When HCG is Added to TRT

[BigDawg]

Hey, I have been reading threads thru out the years since I've been on TRT. I appreciate everyone's advice and stories of their own. However, I haven't seen a question like mine.

I have three children and after my youngest was born, 4 years ago, I began to experience low T symptoms. After blood work the doctor decided to start me on TRT.

After being on TRT for three years my testicles shrunk and I am long producing sperm. My wife and I decided to try for another child. In knowing this my doctor placed me on HCG 3 months ago. The dose is 2000 i/u every other day in conjunction with my testorsterone which is 200 mg every other week.

Is it possible to start producing sperm again while on TrT, or do most men get completely off?

Any advice?

I have noticed the size of my testes have doubled since I have taken HCG.

 

[bochinit]

Get off, use HCG, make a kid.

 

[Vince]

Here's a good thread to read. You may get away with just using HCG, the only way you'll know is by having sperm analysis.

Semen analysis results after adding FSH to TRT and hCG

So after 6 months of adding FSH to my TRT protocol I got a sperm analysis done. A quick background. My fertility was normal before TRT and went to zero when I started TRT without HCG. Adding HCG 500 IU 2x a week my sperm analysis results were: sperm count 2.1mm (normal >=20mm) total sperm 7.2mm...

www.excelmale.com

 

[Cataceous]

Dr. Saya's fertility ranking:

A *very* generalized ranking of relative fertilities (with top being most fertile):

1. Clomid/SERM treatment
2(A). HCG + HMG (or lyophilized FSH)
2(B). Baseline no treatment (no HPTA suppression via TRT, AAS, HCG mono, etc) - assuming no significant degree of primary/secondary/tertiary dysfunction.
3(A). HCG monotherapy (does in fact result in HPTA suppression, especially at higher doses, but *may* move up to #2 in select cases of SECONDARY/TERTIARY hypogonadism)
3(B). TRT + HCG (as we know many men are still able to maintain adequate fertility to conceive)
4. TRT/AAS with no concurrent HCG.

HCG Monotherapy to Clomid Ratio For Fertility

HCG Monotherapy to Clomid Ratio For Fertility

www.peaktestosterone.com

 

[DS3]

Hey, I have been reading threads thru out the years since I've been on TRT. I appreciate everyone's advice and stories of their own. However, I haven't seen a question like mine.

I have three children and after my youngest was born, 4 years ago, I began to experience low T symptoms. After blood work the doctor decided to start me on TRT.

After being on TRT for three years my testicles shrunk and I am long producing sperm. My wife and I decided to try for another child. In knowing this my doctor placed me on HCG 3 months ago. The dose is 2000 i/u every other day in conjunction with my testorsterone which is 200 mg every other week.

Is it possible to start producing sperm again while on TrT, or do most men get completely off?

Any advice?

I have noticed the size of my testes have doubled since I have taken HCG.

Low-dose hCG can prevent sterility in men prescribed testosterone

NEW ORLEANS — Low-dose human chorionic gonadotropin, or hCG, may preserve spermatogenesis in men with hypogonadism treated with intramuscular or transdermal testosterone replacement therapy, according to a speaker at the Androgen Society annual meeting. The estimated male population in their...

www.healio.com

It is possible to conceive a child while on TRT. According to Dr. Ramasamy, 66% of men on TRT become azoospermic, while 33% maintain some sperm in the ejaculate. Below is a study conducted by Dr. Ramasamy wherein he discusses HCG's role in maintaining fertility while on TRT.

Indications for the use of human chorionic gonadotropic hormone for the management of infertility in hypogonadal men - PMC

Hypogonadism among men desiring fertility preservation presents a unique challenge to physicians. Over the past decade the number of younger men with hypogonadism has increased dramatically. These men are often treated with testosterone replacement ...

www.ncbi.nlm.nih.gov

If i were in your shoes, I would continue the co-administration of HCG & Testosterone, conduct a semen analysis after three months and see where you are at. if you are good to go then good deal. If not, then I would (1) add in FSH at 75 iu 3x weekly or (2) drop T and add in Clomid.

 

[Vince]

You may also like to watch this video.

Estradiol in Men: Interview with Urology Professor Dr Ranjith Ramasamy

Nelson Vergel, founder of ExcelMale.com and DiscountedLabs.com and author of Testosterone: A Man's Guide, interviews Dr Ranjith Ramasamy. Dr Ramasamy is the Director of Male Reproductive Medicine and Surgery as well as an Assistant professor in Department of Urology at the University of Miami...

www.excelmale.com

 

[Cips1975]

I am on Test cyp and on 500iu a week of HcG ( been on for 2 plus years) . Had a semen analysis done in Feb at the IVF clinic, and my analysis is normal with the exception of morphology which was slight below. Numbers were not super awesome but within range and good candidate for IVF along with my significant other. I am 44, 45 in July

 

[Gman86]

Just had a kid in December, and conceived him while I was on test with 1000iu’s of HCG per week. Was actually off of HCG completely for a month or two when he was conceived.

 

[buckeye22]

Ask your urologist about stopping test injections and starting protocol of:
50mg Clomid 3x week (MWF) plus add
500iu HcG 3x week (T,Tr,Sa)

 

[DS3]

Ask your urologist about stopping test injections and starting protocol of:
50mg Clomid 3x week (MWF) plus add
500iu HcG 3x week (T,Tr,Sa)

Why the irregularity in Clomid dosing? The most common dosing protocol would be 25 mg daily.

 

[BigDawg]

Low-dose hCG can prevent sterility in men prescribed testosterone

NEW ORLEANS — Low-dose human chorionic gonadotropin, or hCG, may preserve spermatogenesis in men with hypogonadism treated with intramuscular or transdermal testosterone replacement therapy, according to a speaker at the Androgen Society annual meeting. The estimated male population in their...

www.healio.com

It is possible to conceive a child while on TRT. According to Dr. Ramasamy, 66% of men on TRT become azoospermic, while 33% maintain some sperm in the ejaculate. Below is a study conducted by Dr. Ramasamy wherein he discusses HCG's role in maintaining fertility while on TRT.

Indications for the use of human chorionic gonadotropic hormone for the management of infertility in hypogonadal men - PMC

Hypogonadism among men desiring fertility preservation presents a unique challenge to physicians. Over the past decade the number of younger men with hypogonadism has increased dramatically. These men are often treated with testosterone replacement ...

www.ncbi.nlm.nih.gov

If i were in your shoes, I would continue the co-administration of HCG & Testosterone, conduct a semen analysis after three months and see where you are at. if you are good to go then good deal. If not, then I would (1) add in FSH at 75 iu 3x weekly or (2) drop T and add in Clomid.

Thanks for your reply. I had my semen analysis done after three months. I got my results yesterday. My sperm count was 43 million. 32 percent motility.

 

[BigDawg]

expand...

Thanks for your reply. I had my semen analysis done after three months. I got my results yesterday. My sperm count was 43 million. 32 percent motility.

 

[BigDawg]

I am on Test cyp and on 500iu a week of HcG ( been on for 2 plus years) . Had a semen analysis done in Feb at the IVF clinic, and my analysis is normal with the exception of morphology which was slight below. Numbers were not super awesome but within range and good candidate for IVF along with my significant other. I am 44, 45 in July

 

[BigDawg]

What was your morphology? And if sperm is good, why IVF?

 

[Wilson7]

Watch the long term use of Clomid, it shuts down the GH/IGF-I axis. IMO before starting clomid, have your circulating IGF-I checked, then about 4 weeks in and see if there is any difference. Some note a drop of about 40%.

 

[Aging Disgracefully]

Watch the long term use of Clomid, it shuts down the GH/IGF-I axis. IMO before starting clomid, have your circulating IGF-I checked, then about 4 weeks in and see if there is any difference. Some note a drop of about 40%.

Maybe consider adding in some MK677 to preserve GH production?

 

[Wilson7]

AD, it ends up being adding another drug to counter the sides of the first drug that add more sides. There are studies that show HCG will preserve intratesticular T conc and fertility with HRT. If the subject has any concerns about fertility, and is starting HRT they should start HCG concurrently and have their semen analyzed before HRT, a month and then 3 months after. Why try to fix something after it is broken vs preserve it. MK677 has its own issues (water retention, BP increases, etc.) not something an older guy should be throwing in the mix.

 

[Cips1975]

What was your morphology? And if sperm is good, why IVF?

Fiancé had a tubal ligation. I am 44 almost 45 and she is 40. After looking at the options, IVF was the route we chose versus tubal reversal.

 

[buckeye22]

Why the irregularity in Clomid dosing? The most common dosing protocol would be 25 mg daily.

There’s nothing irregular about it. Clomid does not need to be taken on a daily basis. There are plenty of studies on CINAHL & PubMED about Clomid for men’s testosterone and fertility with varying dosages. In addition, this was the protocol I changed to from my urologist before I had my baby at 46 before moving onto test cyp inj.

 

[DS3]

There’s nothing irregular about it. Clomid does not need to be taken on a daily basis. There are plenty of studies on CINAHL & PubMED about Clomid for men’s testosterone and fertility with varying dosages. In addition, this was the protocol I changed to from my urologist before I had my baby at 46 before moving onto test cyp inj.

There are plenty of studies demonstrating that common practice in TRT is to take once weekly injections. However, we know that many men feel better and that it’s significantly more physiological to microdose with EOD test injections. Not all do it by any means, but it is becoming the more optimal manner of administration.

The same can be said of Clomid. Does Clomid have to be take ED? No. Just as testosterone does not have to be taken ED or EOD, but it is more physiological and optimal to do so. Dr. Crisler always suggested taking lower ED doses as opposed to larger EOD doses to reduce side effects.

Dr. Ramasamy and Dr. Lipshultz also suggest this practice as a preferred treatment method.

“For those patients desiring to establish a pregnancy within 6 months, testosterone therapy should be discontinued, and treatment begun with 3000 IU hCG ± clomiphene citrate (25 mg daily) and a semen analysis performed every 2 months.”

Asian Journal of Andrology

www.ajandrology.com