Starting a family?

Hello guys. I've been on TRT for many years and now my wife and I are hoping to start a family. I have been getting advice privately, which I'm super thankful for. But I am just wanting to get some ideas for now from some of you guys as to how to go about it. I assumed the issue is with me because of my TRT, but we're getting some tests done with my wife in about 4-6 weeks just to narrow down if it is me exclusively, or both of us.

What I'm getting at is that we still want to be trying to conceive while we await her testing to be done. Can anyone that has had children in my situation, or might have been off full blast, and conceived? Conception is one area I know absolutely nothing about. I'm taking my hcg 250x 2 weekly and 150mgs test. I have been told by some very reputable people that while TRT can cause sterility, going way up on full blast can actually make a person fertile. This sounds odd to need, but the 2 guys that both of them have conceived while on full blast. Ands not just 1 child, but plural.

The last thing I'll add in my opening is that my wife had been on birth control for about 7 years but has been off her BC now for about 6 months.

Please feel free to ask more questions if needed for a better answer. I'm really struggling here and feel bad for her because she's really wanting a child. I do too. I do have plenty of hcg if anyone thinks her taking it would be beneficial. I'm an open book guys, so ask away! Thanks a lot.

Not sure if this helps but maybe it can give you a start to your research

https://www.ncbi.nlm.nih.gov/pubmed/12185103

Have you tried talking to your TRT Doctor?

Kelkel will have good advice!

I saw a ferility doc before starting my trt. A full blast increasing fertility sounds like complete nonsense. The Fertility doc said that when I wanted to conceive, he would
take me off trt and
run hcg for three months.

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Originally Posted by PT1982

What I'm getting at is that we still want to be trying to conceive while we await her testing to be done. Can anyone that has had children in my situation, or might have been off full blast, and conceived? Conception is one area I know absolutely nothing about. I'm taking my hcg 250x 2 weekly and 150mgs test. I have been told by some very reputable people that while TRT can cause sterility, going way up on full blast can actually make a person fertile. This sounds odd to need, but the 2 guys that both of them have conceived while on full blast. Ands not just 1 child, but plural.

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Going way up on full blast can actually make a person fertile - Short answer, absolutely untrue. Don't listen to that advice.

In my research on optimal HCG dosing (to prevent testicular atrophy), I came across and article: Ramasamy, R., J. M. Armstrong and L. I. Lipshultz (2015). "Preserving fertility in the hypogonadal patient: an update." Asian journal of andrology 17(2): 197. https://www.ncbi.nlm.nih.gov/pubmed/...t%3A+an+update

It's a somewhat involved paper and unless you are trained to read medical literature can get a little confusing. Bottom line summary is that male fertility requires both an LH and FSH signal. The FSH signal tells the Sertoli cells to undergo spermatogenesis and the LH signal tells the Leydig cells to make testosterone. nothing new here, that's reproductive endocrinology 101. What is important to know is that spem aturation requires a certain level of intra-testicular testosterone (ITT). The ITT levels are much higher than in the peripheral blood. So, in order to be fertile, you need to not only stimulate the Sertoli calls to undergo spermatogenesis (with an FSH signal), you also have to get the leydig cells to make T and keep ITT levels high, which requires an LH signal.

Now, HCG enters the story. HCF has both LH and FSH activity. It can provide both an LH and FSH signal in a single hormone. The objective of the article was to determine how much HCG was needed to get ITT levels back to the levels of a normal, healthy, fertile adult male. The bottom line is that about 1000 IU per week is required (best to do this in divided doses 2 or more times per week). Here's a summary I wrote in another post for this study.

• In a RCT of 29 healthy volunteer men undergoing TRT (Age 18-45 yr). They received 200 mg/wk T-Eth
• TRT w/ no HCG = 94% decrease in ITT
• TRT w/125 IU E2D (438 IU/wk) = 25% decrease in ITT
• TRT w/ 250 IU E2D (875 IU/wk) = 7% decrease in ITT
• TRT w/ 500IY E2D (1,750 IU/wk) = 26% decrease in ITT
• The two higher HCG Rx groups had higher serum T levels than placebo by about 290 ng/dL (~10 nmol/L)
• The HCG recovery rate for ITT appears to be about 150IU/day (1060 IU/Wk)

I had a similar conversation with a guy in another forum with a situation very similar to yours. He was using the exact same dose you were using and was scheduled to undergo a semen analysis in a couple weeks. He wondered if he should increase his dose. I counseled him not to at this point because he would be a moving target with the semen analysis. It take 4 to 6 weeks for spermatogenesis to occur. That is, the sperm cells you make today will not be ejaculated for another 4 to 6 weeks. As it turned out, the semen analysis at 250 IU 2X per week showed he was fertile and he did soon conceive a child at that dose. However, I'm guessing that 1000 IU per week would have made him even more fertile based on the results of this study.

Since you 4 to 6 weeks before your semen analysis, your situation is very different. If you were to up the dose to about 1000 IU per week, you should be at peak and stable fertility by the time of your tests. That is, provided your testicles are capable of spermatogenesis. I would suggest dividing that dose up too, such as 150 UY daily, 300 IU E2D, 450 IU E3D or M, W, F, etc..

Best of luck!

Thanks for everything guys (and gal)! My wife is the one that's going to get the tests ran, just to rule her out. My sperm count is low, and I've been in TRT for many years. So should I just run hcg at 1000ius weekly in the meantime? Anything else I should be doing? I'm almost certain the issue is all on me, but she's going to check just to rule her out

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Originally Posted by PT1982

Thanks for everything guys (and gal)! My wife is the one that's going to get the tests ran, just to rule her out. My sperm count is low, and I've been in TRT for many years. So should I just run hcg at 1000ius weekly in the meantime? Anything else I should be doing? I'm almost certain the issue is all on me, but she's going to check just to rule her out

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Yes, that is where I would start and in 4-6 weeks see if there is any improvement in sperm count. You might want to watch your E also as some guys reported E issues with higher HCG levels, but it doesn't seem to bother me at that dose.

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Originally Posted by Youthful55guy

Yes, that is where I would start and in 4-6 weeks see if there is any improvement in sperm count. You might want to watch your E also as some guys reported E issues with higher HCG levels, but it doesn't seem to bother me at that dose.

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Thanks a lot! I will keep check on bloods just because I get them done every 2 months as is. Thanks for the advice! Fertility is one area in completely in the dark about. Other than the hcg, is there anything else you can think of for me to try along with it? Hmg? Anything?

PT re-read the section on HCG and fertility in the study I pm'd you last week.