KelKel, or anyone, some advice. Need babies.

[Little76]

Hey guys.

Haven't posted in many years, so I'm not sure what the most up to date procedures are.

Anyway, been on TRT for about 10 years, primary hypo.

Used HCG on and off through out that time, haven't used for years now.

Came off cold turkey (dumb I know), and the missus fell pregnant in about 6 months.

We are now trying for number 2, so the same as last time, came off cold turkey 4 months ago, nothing yet.

The thing is, I can't do it anymore. I need to go back on. It's affecting my work, my moods, and my family.

It probably wouldn't have been so bad if I did a pct..... but I didn't and here we are.

When I was off last time, my sperm count was about 6 million/ml. That's about as high as it's ever been, but I have not had a test this time round.

My question is, what's around these days (if anything) that will create spermogenisis while on TRT?
HCG? HMG?

Or should I just hit a blast of HCG and PCT and wait it out?

Cost is no issue, and I should be able to get anything I need.

Thanks guys.

[cousinmuscles]

Hey guys.

Haven't posted in many years, so I'm not sure what the most up to date procedures are.

Anyway, been on TRT for about 10 years, primary hypo.

Used HCG on and off through out that time, haven't used for years now.

Came off cold turkey (dumb I know), and the missus fell pregnant in about 6 months.

We are now trying for number 2, so the same as last time, came off cold turkey 4 months ago, nothing yet.

The thing is, I can't do it anymore. I need to go back on. It's affecting my work, my moods, and my family.

It probably wouldn't have been so bad if I did a pct..... but I didn't and here we are.

When I was off last time, my sperm count was about 6 million/ml. That's about as high as it's ever been, but I have not had a test this time round.

My question is, what's around these days (if anything) that will create spermogenisis while on TRT?
HCG? HMG?

Or should I just hit a blast of HCG and PCT and wait it out?

Cost is no issue, and I should be able to get anything I need.

Thanks guys.

Hello, there shouldn't be a need to come off your TRT. HCG and HMG work independently of your HPTA. HCG mimics the function of LH on leydig cells. HMG is a bit more "deluxe" but unsure why you'd need it.

The studies done on HCG prove spermatogenesis can be maintained on TRT.

https://www.ncbi.nlm.nih.gov/pubmed/23260550/

[Little76]

Hello, there shouldn't be a need to come off your TRT. HCG and HMG work independently of your HPTA. HCG mimics the function of LH on leydig cells. HMG is a bit more "deluxe" but unsure why you'd need it.

The studies done on HCG prove spermatogenesis can be maintained on TRT.

https://www.ncbi.nlm.nih.gov/pubmed/23260550/

Thanks mate.

HCG was king years ago, and I'm glad it still is.

I have severe atrophy now though, so was a little worried that going back on would make it harder to bring them back. Maintaining isn't the same as bringing the boys back from the size of a raisin.

Doses.
I remember years ago I was prescribed 5000iu shots every week.
After researching it seemed that it was a bad idea due to desensitisation of the laydig cells.
From memory I ran 500iu x3 a week.

Any advice on what you'd recommend?

That study showed 500iu EOD.

Is there anything else I can add apart from HCG to increase sperm count/ejaculate size?

[Little76]

Does anyone have any other suggestions on what I can or should run alongside HCG to increase spermogenisis and/or ejaculate size?

On or off TRT.....

[cousinmuscles]

https://www.ncbi.nlm.nih.gov/pmc/art...AJA-18-373.pdf

Clinically, hCG has proven successful at inducing and/or
maintaining spermatogenesis alone or in combination with FSH
in patients with hypogonadotropic hypogonadism (HH). HH is an
uncommon but treatable cause of male factor infertility classically
considered secondary to pathology of the hypothalamus or pituitary
gland as seen with Kallman’s syndrome, Prader–Willi syndrome,
panhypopituitarism from prolactinomas, tumors, infection or radiation,
or idiopathic causes.21 Recently, recognition that the increasingly
common use of exogenous TRT and/or AAS can also induce HH,
also known as ASIH, with associated diminished spermatogenesis.
Therefore, men with azoospermia or severe spermatogenic defects due
to classic HH serves as a useful context in whom to appreciate the effect
of gonadotropins upon spermatogenesis clinically. However, due to the
uncommon prevalence of HH, high-quality data are lacking and most
are limited to case reports and retrospective series.41
Historically, treatment approaches for HH have focused upon
physiologic, pulsatile GnRH therapy to induce secondary sex
characteristics and spermatogenesis with reported pregnancy rates
as high as 80%.42,43 However, widespread use of pulsatile GnRH is
inherently limited due to the need for an external pump for periodic
hormone release, cost, and requirement of a functionally intact
pituitary gland to appropriately respond to hypothalamic signals.44
Alternatively, treatment with injectable gonadotropin regimens has
demonstrated equivalent clinical efficacy compared with GnRH for
triggering spermatogenesis based upon a recent meta-analysis.44
Therefore, gonadotropins offer patients an efficacious and more
convenient treatment approach.45 FSH given alone or in combination
with testosterone has proven unsuccessful at inducing spermatogenesis
or maintaining spermatogenesis in those previously induced with
hCG/FSH (hCG 1500 IU and HMG 150 IU both subcutaneous
and 3 times per week), confirming the need for maintenance of
elevated ITT.46 However, long-term use of hCG alone can induce
spermatogenesis in up to 70% of patients, with a greater effect seen
in men with initial testis length >4 cm, but further improvement is
appreciated with the addition of FSH (HMG) suggesting a timelier
recovery with both gonadotropins.47 The success of inducing
spermatogenesis with a combination of hCG and FSH is supported
by several studies (Table 1).41,42,45,48–53 In these data, most begin by
stimulating endogenous testosterone production with trial of hCG
alone with doses ranging from 1500 to 5000 IU 2–3 times per week
titrated according to serum testosterone levels . Most experts treat
with hCG alone for 3–6 months after which a certain number of cases
will result in spermatogenesis induction. In those without adequate
spermatogenesis induction, treatment proceeds with the addition of
FSH with doses ranging from 75 to 400 IU 2–3 times per week titrated
according to semen analysis results. Success defined as induction of
spermatogenesis with >1–1.5 × 106
ml−1 sperm was reported to occur
in 44%–100% of patients treated for 6–144 months.52 Pregnancy rates,
when reported, were observed in 40%–75% of patients usually at sperm
concentration levels below “normal.”42,51,54 Factors predicting success
include larger baseline testis volume, previous natural gonadotropin
exposure (normal puberty), and repeated treatment cycles whereas
previous exogenous testosterone exposure and cryptorchidism
portend a slower response although these findings are variable.42,55

That's the article I found to be best when I bookmarked it.

Run HCG for a long time until your testicles come back to size. If you can source it, add HMG later on.

It seems 500iu EOD is a good dose that won't desensitize the Leydig cells but will increase function to above baseline.

[cousinmuscles]

Coming off TRT after 10 years may or may not work, I don't know, hope someone chimes in. Send kelkel a pm

[Little76]

Coming off TRT after 10 years may or may not work, I don't know, hope someone chimes in. Send kelkel a pm

Thanks brother.

[kelkel]

Excellent advice from Cousin.
There's nothing I need to add.
Links are on-point.

[Little76]

Update.

Had some tests.

Bloods
Testosterone 2.4 (10-33)
SHBG 19 (13-71)
No LH, but probably <2 like always.

Seminal fluid analasys
Volume 4.5ml (>1.5)
Total sperm 0

Convinced doctor to prescribe HCG .
She has given me 6 months worth at 1500iu/wk which I’ll split into 3 doses, M,W,F.

Started back on HRT, but doing 500mg for the next 4 weeks, then I’ll drop back to 250mg.

I’ll do more bloods and sperm in 12-16 weeks and see where we are at.

[Little76]

Hey guys....

Been on HCG 3x500iu every week since this thread.... But I may have made an error.

Reading the leaflet, it says HCG should be taken IM.... .Ive been doing SubQ...... Im sure thats what I did last time

Does it work subQ? or did I dream that up?

[Little76]

Seems like it works, but not as well.

https://academic.oup.com/humrep/arti...11/2294/644343

[kelkel]

Either way works just fine. SQ simply being easier.

[Little76]

Hey guys.

Wednesday I’ll be doing another semen analysis, I’ll get the results by the end of the week.

If it comes back at zero...... should I run a higher amount of HCG ? I’m running 500iu 3x week.

If not, what should I look at adding, and at what doses?


Fingers crossed there’s something going on down there though.

[Kay kay]

While I’m not familiar with the full process you will need to undergo I do know it is very possible and ultimately likely preferable to stay on your trt dosage while doing this. I speak from watching friends accomplish this while remaining on cruise doses.

[Quester]

I'm interested to know how this turns out, please keep posting. Good Luck!

[Little76]

Hey guys.

Wednesday I’ll be doing another semen analysis, I’ll get the results by the end of the week.

If it comes back at zero...... should I run a higher amount of HCG ? I’m running 500iu 3x week.

If not, what should I look at adding, and at what doses?


Fingers crossed there’s something going on down there though.

KelKel? Cousin?