Coming off of TRT to test sperm counts and vas deferens - Advice needed on Clomid

[kewe]

I stop taking my Test last week so the fertility doctor can see my true levels of my LH and FSH, he bumped my HCG to 2500 per week and kept me on my anti Estrogen and wants to do another blood test in a few weeks to see if my LH and FSH improves versus the 0.1 they are now. I had a vasectomy reversal a year ago and he is trying to determine if the reversal went ok or if I am having a sperm issue before we go to any further steps and also he said the high dosage of HCG will keep my T high and to keep my wife happy and am supporting this. A buddy gave me 50 X 25mg pills of Clomid -how much to take and then and how often and should I? I asked the Doc should I take and he said the Anti Estrogen is enough to help but I want to do whatever I can to kick-start these suckers. Any advice?

[IncreaseMyT]

Your LH and FSH will not improve while on HCG.

HCG is partially suppressive. Sounds like a good plan, bad diagnostics.

[kewe]

Your LH and FSH will not improve while on HCG.

HCG is partially suppressive. Sounds like a good plan, bad diagnostics.

It's the plan that he has hus other TRT patients go through so I'll ride it out and see what happens. Other sites are following what he is suggesting along with adding Clomid.

[IncreaseMyT]

It doesn't matter what any sites say. I see lab work of men on TRT or HCG everyday. If you think your LH and FSH are going to rise while on HCG then you don't understand how HCG works.

Obviously neither does your doctor.

Taking clomid while on HCG is pointless as well.

[IncreaseMyT]

Like I said your plan isn't bad, but looking for high LH and FSH while your on HCG is silly.

HCG is great at maintaining or even sparking fertility, but it is suppressive to LH and FSH.

[kewe]

Then what do you recommend?

[kelkel]

Not sure how your doc expects to see your "true" LH/FSH levels by taking you off TRT and only adding HCG. He's assuming that over time your endogenous production of LH/FSH will resume on it's own. Maybe they will, maybe they won't. That will be contingent on what put you on TRT in the first place and how responsive your pituitary is to restarting itself without stimulation from Serms like clomid or nolvadex. If you are secondary hypogonadal and had crap LH/FSH levels originally then odds are that is where you will return.

Adding large amounts of HCG into the mix will only add up to more suppression over time like IMT referenced. Think of it this way, HCG is suppresive as the pituitary senses it doesn't need to produce any further due to the exogenous LH mimic. My initial thought would have been to just stay on your TRT and increase your HCG dose slightly and give it time.

Read this, particularly the section on HCG:

Preserving fertility in the hypogonadal patient: an update

[kewe]

Thanks kelkel. He wanted me to up my hcg and continue my anastrozole and take another blood test. Should I add in Clomid or is it a waste of time and just do what he wants and see whats he suggests after the next.blood work or come of of everything completely? Next week I go in for a sperm test but they tend to blame TRT for my lack of sperm so I am stuck here. He left me on hcg to keep my t high because it what has been keeping my depression at bay so he didn't want me cold turkey.

[Mr.BB]

If you want sperm you need to add HMG which is the analog of FSH, and increase HCG slightly like Kel said.

Urologists sometimes get a bit mixed up with hormones. Tell him you want HMG to test your sperm and not to come off TRT.

You can show him this study if it gets difficult: Combined hMG/hCG treatment in subfertile men with idiopathic normogonadotrophic oligozoospermia

EDIT: also he might not want to use HMG cause of cost, its expensive.

[kewe]

Thanks. I will pass this along. Know anywhere trusted I can buy myself? Please pm me..

[IncreaseMyT]

Well I don't understand the point of testing. And yea HMG is a great tool, but you do not need it to get prego.

If you just crank the HCG you should be prego within a month or 2. You didn't even have to come off the testosterone.

One client of ours called us the other day. 4 years ago he went through all this stuff. We said why don't you just get on TRT and have babies?

His doc threw him out of his office. Long story short he just had his 4th kid!!!! This is a true story. Army guy, think he jumps out of helicopters.

My whole point in responding was why are you looking for FSH and LH? Are you trying to have a kid or are you trying to recover?

If you just want to see if your fertile just get a sperm analysis while on the HCG or come off all the way and go to clomid. Your LH and FSH will be sky high. Once you come off the clomid though they usually plummet. HCG is the best.

If you just want to get pregnant, crank the HCG to 500 to 1,000 IU two to three times per week and monitor your estradiol (with your docs supervision of course).

You should be pregnant in no time, unless of course your primary hypogonadal.

Like I said HMG is great, it may be a little over board for this. Maybe after of years of abuse it would be necessary.

Hope this helps.

[kewe]

Trying to have a kid. I think they base so much on fsh and lh as the index if I am producing sperm. I have been on hcg 1500 for months and my lh and fsh is still close to zero so now I am at 2500 a week and no t and I do blood work in two weeks and see where I am and if he is happy or not. He didnt want to do the sperm analysis until I was off the t. We will see what happens.

[kelkel]

Brilliant! Throw even more HCG at it in effort to elevate pituitary function. Some docs just don't get it.

[Mr.BB]

Thanks. I will pass this along. Know anywhere trusted I can buy myself? Please pm me..

Any pharmacy will get you HMG, you just need a script from your doc, dont understand your question or problem.

So you had a vasectomy reversal, tried to get prego with HCG with no sucess, and the doctor is blaming TRT??

Like the guys above said, your LH and FSH will not rise while you are on HCG.

You are TRT cause you are hypogonadal?? Or you just decided to start TRT for some other reason?

It seems you have secundary hypogonadism cause docs are giving you HCG, so dont really understand how they expect that your pituitary becomes normal releasing loads of LH and FSH, when you got into TRT because of it NOT releasing enough LH. Really brilliant like Kel said.

Tell your lab that you have secundary hypogonadism, so your LH and FSH will never get high.

If your sperm count was close to zero, its your doc who messed up the vasectomy reversal, which is really not uncommon.

[kewe]

I wasn't secondary, I was having depression and trt was suggested as a solution and it really worked. As for my doctor who has been doing doing this for 20 years and has a phd and 1000's of patients I don't think I need to tell you who's side my wife is on, but saying my dr is an idiot isn't helpful. I'm more than glad to pass along info to my doctor and other comments but he is going by what he normally looks at for patients and maybe I am a small minority that is causing him a unique headache being on trt. As for the reversal being successful, if you can tell that from reading then you must have several PhDs because there is no way to know since you never examined me until I have my sperm analysis which will be next week. We never thought my wife would be in a situation to have children but he performed a miracle in her so he is getting any benefit of the doubts currently bit i did print the articles out and will give it to him. Most likely I will be getting too much blood work done and as soon as he see's this isn't working I can suggest an idea from here or he will but as I said he was putting me on hcg to keep my T up so i don't go back into depression. Either way all give this up completely to make my wife happy and suffer until she gets pregnant or find a middle ground

[IncreaseMyT]

I have been on hcg 1500 for months and my lh and fsh is still close to zero so now.

This is completely normal and expected on HCG.

[Mr.BB]

I wasn't secondary, I was having depression and trt was suggested as a solution and it really worked. As for my doctor who has been doing doing this for 20 years and has a phd and 1000's of patients I don't think I need to tell you who's side my wife is on, but saying my dr is an idiot isn't helpful. I'm more than glad to pass along info to my doctor and other comments but he is going by what he normally looks at for patients and maybe I am a small minority that is causing him a unique headache being on trt. As for the reversal being successful, if you can tell that from reading then you must have several PhDs because there is no way to know since you never examined me until I have my sperm analysis which will be next week. We never thought my wife would be in a situation to have children but he performed a miracle in her so he is getting any benefit of the doubts currently bit i did print the articles out and will give it to him. Most likely I will be getting too much blood work done and as soon as he see's this isn't working I can suggest an idea from here or he will but as I said he was putting me on hcg to keep my T up so i don't go back into depression. Either way all give this up completely to make my wife happy and suffer until she gets pregnant or find a middle ground

Sorry, cant help with the wife problem. Can say that personnaly I dont let my wife influence my health decisions, and let me tell you she tries.

We can only comment based on the information you provided.

Best of luck to you!

[kewe]

Thanks. I'm trying to make her happy and so far she is happy that I am following his advice. The toughest thing is that I need an expert on both areas but we will see. It I can up my dosage in hcg and stay on t that would be great.

[kewe]

Quick Update:

So I have been on 4,000 IU's a week of HCG (2k twice a week) and taking anostrozole as I was and no Test and my latest blood work has my Test as 730 and my FSH went from .01 the last two years to .07. I have my next analysis next week for a count and we will see where I am at. I will see if he will continue with this dosage or add in anything else. I have noticed that my depression hasn't been coming back but I guess that is due to my Test being higher than what I normally have.