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So ive been on trt for a few years and want to have more kids. My doc is pulling me off trt and getting started on HCG to get the sperm going again. However, she wants me to do 5,000ui every other day. not only is this expensive ($200 a month even after insurance coverage), i have read elsewhere that it could be damaging and excessive.
what do you guys think about dosing that much HCG?
There is an hcg/Clomid protocol that is most effectively proven in recovery of spermatogenesis after loss due to AAS use. The article is here. I have posted links.Quote:
Originally Posted by jaxbrah
Try the search function. Yes btw that is a bit excessive imo.
https://www.ncbi.nlm.nih.gov/m/pubmed/25904023/
Follow the link. Pretty sure this is it
Your doc is half right on half the compounds that work best.
That's 25%...
He gets an F.
I am sure he got C's in med school.
Tell him his grades are slipping and I expect better by midterm.
You should have been on HCG the entire time you were on TRT. I hate to say it but find a doc with actual testicals. If she had them she may realize that adding HCG maintains testicular function as well as spermatogenesis. Also, read this and show it to your doc. You may not need to come off TRT, adding HCG to your protocol over time may do the trick for you.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4378070/
If you use HMG, after an initial run of just hcg to get your nuts in order,
then you don’t need to come off TRT.
(HMG is more expensive than hcg, so you want to use hcg instead for as much time as possible, but HMG will start spermatogenesis even if you’re on a ton of roids)
Seems way excessive to me. Also, you do not have to come off TRT to regain fertility if the testicles are still responsive to LH/FSH (hence HCG). The research I've seen is that approximately 1000 IU per week in divided doses (at least 3 per week) is all it takes to regain normal testicular function in health volunteers receiving 200 mg of T-eth per week (a stout dose of T, I might add). They measured Intatesticular testosterone (ITT) levels, which is a marker of fertility. Sperm cells need a higher local T environment to mature properly than what normally occurs in the peripheral circulation.Quote:
Originally Posted by jaxbrah
I agree with all of this, except that it might be difficult to regain fertility with hcg alone once you’ve lost it during TRT. According to what I’ve been taught you need FSH as well to regain fertility once it’s lost.Quote:
Originally Posted by Youthful55guy
But it is possible to remain fertile on TRT with hcg alone.
But once spermatogenesis has stopped, I think it usually requires a bit more than just hcg (if you don’t stop TRT) to regain it.
HMG will do the trick however.
and hcg might do it, but I wouldn’t count on it.
Regarding hcg dosage my understanding is that 250-500u x 3 a week is sufficient, and that more than 500u x 3 might actually do more harm than good.
HMG is simply lyophilized FSH extracted from the urine of post-menopausal women, although there is some research that point to a slightly longer half life of FSH in anestrous females (65 minutes vs. 4 hours). This may indicate some alterations of the structure of the protein. Regardless, FSH/HMG is not only extremely expensive, it has a very short half life in comparison to HCG (24 to 36 hours). So use of HMG in preserving or re-attainment of fertility is logistically challenging and expensive.Quote:
Originally Posted by DocToxin8
HCG has both LH and FSH like activity, so it functionally replaces both hormones in clinical use, although it's ability to bind to LH receptors is much stronger than that of FSH. Never the less, it has been used successfully in clinical practice to stimulate fertility in TRT treated men. I've read numerous accounts in various forums supporting that 500 to 1000 IU per week is effective in establishing pregnancy.
Here's 2 articles that discuss it, both are available open access from the publishers. The first one is a small study of human volunteers using both TRT and HCG. You have to dig deep into the full article to see that 1000 IU per week is about optimal. The second article is a clinical opinion paper, and recommends a much higher doses (17500 to 10,500 IU per week), depending on the speed with which the individual wishes to reestablish fertility and the length of time on TRT. This seems a bit excessive and expensive to me and the authors don't really support it with any research data.
Coviello, A.D., Matsumoto, A.M., Bremner, W.J., Herbst, K.L., Amory, J.K., Anawalt, B.D., Sutton, P.R., Wright, W.W., Brown, T.R., Yan, X., et al. (2005). Low-dose human chorionic gonadotropin maintains intratesticular testosterone in normal men with testosterone-induced gonadotropin suppression. J Clin Endocrinol Metab 90, 2595-2602.
Ramasamy, R., Armstrong, J.M., and Lipshultz, L.I. (2015). Preserving fertility in the hypogonadal patient: an update. Asian J Androl 17, 197.