HCG Dosage/Frequency

[OoberVir]

This is my first thread and I wanted to start it off by thanking you guys for all the information you provide on this forum. It has really helped me out and also allowed me to determine that my doctor more or less knows what he is doing. However, I feel his recommended dosage of HCG too much.

The dosage he put me on was around 500iu ED. Based on what I've read I know this dosage to be too high. However, as I am relatively young for a TRT I am interested in having kids later. So I switched my dosage to 500iu EoD as per the study that was done at UC San Diego, maintaining spermatogenesis in young males at that dosage. This is also a higher dosage than seems to be recommended on this forum. I understand the concern of leydig desensitization and intratesticular estradiol levels but I was wondering if you could refer me to any studies or literature that would demonstrate this. Also is it reasonable to assume that spermatogenesis would be maintained a lower dosage, i.e. the type recommended on this forum? Thanks

[MickeyKnox]

Hi and welcome.

Are you now on TRT with Testosterone as a base that includes hCG to prevent testicular atrophy? Or are you being treated with hCG only?

[steroid.com 1]

IMO, 500 iu EOD is still too much. Dr. John Crisler is now prescribing starting at 100 iu daily. Lower doses more frequently mimics the bodies more natural diurnal process.

The efficacy for hCG for both Primary and Secondary Hypogonadism has been documented.

Tung-Chin Hsieh, Alexander W. Pastuszak, Kathleen Hwang and Larry I. Lipshultz*,†

From the Division of Urology, University of California-San Diego (TCH), San Diego, California, Scott Department of Urology, Baylor College of Medicine (AWP, LIL), Houston, Texas, and Department of Urology (KH), Brown University School of Medicine, Providence, Rhode Island

Purpose: Testosterone replacement therapy results in decreased serum gonadotropins and intratesticular testosterone , and impairs spermatogenesis, leading to azoospermia in 40% of patients. However, intratesticular testosterone can be maintained during testosterone replacement therapy with co-administration of low dose human chorionic gonadotropin , which may support continued spermatogenesis in patients on testosterone replacement therapy.

Materials and Methods: We retrospectively reviewed the records of hypogonadal men treated with testosterone replacement therapy and concomitant low dose human chorionic gonadotropin (HCG ). Testosterone replacement consisted of daily topical gel or weekly intramuscular injection with intramuscular human chorionic gonadotro- pin (500 IU) every other day. Serum and free testosterone, estradiol, semen parameters and pregnancy rates were evaluated before and during therapy.

Results: A total of 26 men with a mean age of 35.9 years were included in the study. Mean followup was 6.2 months. Of the men 19 were treated with injectable testosterone and 7 were treated with transdermal gel. Mean serum hormone levels before vs during treatment were testosterone 207.2 vs 1,055.5 ng/dl (p <0.0001), free testosterone 8.1 vs 20.4 pg/ml (p = 0.02) and estradiol 2.2 vs 3.7 pg/ml (p = 0.11). Pretreatment semen parameters were volume 2.9 ml, density 35.2 million per ml, motility 49.0% and forward progression 2.3. No differences in semen parameters were observed during greater than 1 year of followup. No impact on semen parameters was observed as a function of testosterone formulation. No patient became azoospermic during concomitant testosterone replacement and human chorionic gonadotropin therapy. Nine of 26 men contributed to pregnancy with the partner during followup.

Conclusions: Low dose human chorionic gonadotropin appears to maintain semen parameters in hypogonadal men on testosterone replacement therapy. Concurrent testosterone replacement and human chorionic gonadotropin use may preserve fertility in hypogonadal males who desire fertility preservation while on testosterone replacement therapy.

[OoberVir]

Hi and welcome.

Are you now on TRT with Testosterone as a base that includes hCG to prevent testicular atrophy? Or are you being treated with hCG only?

I'm taking 60mg of testosterone cyp twice a week, along with hCG. The thought is to keep me fertile throughout TRT but preventing testicular atrophy would also be nice.

IMO, 500 iu EOD is still too much. Dr. John Crisler is not prescribing starting at 100 iu daily. Lower doses more frequently mimics the bodies more natural diurnal process.

The efficacy for hCG for both Primary and Secondary Hypogonadism has been documented.

Tung-Chin Hsieh, Alexander W. Pastuszak, Kathleen Hwang and Larry I. Lipshultz*,†

From the Division of Urology, University of California-San Diego (TCH), San Diego, California, Scott Department of Urology, Baylor College of Medicine (AWP, LIL), Houston, Texas, and Department of Urology (KH), Brown University School of Medicine, Providence, Rhode Island

Purpose: Testosterone replacement therapy results in decreased serum gonadotropins and intratesticular testosterone , and impairs spermatogenesis, leading to azoospermia in 40% of patients. However, intratesticular testosterone can be maintained during testosterone replacement therapy with co-administration of low dose human chorionic gonadotropin , which may support continued spermatogenesis in patients on testosterone replacement therapy.

Materials and Methods: We retrospectively reviewed the records of hypogonadal men treated with testosterone replacement therapy and concomitant low dose human chorionic gonadotropin (HCG ). Testosterone replacement consisted of daily topical gel or weekly intramuscular injection with intramuscular human chorionic gonadotro- pin (500 IU) every other day. Serum and free testosterone, estradiol, semen parameters and pregnancy rates were evaluated before and during therapy.

Results: A total of 26 men with a mean age of 35.9 years were included in the study. Mean followup was 6.2 months. Of the men 19 were treated with injectable testosterone and 7 were treated with transdermal gel. Mean serum hormone levels before vs during treatment were testosterone 207.2 vs 1,055.5 ng/dl (p <0.0001), free testosterone 8.1 vs 20.4 pg/ml (p = 0.02) and estradiol 2.2 vs 3.7 pg/ml (p = 0.11). Pretreatment semen parameters were volume 2.9 ml, density 35.2 million per ml, motility 49.0% and forward progression 2.3. No differences in semen parameters were observed during greater than 1 year of followup. No impact on semen parameters was observed as a function of testosterone formulation. No patient became azoospermic during concomitant testosterone replacement and human chorionic gonadotropin therapy. Nine of 26 men contributed to pregnancy with the partner during followup.

Conclusions: Low dose human chorionic gonadotropin appears to maintain semen parameters in hypogonadal men on testosterone replacement therapy. Concurrent testosterone replacement and human chorionic gonadotropin use may preserve fertility in hypogonadal males who desire fertility preservation while on testosterone replacement therapy.

Thanks, I was also curious about any literature (or anecdotes) on hCG's effect on intratesticular estradiol or about the possibly of maintaining sperm production at a lower dosage.