Regaining Fertility on TRT

[phaedo]

This question is fairly straightforward, yet the myriad of answers make the solution a quagmire of possibilities.

I was fertile before, but after 2.5 years on TRT (and no hCG or AI), a recent sperm counts proves me as azoospermia.

Now several fertility protocols involve clomid, hCG, or a combination of hCG and hMG. I've also seen AI's thrown in the mix sometimes. It seems, however, that all these approaches require the cessation of TRT. For the most obvious of reasons, I do not want stop TRT -- simply put, my life would be hell.

My question is this: can we, as TRT patients, regain fertility without coming off testosterone?

I have plenty more to say, but I thought best to start this discussion here -- for my sake as a hopeful father and others, who may find themselves in a similar predicament.

[TraceMYD]

Great topic. I took a proactive approach and got my sperm frozen before getting on TRT, my doc made it very clear that TRT could make me not fertile.

I was surprised that I had such a low sperm count before starting TRT.

I think this is something that should be a standard test amongst people under 35 getting on TRT.

[phaedo]

Great topic. I took a proactive approach and got my sperm frozen before getting on TRT, my doc made it very clear that TRT could make me not fertile.

I was surprised that I had such a low sperm count before starting TRT.

I think this is something that should be a standard test amongst people under 35 getting on TRT.

^ Yeah, exactly. When I posed the question to my original endocrinologist who started me on TRT, I was told "not to worry about it" as it "won't be a problem." Ahhh, yes it is a very a real problem lol.

If I must come off TRT for sometime to restart and load the bus, so to speak, than I will bank sperm as you did. Except I'd rather not want to come off TRT if there are possible ways around the issue.

[vetvso]

I have had similar issues, and have went off TRT and take HCG with Clomid and 10mg anavar this has resolved most of my issues with a increase of Test and I will get blood work next week.

For me I was suffering major symptoms of high blood pressure and major water retention. I will stay on this protocol until I fully recover, and yes I will have to cycle on and off of test unless I get lucky and recover to higher levels.

[phaedo]

Was Anavar prescribed by your doctor?

[phaedo]

Just received word from my doctor that he'd like to start me on 3000 UI of hCG and 75 UI of hMG three times weekly. He would, unfortunately (or maybe not?), like to stop the testosterone supplementation. Thoughts?

Are hCG and hMG effective with or without testosterone? Or does exogenous testosterone suppress FSH/LH, even when stimulated by analogues?

[VTX1800]

I'm waiting for a reply on this as well. I'm in the same boat as you. Doc prescribed clomid 25mg daily with my cyp, hcg, anastrozole. My LH and FSH were still 0.2 after my 6 week BW so I don't think the clomid is helping. I'm scheduled for a sperm analysis In a few weeks.

How much is your hmg??? From what I read at 75iu 3 times there is an 80% success rate on pregnancy. I found hmg for $35 for 75iu but it's just not affordable. To increase success rate I do believe you will have to stop the test, but maybe not??? Also look into having your wife take hmg as well. Good luck, my wife and I are both 30 and trying to have our first child.

[phaedo]

I'm waiting for a reply on this as well. I'm in the same boat as you. Doc prescribed clomid 25mg daily with my cyp, hcg, anastrozole. My LH and FSH were still 0.2 after my 6 week BW so I don't think the clomid is helping. I'm scheduled for a sperm analysis In a few weeks.

How much is your hmg??? From what I read at 75iu 3 times there is an 80% success rate on pregnancy. I found hmg for $35 for 75iu but it's just not affordable. To increase success rate I do believe you will have to stop the test, but maybe not??? Also look into having your wife take hmg as well. Good luck, my wife and I are both 30 and trying to have our first child.

Originally, the doctor (a reproductive urologist... not a fertility specialist) thought to start me on Clomid everyday, though he wanted to first consult with fertility specialists for guidance. In the mean time, I emailed him several studies from PubMed demonstrating the effectiveness of gonadotropin therapy (like you said, upwards of 80%). The doc went ahead and had the pharmacy order hCG/hMG. I'm unsure of the cost (my insurance covers it) but will let you know.

You didn't stop testosterone with the Clomid? My doctor would of had me quit TRT regardless (Clomid or hCG/hMG) - apparently exogenous testosterone will suppress FSH/LH even stimulated by analogs? Not sure...

Don't give up hope yet though! From the many studies I've read, it takes about 90 for the Leydig and Sertoli cells to result in a detectable sperm count and up to 6 months for what could be considered a "healthy level." My wife and I are both 25 and trying to conceive for the first time. Hopefully, I can use a sperm bank in the future, assuming gonadotropin therapy works for me...

[steroid.com 1]

TRT is for life; stopping and starting at this point (unless something insidious like cancer) makes little sense to me.

What are your Doctor's objectives?

I see two:

1) He wants to restart HPTA by stopping your TRT and kick starting it with the HCG and hMG (although Clomid would probably be a better option). With this however, and that is if you are successful i getting HPTA to restart, will only put you back to where your serum levels were before you started your TRT which I am assuming were not good so you know what you are in for when that happens not discounting the crash that will occur before HPTA gets back to functioning again.

2) Just stay on your TRT protocol and add in HCG per the sticky above in the forum. HCG will reactivate your testes and you will begin producing natural endogenous testosterone again. The good thing is you don't need to come off your protocol and HCG use in TRT is highly recommended anyway. We need our testes to function no matter what and because HCG is an LH analog it does other things in the body and brain where we have LH receptors.

Even if you come off, and if you can get HPTA to restart, at best you are only going to get back to your low levels again. And at some point you would need to get back on your TRT protocol for all the reasons you're on it now.

If it were me, I just add in the HCG to get the testes back to a normal healthy functioning state and don't come off TRT.

Many a man has gotten their wives prego when on TRT with HCG...

[phaedo]

My doctor's ultimate objective is for my wife to conceive a child - at the moment, it's not happening (and confirmed by a semen analysis).

Without a single iota of doubt, I want to stay on TRT. I'm stressing out at the thought of crashing and going back to my old "low-T" ways. My total testosterone measured 38 ng/dl at the time I went on TRT, and with any combination of words to explain the fatigue, depression, and lack of ambition would be an understatement.

The question still remains: will hCG and hMG be adequate to restart sperm production, even with supplementing exogenous testosterone? Or must I discontinue TRT? If I had any kind of medical literature or empirical reasoning showing fertility can be regained while continuing TRT, I would be extremely grateful.

However, the significance of conceiving a child and having a family trumps my well-being, at least for the meantime, and so if it comes down to it, I'm willing to give up TRT for the interim. But really, it would be hell.

[VTX1800]

The best option in my opinion is to try the hcg hmg while remaining on protocol. Just get a sperm analysis done as often as possible. This is my plan as well minus hmg or the time being. If my sperm analysis is a no go then I plan on stopping the exogenous test and hope for a restart. Yes I know I'm suppressed and I know I will feel like hell again but until the job gets done that's all I can do. Before I drop the test I will def. give hmg a try. Everything you mentioned above is similar to what I'm experiencing now. Ye many guys get there wives prego while on TRT but when your sperm count is 0 then you obviously have no other choice than to stop test and go for a restart and allow enough time to increase sperm production. Assuming one is using hcg in there protocol and all else fails that is.
I thought insurance wouldn't cover fertility drugs such as hmg? I do belie I need to look into this further.

[kruno1970]

Same situation here. Started on 150 ml of Test E and then add hcg 2 weeks in at 500 iu's 3x week. Then doc told me to go off test after 4 weeks and started 1000iu 3x a week protocal(total 7 weeks in). Going for bloodwork soon (next week) but I did notice strength decreasing and overall well-being but not as bad as other posts have stated. What I would like know has anyone been on trt (test and hcg) and had their sperm count tested? If so, what was your count. Would like to get back on about 100ml of test a week but still have active sperm production.

Wife and I are going IVF route so I know I dont need sperm to be super high because fertility lab will take the good sperm and fertilize the egg. Any feedback would be much appreciated.

[phaedo]

Same situation here. Started on 150 ml of Test E and then add hcg 2 weeks in at 500 iu's 3x week. Then doc told me to go off test after 4 weeks and started 1000iu 3x a week protocal(total 7 weeks in). Going for bloodwork soon (next week) but I did notice strength decreasing and overall well-being but not as bad as other posts have stated. What I would like know has anyone been on trt (test and hcg) and had their sperm count tested? If so, what was your count. Would like to get back on about 100ml of test a week but still have active sperm production.

Wife and I are going IVF route so I know I dont need sperm to be super high because fertility lab will take the good sperm and fertilize the egg. Any feedback would be much appreciated.

How long were you on TRT before you introduced hCG?

[VTX1800]

I can give you an answer after May 17th when I do my semen analysis. I've been on hcg 250IU mwf and test c 200mg a week. I will post my results on this thread.

[kruno1970]

Only 2 weeks.

[kruno1970]

I can give you an answer after May 17th when I do my semen analysis. I've been on hcg 250IU mwf and test c 200mg a week. I will post my results on this thread.

Sounds good. How long have you been on Test and HCG?

[Timm1704]

Any updates on this issue fellas? I am in exactly the same boat as the original poster, having been on testosterone for around 7 years practically non-stop (aside from several short breaks that in no way would give my balls a chance of recovery). Had sperm analysis done last year and it was 0, was once fertile so am told there is hope. REALLY dont want to come off testosterone completely, as it would have a huge negative impact on me personally and professionally, but if there is no other way then I guess Id have to for awhile.

[SOL!D5NAK3]

My fsh is low off cycle , so i was researching for this kind of situation a while .
The thing is you need adequate levels of testosterone for sperm production plus FSH. So if some one is on trt for more than 6 months i think the chance for having test levels at the least is very slim , and you have to do a poweful hcg-clomid+tamox-maybe another hcg and after that another clomid tamox and it takes time.
I did not found any studies on guys on trt and fertility but i think fsh+lh (hmg) injections would really help. It is just a suggestion and i have not practiced it but if i was in your situation i would have done 75iu(or 150) of hmg eod 500iu hcg eod at the start of my wife's period until ovulation and conceiving.