Fertility Issue

[mkt_cycle]

There's not much point to this thread, but since the question about TRT and fertility comes up alot, I figured I'd share my experience.

I've been on 100mg ew for about 5 years now. I just got married and am trying to get the wife pregnant. Well, I went for an analysis and my worst fear was confirmed: 0 sperm. That's ZERO! I'm well aware that this happens sometimes on TRT, but it was still kind of a shock when I saw the number. After the new year, I will be going to a urologist to try to produce some swimmers. Meanwhile I've stopped the injections. I won't get into details, but my doctor is not much help here. His advice is just stop and everything will be cool. So until I see the urologist, I'm on my own.

One thing to mention is that before I started, I felt pretty good and don't remember any major issues, other than some difficulty gaining muscle. Of course I've felt great since being on. My doctor had done some routine tests and noticed that my test levels were around 330. He suggested TRT, but I did not start until a couple years later. At that point I had done a lot of research and knew exactly what I was getting into. To be 100% honest, my main motive was muscle gain and higher sex drive, which it worked well for.

So, I'm hoping that the crash will not as bad as some of the experiences others here have had. It's been two weeks since the last injection and I feel the same. IBut, I know that's probably normal and the big 'crash' is a few weeks away. I'll keep this updated as time goes on.

[jasondd1]

My guess is they will put you on some sort of clomid, hcg regiment with possible hmg. Im curious if you had been on hcg this whole time along with trt if you would still be at zero. Check the sticky at the top about hcg. 5 years with no hcg would mean no sperm for anyone. Assuming you had sperm before, this can most likely be fixed. Might take 6 months or so.

[mkt_cycle]

I think it should be able to be fixed. Like I said, I was aware possible fertility issues but I didn't think much of it. My doctor has told me through the years that none of his TRT patients have had any fertility issues that he knows of (I guess I'm the first ). So it's a combination of mine & my doctor's fault for not being more proactive about my treatment. Like you said, if I was producing before, there's no reason I shouldn't be able to restart. It's just going to be a long, slow process.

[steroid.com 1]

Were you using HCG during these 5 years as part of your TRT protocol?

If not, you wouldn't have any sperm production as you are shut down.

You're still shut down BTW and will need to be restarted as noted here.

[mkt_cycle]

I've never used HCG. I checked out your sticky on HCG (very useful BTW), but where is the restart information you mentioned?

[AnabolicDoc]

To the OP,

Most infertility doctors still start with Clomid and if that doesn't work to increase your test levels, they will switch to or add hcg. If that doesn't work they will then add/switch to either an FSH analog, such as Gonal-F, Follistim AQ, or Bravelle or they will add/switch to menotropins (commonly known as HMG), such as Repronex or Menopur. Success rates are high assuming you were making sperm before starting TRT. And as long as they can get u to produce some sperm you can have a child using ICSI (easier if u Google it than if I explain) coupled with IVF .

The algorithm most doctors use depends on institutional protocol and their training program

Feel free to PM me if you have more questions.

[Henryhill470]

Good luck buddy

[Henryhill470]

To the OP,

Most infertility doctors still start with Clomid and if that doesn't work to increase your test levels, they will switch to or add hcg. If that doesn't work they will then add/switch to either an FSH analog, such as Gonal-F, Follistim AQ, or Bravelle or they will add/switch to menotropins (commonly known as HMG), such as Repronex or Menopur. Success rates are high assuming you were making sperm before starting TRT. And as long as they can get u to produce some sperm you can have a cold using ICSI (easier if u Google it than if I explain) coupled with IVF .

The algorithm most doctors use depends on institutional protocol and their training program

Feel free to PM me if you have more questions.

If you are on TRT (200mg a week) and your running HCG 250mg EOD would that increase your sperm count ? Just curious ?

[AnabolicDoc]

There's no general answer for your question bc not everyone shuts down their sperm production in response to TRT. Researchers don't know why some ppl shut down and others don't. That's why the search for male contraception continues although MENT (trestolone) may be the answer.

Just as an aside, you may want to consider a semen analysis if this is important to u just to see where you stand. Also some would argue that the eod hcg is too often bc hcg has a 23-hr half life (according to the Pregnyl prescribing insert) and that the constant hcg may desensitize your testicles (Leydig cells) to LH and make it difficult to resume natural testosterone production if you want to come off of TRT some day.

But if you are part of the majority that shuts down sperm production in response to TRT, periodic hcg will prob just make it easier to resume natural testicular function some day but may or may not give you enough sperm for impregnation.

The problem in giving you a good answer is the lack of solid research in this area and not knowing what your response is, regarding sperm production, to TRT. I wish I could give u a better answer.

[Henryhill470]

There's no general answer for your question bc not everyone shuts down their sperm production in response to TRT. Researchers don't know why some ppl shut down and others don't. That's why the search for male contraception continues although MENT (trestolone) may be the answer.

Just as an aside, you may want to consider a semen analysis if this is important to u just to see where you stand. Also some would argue that the eod hcg is too often bc hcg has a 23-hr half life (according to the Pregnyl prescribing insert) and that the constant hcg may desensitize your testicles (Leydig cells) to LH and make it difficult to resume natural testosterone production if you want to come off of TRT some day.

But if you are part of the majority that shuts down sperm production in response to TRT, periodic hcg will prob just make it easier to resume natural testicular function some day but may or may not give you enough sperm for impregnation.

The problem in giving you a good answer is the lack of solid research in this area and not knowing what your response is, regarding sperm production, to TRT. I wish I could give u a better answer.

Thanks buddy !

[mkt_cycle]

Thanks for the info... I should be able to get an appointment with a urologist in a couple weeks and hopefully one who is knowledgeable about this subject. Getting my sperm tested or better yet storing some would have been the way to go, but hey, I have to deal with the situation as it is now. But, I'm pretty hopeful about the situation at this point. I've haven't injected now for 3 weeks so I'm wondering if my body is getting any signal yet to start production (I know it's much more complicated than that). I don't feel any side effects of stopping....yet. Still waiting for the big crash.

[mkt_cycle]

Henryhill470, Thank you! I will need it.

[mkt_cycle]

Just a quick update... I went to the urologist and he ordered some bloodwork (test, LH etc.) and said to come back in 6 weeks. So looks like no clomid or HCG anytime soon. Feeling like I've lost a little strength but nothing significant. All I'm hoping for at this point (other than getting the wife pregnant) is keeping the gains that I have. Upping calories and cleaning up the diet a bit to hopefully maintain, maybe even gain a little.

[lovbyts]

I just back from the urologist also today for ferility/vasectomy reversal. It was only a consoltation and he gave me rx for 3 months hcg and or (my descesion) clomid. He wants me to try hcg first.

He also ordered the full bloodwork.

[mkt_cycle]

I just back from the urologist also today for ferility/vasectomy reversal. It was only a consoltation and he gave me rx for 3 months hcg and or (my descesion) clomid. He wants me to try hcg first.

He also ordered the full bloodwork.

Ya know, you don't have to brag about it!

This guy is more interested in finding out why I had low T in the first place than treating me for anything. So I don't fault him for that but I was definitely looking for him to prescribe something. I told him I was crashing hard but he said there was nothing he could do and I had to wait it out. Looking at the paperwork again, I see he also prescribed an ultrasound.

[lovbyts]

Sorry using app from smart phone so I didnt write more. Didnt mean to come across that way. Will add to it later from work and real keyboard

[mkt_cycle]

I was just messing around! Good luck with everything. Is the reversal procedure another surgery?

[lovbyts]

Thanks but yeah it did sound bad when I went back to look. With the app on the phone I also only saw the one post above mine for some reason. I have a real keyboard now so you will just have to bear with the poor spelling and grammar. lol


OK what I meant to get at was it's a little ironic the difference between one doctor and another. Here you are with an obvious problem and expecting some type of help and the obvious solution should be just to put you on HCG now but yes also order the bloodwork.

I have been on TRT for about 5 years also.
I had a vasectomy about 10 years ago and am considering a reversal. He said lets first see if we can get things working before the reversal because it works better that way or you have a better chance of the reversal not causing as secondary blocage. He wants me to start the HCG and come back in 3 months to talk more about options and see how Im feeling but if I start to feel bad at any time to come in right away.

He said he wants me to stop TRT also of course but he says it's because 90%+ people become sterile and yes he realizes a lot of people think the opposite but claims it's proven even recently that it's above 90% especially after 3+ years???

He thinks after 6 months on HCG it would be a good time to do an extraction to see if there are any live kicking swimmers and if there are to go ahead with the reversal. He said it could take up to a year even and we may have to do HCG and Clomid combined but likes HCG better due to no worries about estrogen as there are with clomid. That's what he said...

He said that if I start feeling bad and the HCG and Clomid don't help he will consider a TRT/HCG/Clomid combination along with some other options.

I was asked to do blood-work today but he said I could wait if we wanted to talk about things first. He still sent me on my way with a 3mo prescription of HCG and Clomid and said he would put down for insurance purposed it's for TRT for now. So far I like this guy and he seems to be willing to work with me/us on what we decide.

I was also going to wait for the blood-work since I just had some done by private labs last week mid cycle to see where I was at and would rather do it when I know things are a little more normal. Good thing to. I just got my results back and it was just a tad high.

Good luck with your doc and I just meant to share similar experience and maybe offer something to think about when you go see yours again and vise versa.

Not trying to hijack your thread and i will start my own. Just hoping to share some information since it's similar in some ways.
How old are you? Your doc didnt look for why you were low T when you started TRT?

[AnabolicDoc]

Yea the number of ppl who shut down (become infertile) on TRT is very high. I've seen numbers as high as 80% after 6 months of high dose TRT. I believe your doctor is correct in saying that about 90% of ppl shut down after 3 years on TRT. It's amazing that some ppl retain function, I think.

To the OP, did u think about getting a second opinion? I just don't understand how your doc is going to find out the cause of your low T after 5 years of TRT. If he could figure out from the old bloodwork that's a diff story, but to think that your blood tests now will reveal the cause that wasn't apparent in the bloodwork 5 years ago seems difficult. All of your hormone levels will be skewed from your previous TRT. And studies show that without intervention, it can take 2 to 18 months to regain function once one has shutdown.

Just a thought. It can't hurt to hear what another doc has to say. Does your doc specialize in infertility or is he a general urologist? Also do you want to post your bloodwork from 5 years ago?

[mkt_cycle]

Thanks but yeah it did sound bad when I went back to look. With the app on the phone I also only saw the one post above mine for some reason. I have a real keyboard now so you will just have to bear with the poor spelling and grammar. lol


OK what I meant to get at was it's a little ironic the difference between one doctor and another. Here you are with an obvious problem and expecting some type of help and the obvious solution should be just to put you on HCG now but yes also order the bloodwork.

I have been on TRT for about 5 years also.
I had a vasectomy about 10 years ago and am considering a reversal. He said lets first see if we can get things working before the reversal because it works better that way or you have a better chance of the reversal not causing as secondary blocage. He wants me to start the HCG and come back in 3 months to talk more about options and see how Im feeling but if I start to feel bad at any time to come in right away.

He said he wants me to stop TRT also of course but he says it's because 90%+ people become sterile and yes he realizes a lot of people think the opposite but claims it's proven even recently that it's above 90% especially after 3+ years???

He thinks after 6 months on HCG it would be a good time to do an extraction to see if there are any live kicking swimmers and if there are to go ahead with the reversal. He said it could take up to a year even and we may have to do HCG and Clomid combined but likes HCG better due to no worries about estrogen as there are with clomid. That's what he said...

He said that if I start feeling bad and the HCG and Clomid don't help he will consider a TRT/HCG/Clomid combination along with some other options.

I was asked to do blood-work today but he said I could wait if we wanted to talk about things first. He still sent me on my way with a 3mo prescription of HCG and Clomid and said he would put down for insurance purposed it's for TRT for now. So far I like this guy and he seems to be willing to work with me/us on what we decide.

I was also going to wait for the blood-work since I just had some done by private labs last week mid cycle to see where I was at and would rather do it when I know things are a little more normal. Good thing to. I just got my results back and it was just a tad high.

Good luck with your doc and I just meant to share similar experience and maybe offer something to think about when you go see yours again and vise versa.

Not trying to hijack your thread and i will start my own. Just hoping to share some information since it's similar in some ways.
How old are you? Your doc didnt look for why you were low T when you started TRT?

Thanks for sharing... I'm really surprised that HCG/Clomid might help undo the vasectomy. I would have thought for sure that it could only be done by surgery (not that I know much about the subject though). When you say extraction, does that mean a semen analysis or actually going in there to look for it(ouch!)?

You definitely lucked out on finding a doctor that will work with you. Keep us posted how the HCG works for you. Hopefully I will get my hands on some soon too.

I'm 35. No, my doc didn't look for a reason and at that time I was just wanted to get things started. Obviously a mistake, but nothing I can do now. When I started, he just gave me a speech about how low T is very common now and that nobody is sure why it's affecting so many young men.

[mkt_cycle]

Yea the number of ppl who shut down (become infertile) on TRT is very high. I've seen numbers as high as 80% after 6 months of high dose TRT. I believe your doctor is correct in saying that about 90% of ppl shut down after 3 years on TRT. It's amazing that some ppl retain function, I think.

To the OP, did u think about getting a second opinion? I just don't understand how your doc is going to find out the cause of your low T after 5 years of TRT. If he could figure out from the old bloodwork that's a diff story, but to think that your blood tests now will reveal the cause that wasn't apparent in the bloodwork 5 years ago seems difficult. All of your hormone levels will be skewed from your previous TRT. And studies show that without intervention, it can take 2 to 18 months to regain function once one has shutdown.

Just a thought. It can't hurt to hear what another doc has to say. Does your doc specialize in infertility or is he a general urologist? Also do you want to post your bloodwork from 5 years ago?

I think your right on about going to a new doctor. Unfortunately, that means changing HMO networks and it is kind of a crapshoot as to whether I get a primary doc who knows anything at all about TRT. I'll just have to take my chances. The guy I went to is a general urologist and I didn't see anywhere that said he was a fertility specialist.

Unfortunately, I don't have any labs from back when I started. All I can remember is that total T was between 250-350 each time I got tested.

[lovbyts]

The surgery would still be necessary after determining that the sperm cell count is good and everything is working properly that's what the HCG and clomid would be 4 just getting the sperm working again. If everything works after the test then they would go in an actually re connect the plumbing.

[TraceMYD]

Mkt_cycle

Not sure if this info helps any but I have been on TRT for 11months using test e 200mg week and also added hcg to my protocol about 3months after I started. I'm 35y/o

I did make sure to get my sperm frozen before I started TRT and my count was pretty low.

I also been trying to get my fiancée pregnant since I started TRT with no success.

Her doctor told us to try for a year first naturally.

So at this point we have to also have to consider her fertility as well and that's our next step.

My point is, there seems to be a lot of pieces to the puzzle regardless of what you do.

[AnabolicDoc]

Mkt_cycle

Not sure if this info helps any but I have been on TRT for 11months using test e 200mg week and also added hcg to my protocol about 3months after I started. I'm 35y/o

I did make sure to get my sperm frozen before I started TRT and my count was pretty low.

I also been trying to get my fiancée pregnant since I started TRT with no success.

Her doctor told us to try for a year first naturally.

So at this point we have to also have to consider her fertility as well and that's our next step.

My point is, there seems to be a lot of pieces to the puzzle regardless of what you do.

If you were low to begin with, your levels are probably much lower since starting TRT. You should consider a repeat semen analysis while your wife gets looked an initial infertility evaluation.

[AnabolicDoc]

I think your right on about going to a new doctor. Unfortunately, that means changing HMO networks and it is kind of a crapshoot as to whether I get a primary doc who knows anything at all about TRT. I'll just have to take my chances. The guy I went to is a general urologist and I didn't see anywhere that said he was a fertility specialist.

Unfortunately, I don't have any labs from back when I started. All I can remember is that total T was between 250-350 each time I got tested.

I think it's definitely preferable to see a urologist who specializes in infertility. Check your plan policy and see if you can go out of network for a higher copay (or for instance a co-insurance where you pay a pe rcentage of the doctor's fee).

Also find out if there are other urologists available in your network, call them and see who has experience with infertility). Bc of the lack of make fertility doctors, there are some that practice remotely but that would probably be very expensive as it would be out-of-pocket. I don't know if your plan will let you send in a claim for partial reimbursement.

If you're interested you can always get your old lab results from your doctor and post them if you think it would help.

[TraceMYD]

If you were low to begin with, your levels are probably much lower since starting TRT. You should consider a repeat semen analysis while your wife gets looked an initial infertility evaluation.

I agree, we know the TRT probably made it worse and a recount is planned to be done after her evaluation as her fertility may be zero as well.

[mkt_cycle]

Mkt_cycle

Not sure if this info helps any but I have been on TRT for 11months using test e 200mg week and also added hcg to my protocol about 3months after I started. I'm 35y/o

I did make sure to get my sperm frozen before I started TRT and my count was pretty low.

I also been trying to get my fiancée pregnant since I started TRT with no success.

Her doctor told us to try for a year first naturally.

So at this point we have to also have to consider her fertility as well and that's our next step.

My point is, there seems to be a lot of pieces to the puzzle regardless of what you do.

Thanks for the input. That's discouraging that the HCG doesn't seem to be helping in your case. Have you gotten a recent semen analysis? My wife is also going for testing since there's some indications that she might have some issues too.

Hope everything works out for you. If you do go for a semen analysis, let us know what the numbers look like.

[mkt_cycle]

I think it's definitely preferable to see a urologist who specializes in infertility. Check your plan policy and see if you can go out of network for a higher copay (or for instance a co-insurance where you pay a pe rcentage of the doctor's fee).

Also find out if there are other urologists available in your network, call them and see who has experience with infertility). Bc of the lack of make fertility doctors, there are some that practice remotely but that would probably be very expensive as it would be out-of-pocket. I don't know if your plan will let you send in a claim for partial reimbursement.

If you're interested you can always get your old lab results from your doctor and post them if you think it would help.

I've made the switch to a new network after I found a urologist that specializes in infertility. Hopefully things go smooth as far as getting a referral right away from the new primary care doctor.

Next week I am going for bloodwork for testosterone., LH, & FSH. I'll post up the results when I get them. But I wonder, does anyone think it's too early to get these things tested? My last injection (100 mg cyponate) was December 7th. I'm just wondering if there's still anything in my system that might skew the results.

[AnabolicDoc]

I don't think it's an issue of test cyp being in your system. But I do think it's really and a little pointless. Your testosterone, LH, and FSH will ask be low as until 6 weeks ago you've been on years of TRT. But if that's what your doc wants b4 giving u a referral, what can you do.

[Canadream]

Been down the said road before as well..

ANY testosterone that you take will shut down your own production...in order for your natural test levels to recover you cannot take any testosterone or AAS AT ALL. Aromasin is an aromatase inhibitor that also increases natural testosterone production...

here is what i would do:

Wk 1: 1500iu of HCG 2x per week (mon, thurs), 25mg of Aromasin per day
Wk 2: 1500iu of HCG 2x per week (mon, thurs), 25mg of Aromasin per day
Wk 3: 1000iu of HCG 2x per week (mon, thurs), 25mg of Aromasin per day
Wk 4: 1000iu of HCG 2x per week (mon, thurs), 25mg of Aromasin per day
Wk 5: 100mg of clomid per day, 25mg of Aromasin per day
Wk 6: 50mg of clomid per day, 25mg of Aromasin per day
Wk 7: 50mg of clomid per day, 25mg of Aromasin per day
Wk 8: 50mg of clomid per day, 25mg of Aromasin per day
Wk 9-10: 25mg of Aromasin per day

Remember during this time you cannot take any AAS whatsoever...no test, no gels, nothing... 2-3 weeks after you are finished this protocol get your test and sperm count checked again.

[lovbyts]

Been down the said road before as well..

ANY testosterone that you take will shut down your own production...in order for your natural test levels to recover you cannot take any testosterone or AAS AT ALL. Aromasin is an aromatase inhibitor that also increases natural testosterone production...

here is what i would do:

Wk 1: 1500iu of HCG 2x per week (mon, thurs), 25mg of Aromasin per day
Wk 2: 1500iu of HCG 2x per week (mon, thurs), 25mg of Aromasin per day
Wk 3: 1000iu of HCG 2x per week (mon, thurs), 25mg of Aromasin per day
Wk 4: 1000iu of HCG 2x per week (mon, thurs), 25mg of Aromasin per day
Wk 5: 100mg of clomid per day, 25mg of Aromasin per day
Wk 6: 50mg of clomid per day, 25mg of Aromasin per day
Wk 7: 50mg of clomid per day, 25mg of Aromasin per day
Wk 8: 50mg of clomid per day, 25mg of Aromasin per day
Wk 9-10: 25mg of Aromasin per day

Remember during this time you cannot take any AAS whatsoever...no test, no gels, nothing... 2-3 weeks after you are finished this protocol get your test and sperm count checked again.

That looks pretty much like what my urologist is suggesting if hcg won't work alone.

[Canadream]

I juiced for yearss, no stop, no breaks, no PC. The said worked for me, wife was pregnant in 4 months.

That looks pretty much like what my urologist is suggesting if hcg won't work alone.

[mkt_cycle]

Just a quick update. I switched insurance and went to a urologist who specializes in fertility. He said he has seen this a lot and that sperm production usually comes back on its own without any treatment. I'm going to get testosterone, FSH, and LH tested next week. He said if numbers come back low he would likely start me on Clomid. I'm not sure what his definition of 'low' is.

It's been almost 2 months since last injection and to be honest I feel as great as I did when I was on. A little decline in sex drive and strength, but overall mood and well-being are fine. It should be interesting to see where the test numbers are at.

[mkt_cycle]

The surgery would still be necessary after determining that the sperm cell count is good and everything is working properly that's what the HCG and clomid would be 4 just getting the sperm working again. If everything works after the test then they would go in an actually re connect the plumbing.

Any updates on your progress?

[louie2400]

Just a quick update. I switched insurance and went to a urologist who specializes in fertility. He said he has seen this a lot and that sperm production usually comes back on its own without any treatment. I'm going to get testosterone, FSH, and LH tested next week. He said if numbers come back low he would likely start me on Clomid. I'm not sure what his definition of 'low' is.

It's been almost 2 months since last injection and to be honest I feel as great as I did when I was on. A little decline in sex drive and strength, but overall mood and well-being are fine. It should be interesting to see where the test numbers are at.

Thats great hear! So you haven't had any form on TRT in 2 months and you feel no different than you did when on TRT?

[mkt_cycle]

Thats great hear! So you haven't had any form on TRT in 2 months and you feel no different than you did when on TRT?

That's correct. In retrospect, I didn't feel a whole lot different after I started in the first place. The areas that did noticeably improve where sex and muscularity. But don't get me wrong, as soon as I'm able to get back on, I will do so! Other than the sperm shutdown, there don't seem to be any drawbacks for me, so why not just stay on it.

[mkt_cycle]

Ok, got bloodwork results back. It's been about 9 weeks since last injection. The doc is out for a week so I'll have to wait to hear what he says. Still don't feel much different than when I was 'on'.

Tesosterone Total- 191 (Reference range: 241-827)

Prolactin - 3.7 (2-18)

LH - 4.9 (1.5 - 9.3)

FSH - 8.4 (1.6 - 8.4)

[APIs]

Good luck, glad & amazed that you feel pretty good. How has your strength & workouts been affected? Must have been a scary proposition coming off!

[mkt_cycle]

Good luck, glad & amazed that you feel pretty good. How has your strength & workouts been affected? Must have been a scary proposition coming off!

Thanks. I was definitely freaking out about coming off, probably borderline paranoid. My lifts initially dropped-off a little, but I've hit several PR's over the last couple months, including today (final set of shoulder press with 75's ). My bench sucks, but that's normal. Weight has been holding steady at 195 for a loooooong time now (even before stopping TRT).

[mkt_cycle]

I'm worried about the FSH being high as I know that there's less likely a chance to produce sperm with an elevated level. Can anyone provide any more information or experience? Again, my doc is out until next week, so I'm left alone to try to interpret the results.