Hey everyone. I know a lot of this topic has been covered a few times, but since every case is different I figured I would start an original post and invite input from the entire community. Ill put as much detail as possible. A brief bio:
40yo retired military, Registered dietitian and full-time student. No kids, although at 23 I did have a pregnancy situation that unfortunately the other party did not want to follow through with. The good news is I know at one time I was fertile, and this is a secondary condition. The bad news is that the experience mentally rattled me, and is one of a few reasons I decided to jump on T Enanthate at moderate to high doses, as well as other AAS here and there over the years, with no regard for side effects or fertility. I was always active, ate well, and otherwise very healthy so I never really needed ancillaries, or so I thought. Even when my TT was over 2000 and Free over 350, I never aromatized or had issues other than testicular atrophy. Fast forward 13 years of TE administration with very few breaks, no HCG or ancillaries, and now my lady wants kids, and frankly so do I.
Being in the nutrition and now the medical world, I scoured PubMed and Google Scholar for studies on my situation and came away with a protocol of 2500iu HCG EOD/25mg Enclomiphene ED. I took my last shot of T June 10, 2017, and started in July. I ran labs Sept 25. Which were as follows:
Labs were run through LabCorp:
TT 1125 (250-1100ng/dl)
FT 129.6 (46-224pg/ml)
BAT 266.5 (110-575ng/dl)
LH 1.1 (1.5-9.3Miu/ml)
FSH 4.1 (1.6-8Miu/ml)
DHEA 128 (106-464mcg/dl)
SBGH 48 (10-50nmol/L)
Estradiol Ultrasensitive: 10 ( <or=29pg/ml)
All lipids, IGF-1, CBC and thyroid values looked good.
With this, I was pleased that my TT was this high only 90 days post-long-term T use. I felt an increase in testicular volume, and overall pretty decent. I decided I wanted to put this in the hands of Defy and Dr. Saya, who was very understanding and agreeable, suggesting I stay on the enclomiphene if I trust the source, keep HCG as is, add DHEA 50 ED, gave me 0.25mg Anastrozole in the event I needed it, and also said FSH was an option if needed, so I picked up a few bottles, expecting that I would probably need to do an initial blast. He ordered a Semen analysis and said to check in with labs in 90 days from late October. One theme I noticed throughout my research on PubMed, as well as several stories from members like 'Healthman, Dni.labs, and Mrj, HopefulStory and more', was that regular dosing of FSH is the key to restoration, especially after a long suppression. So that was in the back of my mind and picked up plenty from Empower.
We are now 32 days into the original protocol, and I feel like I'm 40 going on 70. I have zero motivation, zero energy, and zero libido. ZERO. To the point where I feel like if I went to do my SA I would need a cialis or viagra just to attain the sample. Now my testes continue to regain their original size, and based on my labs I believe I am moving in the right direction from a restoration aspect, but the caveat to that is feeling awful. I know Clomid, and especially enclomiphene alone are supposed to be the best treatment for fertility, but I also know many people feel awful on SERMs and my E2 is 10 is definitely not helping.
So, long story longer, after reading the accounts of the already mentioned members, as well as posts by Nelson, Dr Crisler, and Dr. Saya, I feel I may have gone into this incorrectly. I hadn't seen the studies or anecdotes on this forum, only the medical literature. What I was very happy to learn was the number of men, regardless of age or duration of TRT use, full recovery is attainable while remaining on TRT, by adding enough HCG and FSH. Those numbers need to be dialed in according to each individual person, but the average use I am seeing be successful is anywhere from 100-150mg T split 2-3x/week, either IM or SQ, 250-500iu HCG ed or EOD, either IM or SQ, and FSH SQ from 40iu biweekly up to 75iu/day (higher, more frequent dosing for older males with more androgen history), and Adex PRN based on symptoms. I also see many posts by Nelson saying adding HCG at 500iu EOD actually is more effective at restoring fertility than HCG mono, with fewer sides, and Dr. Crisler saying that when comparing equal labs, people on TRT generally feel better across the board than on HCG mono.
I feel that my system is definitely kicking in, and the near 6-month break was probably a good thing regardless, but I can't deal with feeling like this. Not when it seems very plausible and even preferred to remain on T and add in HGG and FSH. I plan to run labs early Jan, and I would like to get the SA done if I can manage to pull it off, just to see where I am. I know that it takes approximately 80 days to create healthy sperm, and being that I only stopped TRT in June and started the ancillaries in July I don't expect to see a full recovery, but I do think I will see some improvement (I hope). I need to pull labs and see Dr. Saya in Jan, but I really am considering jumping back on T, with the above-described dosing. I have some T enanthate left, and Id probably starts at 40-50mg SQ MWF, 500iu HCG SQ EOD, and FSH 75iu ED to start, and then based on parameters adjust doses down, especially once recovery is made. While fertility is the priority, It's not a super rush as my girl is younger, and I still have a few years of school left. We would like it to happen within the year, but if it waits for 2-3 that's fine, provided I'm feeling well. At this rate, I won't have a girl if I keep feeling like the Grinch who Stole Christmas!. In fact, based on the last labs, and testicular volume I feel I'm already on the right track.
Obviously, I need to follow-up with Dr. Saya, who hopefully will come across this, but all things being equal I would like any input or suggestions on this entire situation by anyone on here. I have enough supplies to begin that protocol and even at 75iu FSH a day I have a little over 3 months worth, which in my research is more than enough to at least kickstart production and then lower it moving forward. But I can't last another 60 days on just the HCG/Enclomiphene. I know that the SERM is ideal for regaining fertility off T, but I think and pray I have put in enough time. It's not worth feeling like this every day. I appreciate everyone's suggestions and input.
40yo retired military, Registered dietitian and full-time student. No kids, although at 23 I did have a pregnancy situation that unfortunately the other party did not want to follow through with. The good news is I know at one time I was fertile, and this is a secondary condition. The bad news is that the experience mentally rattled me, and is one of a few reasons I decided to jump on T Enanthate at moderate to high doses, as well as other AAS here and there over the years, with no regard for side effects or fertility. I was always active, ate well, and otherwise very healthy so I never really needed ancillaries, or so I thought. Even when my TT was over 2000 and Free over 350, I never aromatized or had issues other than testicular atrophy. Fast forward 13 years of TE administration with very few breaks, no HCG or ancillaries, and now my lady wants kids, and frankly so do I.
Being in the nutrition and now the medical world, I scoured PubMed and Google Scholar for studies on my situation and came away with a protocol of 2500iu HCG EOD/25mg Enclomiphene ED. I took my last shot of T June 10, 2017, and started in July. I ran labs Sept 25. Which were as follows:
Labs were run through LabCorp:
TT 1125 (250-1100ng/dl)
FT 129.6 (46-224pg/ml)
BAT 266.5 (110-575ng/dl)
LH 1.1 (1.5-9.3Miu/ml)
FSH 4.1 (1.6-8Miu/ml)
DHEA 128 (106-464mcg/dl)
SBGH 48 (10-50nmol/L)
Estradiol Ultrasensitive: 10 ( <or=29pg/ml)
All lipids, IGF-1, CBC and thyroid values looked good.
With this, I was pleased that my TT was this high only 90 days post-long-term T use. I felt an increase in testicular volume, and overall pretty decent. I decided I wanted to put this in the hands of Defy and Dr. Saya, who was very understanding and agreeable, suggesting I stay on the enclomiphene if I trust the source, keep HCG as is, add DHEA 50 ED, gave me 0.25mg Anastrozole in the event I needed it, and also said FSH was an option if needed, so I picked up a few bottles, expecting that I would probably need to do an initial blast. He ordered a Semen analysis and said to check in with labs in 90 days from late October. One theme I noticed throughout my research on PubMed, as well as several stories from members like 'Healthman, Dni.labs, and Mrj, HopefulStory and more', was that regular dosing of FSH is the key to restoration, especially after a long suppression. So that was in the back of my mind and picked up plenty from Empower.
We are now 32 days into the original protocol, and I feel like I'm 40 going on 70. I have zero motivation, zero energy, and zero libido. ZERO. To the point where I feel like if I went to do my SA I would need a cialis or viagra just to attain the sample. Now my testes continue to regain their original size, and based on my labs I believe I am moving in the right direction from a restoration aspect, but the caveat to that is feeling awful. I know Clomid, and especially enclomiphene alone are supposed to be the best treatment for fertility, but I also know many people feel awful on SERMs and my E2 is 10 is definitely not helping.
So, long story longer, after reading the accounts of the already mentioned members, as well as posts by Nelson, Dr Crisler, and Dr. Saya, I feel I may have gone into this incorrectly. I hadn't seen the studies or anecdotes on this forum, only the medical literature. What I was very happy to learn was the number of men, regardless of age or duration of TRT use, full recovery is attainable while remaining on TRT, by adding enough HCG and FSH. Those numbers need to be dialed in according to each individual person, but the average use I am seeing be successful is anywhere from 100-150mg T split 2-3x/week, either IM or SQ, 250-500iu HCG ed or EOD, either IM or SQ, and FSH SQ from 40iu biweekly up to 75iu/day (higher, more frequent dosing for older males with more androgen history), and Adex PRN based on symptoms. I also see many posts by Nelson saying adding HCG at 500iu EOD actually is more effective at restoring fertility than HCG mono, with fewer sides, and Dr. Crisler saying that when comparing equal labs, people on TRT generally feel better across the board than on HCG mono.
I feel that my system is definitely kicking in, and the near 6-month break was probably a good thing regardless, but I can't deal with feeling like this. Not when it seems very plausible and even preferred to remain on T and add in HGG and FSH. I plan to run labs early Jan, and I would like to get the SA done if I can manage to pull it off, just to see where I am. I know that it takes approximately 80 days to create healthy sperm, and being that I only stopped TRT in June and started the ancillaries in July I don't expect to see a full recovery, but I do think I will see some improvement (I hope). I need to pull labs and see Dr. Saya in Jan, but I really am considering jumping back on T, with the above-described dosing. I have some T enanthate left, and Id probably starts at 40-50mg SQ MWF, 500iu HCG SQ EOD, and FSH 75iu ED to start, and then based on parameters adjust doses down, especially once recovery is made. While fertility is the priority, It's not a super rush as my girl is younger, and I still have a few years of school left. We would like it to happen within the year, but if it waits for 2-3 that's fine, provided I'm feeling well. At this rate, I won't have a girl if I keep feeling like the Grinch who Stole Christmas!. In fact, based on the last labs, and testicular volume I feel I'm already on the right track.
Obviously, I need to follow-up with Dr. Saya, who hopefully will come across this, but all things being equal I would like any input or suggestions on this entire situation by anyone on here. I have enough supplies to begin that protocol and even at 75iu FSH a day I have a little over 3 months worth, which in my research is more than enough to at least kickstart production and then lower it moving forward. But I can't last another 60 days on just the HCG/Enclomiphene. I know that the SERM is ideal for regaining fertility off T, but I think and pray I have put in enough time. It's not worth feeling like this every day. I appreciate everyone's suggestions and input.
