Hi, first time posting - had lots of value out of these forums and read most of the stickied and recommended logs for fertility restoration following TRT. Wanted to set out where I'm up to so far and history to (hopefully) get some advice or at least perspectives from the community. Also just to set all this out, as it's not the kind of thing that's simple or understandable to discuss with friends.
History in short
40 year old guy, based in the UK. Multiple low T symptoms and low / normal T levels stretching back more than 12 years ~ 13nmol/l / 375 ng/dl. Aged 28, and perhaps fairly as a single guy hoping for fertility, NHS declined to prescribe long-term even though a short term trial of testogel did show symptom relief. Struggled on almost 10 years or so, napping during the day, little energy, good patches and bad patches. During this time I met my now wife. Conceived my 3.5 year old son first month of trying back in late 2021 and while waiting for semen analysis (had one performed as a baseline given my issues to check no problems) Ironically, the results came back low (6m total count) and we received the results the week after the pregnancy test. Pregnancy co-incided with a new job - longer hours, travel, more stress. Weighed up the pros and cons of starting TRT and decided I needed the energy to be a good Dad, make the career move work etc.
Started 50mg x 2 per week cypionate and 350iu HCG x 2 per week a few months after conceiving. Symptom releif was dramatic and has been sustained. The only thing not to fully improve has been libido, but fatigue, concentration, mood, stamina etc all great.
Where I am now
Started to trying to conceive last July to add to the family. Nothing happened for the first two months so decided to get a semen analysis (home kit) which came back at zero. Subsequent lab semen test validated that. Obivously panicking with that result despite the HCG. Can only thing a) HCG dose was insufficient b) HCG wasn't genuine (had to source myself) c) HCG alone insufficient to maintain fertility for me.
Transferred my care to a TRT specialist with interest in fertility. Initially took me off all exogenous testosterone for eight weeks with just 150iu HCG daily, Clomid 50mg every third day and 75mg HMG x 2 per week. Bloods at that two month mark revealed testosterone back at the levels I'd naturally produce at 13nmol/l / 375 ng/dl. Subjectively I did not feel good. With natural response ok, my doctor added back in 6mg Test cyp daily. Levels then at the top of the range within a month. I still didn't feel great, however. Subjectively I'd say my testicles were hanging a little lower but nothing dramatic.
Semen analyses in November and Decemeber still showed zero count. I consulted with a fertility specialist at a reproductive centre so said the HCG dose was insufficient and should have been pulsatile. He saw no resason to take me off the exogenous TRT and referred to the Larry Lipshultz research. Clomid was discontinued (he does not like it) and HCG was increased to 5000iu per week split across three doses and HMG to 75iu x 3 per week. This was 11 January. Subjectively, lots of the random joint pain and mood swings I was having have gone (assume due to dropping clomid?) Experiencing some fatigue and water weight gain but no other obvious signs of high E2. Home semen analysis performed last week still showed no sperm.
So we're now five and a half months on of adding (confirmed genuine but perhaps not at the right dose) HCG and HMG into the protocol with no results at all. I know I have been fertile in the past with the 6m count in 2021 (which I conceived my son with) and a 45m total count performed 12 years ago during initial investigations.
Current thoughts:
* Should I not have seen something by now with the regime, especially with the HMG?
* Could the exogenous Testosterone be suppressing things? Even with the LL research, it's hard not to wonder that. No desire to suffer through more months of symptoms without exogenous T, but would be willing to if that was the blocker. There do seem to be anedtoral accounts across Reddit and other forums of people who had no luck with HCG/HMG but did with Clomiphene/enclomiphene
* Is there anything else I could be adding to the protocol?
Otherwise fit and well. Normal BMI, 12% BF. Weights and cardio. Healthy diet, multivitamin, fish oil, COQ10.
Thoughts and advice gratefully received. Thank you.
History in short
40 year old guy, based in the UK. Multiple low T symptoms and low / normal T levels stretching back more than 12 years ~ 13nmol/l / 375 ng/dl. Aged 28, and perhaps fairly as a single guy hoping for fertility, NHS declined to prescribe long-term even though a short term trial of testogel did show symptom relief. Struggled on almost 10 years or so, napping during the day, little energy, good patches and bad patches. During this time I met my now wife. Conceived my 3.5 year old son first month of trying back in late 2021 and while waiting for semen analysis (had one performed as a baseline given my issues to check no problems) Ironically, the results came back low (6m total count) and we received the results the week after the pregnancy test. Pregnancy co-incided with a new job - longer hours, travel, more stress. Weighed up the pros and cons of starting TRT and decided I needed the energy to be a good Dad, make the career move work etc.
Started 50mg x 2 per week cypionate and 350iu HCG x 2 per week a few months after conceiving. Symptom releif was dramatic and has been sustained. The only thing not to fully improve has been libido, but fatigue, concentration, mood, stamina etc all great.
Where I am now
Started to trying to conceive last July to add to the family. Nothing happened for the first two months so decided to get a semen analysis (home kit) which came back at zero. Subsequent lab semen test validated that. Obivously panicking with that result despite the HCG. Can only thing a) HCG dose was insufficient b) HCG wasn't genuine (had to source myself) c) HCG alone insufficient to maintain fertility for me.
Transferred my care to a TRT specialist with interest in fertility. Initially took me off all exogenous testosterone for eight weeks with just 150iu HCG daily, Clomid 50mg every third day and 75mg HMG x 2 per week. Bloods at that two month mark revealed testosterone back at the levels I'd naturally produce at 13nmol/l / 375 ng/dl. Subjectively I did not feel good. With natural response ok, my doctor added back in 6mg Test cyp daily. Levels then at the top of the range within a month. I still didn't feel great, however. Subjectively I'd say my testicles were hanging a little lower but nothing dramatic.
Semen analyses in November and Decemeber still showed zero count. I consulted with a fertility specialist at a reproductive centre so said the HCG dose was insufficient and should have been pulsatile. He saw no resason to take me off the exogenous TRT and referred to the Larry Lipshultz research. Clomid was discontinued (he does not like it) and HCG was increased to 5000iu per week split across three doses and HMG to 75iu x 3 per week. This was 11 January. Subjectively, lots of the random joint pain and mood swings I was having have gone (assume due to dropping clomid?) Experiencing some fatigue and water weight gain but no other obvious signs of high E2. Home semen analysis performed last week still showed no sperm.
So we're now five and a half months on of adding (confirmed genuine but perhaps not at the right dose) HCG and HMG into the protocol with no results at all. I know I have been fertile in the past with the 6m count in 2021 (which I conceived my son with) and a 45m total count performed 12 years ago during initial investigations.
Current thoughts:
* Should I not have seen something by now with the regime, especially with the HMG?
* Could the exogenous Testosterone be suppressing things? Even with the LL research, it's hard not to wonder that. No desire to suffer through more months of symptoms without exogenous T, but would be willing to if that was the blocker. There do seem to be anedtoral accounts across Reddit and other forums of people who had no luck with HCG/HMG but did with Clomiphene/enclomiphene
* Is there anything else I could be adding to the protocol?
Otherwise fit and well. Normal BMI, 12% BF. Weights and cardio. Healthy diet, multivitamin, fish oil, COQ10.
Thoughts and advice gratefully received. Thank you.
