h) versus LH (~30 min) and increased receptor activity. The increased LH receptor activity, along with its longer half-life, makes it a clinically useful LH analog."</p><p></p><p>"FSH given alone or in combination with testosterone has proven unsuccessful at inducing spermatogenesis or maintaining spermatogenesis in those previously induced with hCG/FSH (hCG 1500 IU and HMG 150 IU both subcutaneous and 3 times per week), confirming the need for maintenance of elevated ITT.<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4854084/#ref46" target="_blank">46</a> However, long-term use of hCG alone can induce spermatogenesis in up to 70% of patients, with a greater effect seen in men with initial testis length >4 cm, but further improvement is appreciated with the addition of FSH (HMG) suggesting a timelier recovery with both gonadotropins.<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4854084/#ref47" target="_blank">47</a> The success of inducing spermatogenesis with a combination of hCG and FSH is supported by several studies (<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4854084/table/T1/" target="_blank"><strong>Table 1</strong></a>).<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4854084/#ref41" target="_blank">41</a>,<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4854084/#ref42" target="_blank">42</a>,<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4854084/#ref45" target="_blank">45</a>,<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4854084/#ref48" target="_blank">48</a>,<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4854084/#ref49" target="_blank">49</a>,<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4854084/#ref50" target="_blank">50</a>,<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4854084/#ref51" target="_blank">51</a>,<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4854084/#ref52" target="_blank">52</a>,<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4854084/#ref53" target="_blank">53</a> In these data, most begin by stimulating endogenous testosterone production with trial of hCG alone with doses ranging from 1500 to 5000 IU 2–3 times per week titrated according to serum testosterone levels. Most experts treat with hCG alone for 3–6 months after which a certain number of cases will result in spermatogenesis induction. In those without adequate spermatogenesis induction, treatment proceeds with the addition of FSH with doses ranging from 75 to 400 IU 2–3 times per week titrated according to semen analysis results."</p><p></p><p><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4854084/" target="_blank">Recovery of spermatogenesis following testosterone replacement therapy or anabolic-androgenic steroid use</a></p></blockquote><p></p>
[QUOTE="Sides, post: 163420, member: 31749"] Well, while I always learn a lot from your posts, I have to disagree with you there. Yes, HMG is LH + FSH. However, there is not sufficient LH in HMG to achieve optimal levels of intra-testicular testosterone and optimal fertility, at least not without spending a small fortune, as HMG is usually an expensive product. Most preparations of HMG are 75/75iu or 150/150iu of LH and FSH. This amount of LH is useful, but comparatively little compared to the 500iu of HCG or more suggested every-other-day or twice a week in most fertility protocols. And HCG is actually preferred to LH in fertility protocols, due to the much longer half-life of HCG compared to injected LH (30-36 hours compared to only 30 minutes or so), and the increased LH receptor activity of HCG. The bottom line is that the most effective (and cost-effective) fertility protocols are going to include some combination of HCG to optimally stimulate the Leydig cells to produce high enough levels of intra-testicular testosterone, and HMG or FSH to optimally stimulate the Sertoli cells for spermatogenesis. "Human chorionic gonadotropin (hCG) is a naturally occurring protein produced by the human placenta with a serum half-life of approximately 36 h. Structurally, hCG shares an identical α-subunit with LH and FSH. However, hCG has a unique β-subunit that is virtually identical to the LH β-subunit except that it has an additional 24 amino acid tail at the amino terminus of the protein, which is highly glycosylated and leads to both a longer circulating half-life of hCG (~36 h) versus LH (~30 min) and increased receptor activity. The increased LH receptor activity, along with its longer half-life, makes it a clinically useful LH analog." "FSH given alone or in combination with testosterone has proven unsuccessful at inducing spermatogenesis or maintaining spermatogenesis in those previously induced with hCG/FSH (hCG 1500 IU and HMG 150 IU both subcutaneous and 3 times per week), confirming the need for maintenance of elevated ITT.[URL='https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4854084/#ref46']46[/URL] However, long-term use of hCG alone can induce spermatogenesis in up to 70% of patients, with a greater effect seen in men with initial testis length >4 cm, but further improvement is appreciated with the addition of FSH (HMG) suggesting a timelier recovery with both gonadotropins.[URL='https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4854084/#ref47']47[/URL] The success of inducing spermatogenesis with a combination of hCG and FSH is supported by several studies ([URL='https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4854084/table/T1/'][B]Table 1[/B][/URL]).[URL='https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4854084/#ref41']41[/URL],[URL='https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4854084/#ref42']42[/URL],[URL='https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4854084/#ref45']45[/URL],[URL='https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4854084/#ref48']48[/URL],[URL='https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4854084/#ref49']49[/URL],[URL='https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4854084/#ref50']50[/URL],[URL='https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4854084/#ref51']51[/URL],[URL='https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4854084/#ref52']52[/URL],[URL='https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4854084/#ref53']53[/URL] In these data, most begin by stimulating endogenous testosterone production with trial of hCG alone with doses ranging from 1500 to 5000 IU 2–3 times per week titrated according to serum testosterone levels. Most experts treat with hCG alone for 3–6 months after which a certain number of cases will result in spermatogenesis induction. In those without adequate spermatogenesis induction, treatment proceeds with the addition of FSH with doses ranging from 75 to 400 IU 2–3 times per week titrated according to semen analysis results." [URL="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4854084/"]Recovery of spermatogenesis following testosterone replacement therapy or anabolic-androgenic steroid use[/URL] [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Clomid for PCT, fertility or low T
Support for HMG during TRT to restore count
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