HRT and Infertility

[tripleoption]

should not

[mxim]

what are your total T levels at 150mgs per week? also,you should always use hcg in small dosages(250 iu 2x per week) as part of your HRT therapy. in order to restore your fertility,you will need to come off of T completely. hcg and clomid help assist in restoration of fertility.it will come back.remember,even a low sperm count can cause a pregnancy.the key is the sperm quality.
mxim

[mranak]

Have you had labs done for LH and FSH? It is possible that you need need HMG (contains FSH and LH) in addition to the hCG (which is effectively just LH).

[mranak]

Originally Posted by tripleoption

I will get the HMG this week. So I should continue the HCG with the HMG?

I'm not a fertility expert. I believe that they are often used together.

Originally Posted by tripleoption

What is an effective dose of HCG? I have been on the 1.5 ml for a while now.

What is the concentration per mL of your hCG? Does your hCG come as 10,000 IU with 10mL of water?

[earthdog]

Holy Gonadotrophin, Batman! That's a lot of hCG!

If I'm doing my math right, you're taking in 4,500 IU of hCG per week. At that dosage, you may risk developing LH insensitivity. Swale says that you should never take more than 500IU at a time. Many of his patients are on 250-500IU 2 or 3 times per week. These are dosages for TRT patients. I'm not a fertility expert either, so it may be that higher dosages are needed for fertility. I know I'm not being much of a help by only telling you what not to do. Hopefully someone else will chime in here.

[jwtex]

I have been on HRT for 4.5 years. I am 59 and my wife wanted to have children (she is a lot younger than I am) before it was too late. We tried for over a year with no luck. My sperm counts were very low as I had not been using any HCG with my therapy. My doc and Swale came up with a protocol that we tried. I was taking 250 IU’s a day of HCG and my same 100 mg of test cyp. I went way over range with my total, free and E2 with the daily HCG and 100 mg of Test. so we reduced my test shot to 50 mg a week and maintained the 250 IU’s of HCG every day. With that protocol; we got pregnant in the 3rd month. I am now a proud poppa of my 4th child. My next youngest is 27. It is kind of tough getting use to the middle of the night wake ups but boy is it worth it. It keeps one VERY young.

[androjello]

Am I reading right, .5 mg of test?

[mranak]

Originally Posted by tripleoption

Thanks so much for the advice...So you took 250 IU of HCG daily intramuscularly? I guess my Dr. had me on an ungodly amount of HCG...

What your doctor is doing isn't uncommon. Many doctors use even larges doses of hCG, on a weekly basis. We know better now than to do that, but it takes years for the overall medical community to switch to a new protocol.

hCG is cheap but HMG isn't. hCG usually does the trick, so hCG without HMG is usually attempted first. If that doesn't work, then some HMG might be in order, from what I can gather.

Were your testes atrophied when you were on HRT during those years?

[jwtex]

I note now that the deed is done, I now use 250 IU's of HCG 2 x a week and I am back up to 100 mg of Test Cyp a week. During our efforts to get pregnant I was injecting 250 to 350 IU’s of HCG Daily, Sub Q. I had to reduce my Test. shot in half as I was more than double the upper range in Free and Total as well as E2. With the Test reduction I maintained top of range. As soon as the pregnancy occurred I went back to 100 mg of Test Cyp and 250 IU’s of HCG two time a week.

[SWALE]

125IU per day would be about right.

[jimmy]

Originally Posted by SWALE

125IU per day would be about right.

so know more than 500iu a day. no less than 250iu a day? This would be the protocal for fertility? Do you need to take test with it?

[mranak]

jimmy: For most guys, the typical TRT regimen (testosterone and hCG) works well for them and they also maintain their fertility. But, there are no absolutes. Some men need a different regimen when they are trying ton conceive.

[jimmy]

My Endo has me on 500iu of hcg once per week and 100mg of test cyp. But as I understand it hcg has a half life of 2.5 days so you really need to do it twice per week at least? I was origionally on hcg 500units everyday, but it did not quite cut it, so this is what I on now. So we are trying to conceive, and my testicals have some shrinkage, so to get them back am I going to have to stop the test and just do hcg to get them back up or what does anyone think?

[mranak]

No way does hCG have a 1/2 life of 2.5 days.

It sounds like you suffer from primary hypogonadism. Taking a resonable dosage of hCG might do the job for you. Another option might be to take a SERM (like Clomid) which will hopefully get your pituitary to release both LH and FSH. I don't suggest this for long-term HRT, but I personally don't see an issue with using a SERM to improve fertility when needed.

[jimmy]

I did 100mg of clomid for almost 3 months by itself. My levels were still really low. It did some but not much. Can you take clomid with hcg? So the half life of hcg isn'ty even that long? I remember when I first started they gave me hcg 1000iu twice per week , I always thought it went up and down like a yo yo. HCG by itself got my levels up and my estradial stayed fairly low. I never felt right and kind of puffy or bloated. A lot better with a little hcg and testosterone.