trt and infertility

[ili]

First off great site,very informative,actually why I am posting is info learned while browsing here.Last year at 34 my test levels came in low,everything else was fine on blood work,so my doc started me with test depo,felt much better,stronger in weight room,body looked better,erections very strong,but libido wasn't the best,sometimes would be strong,but not consistent,I was doing 150mgs once per week,put me at top of range(if i had to do shots I say make best of it and stay at top of range)So after 7 months or so I read here that hcg is needed to maintain fertility,even brought doc copy of dr.crisler's report,he said U.S. is not as conservative as Canada(where i'm at)and that staying in normal range would not affect fertility.I ask for fertilty test wich he agreed to.I did not go for test as I was in the planning for my upcoming wedding,after the wedding finally go for test,(lot harder thatn i thought),So my doc calls me in and says there is no sperm at all,could be I have blockage or can;t produceThis was begining of October,I was in shock,he knows I want to start a family,said he would send me to a specialist,but would have me do another test at end of the month(wich will be this week)I told him I think it's the trt,he said I should have some sperm,but to go off the shots till I do the next sperm analysis.So I have not done any shots since,actually I feel pretty good,not as tired as before therapy,don't feel as pumped,libido is very low though,so could it be the trt causing no fertility? ,I guess I'll know more after second test,if i do get any sperm on second test,what would you guys suggest,no more trt,or would hcg be needed?hopefully doc would approve hcg(doubt it)sorry for the long post,but very worried,my new wife undertands,says she dosn 't care kids or not,but i feel bad.She would be a great mom,doc said there is still a chance they could get sperm from testicles and do some type of invitro.But hopefully I can get sperm production.Thanks for your time any experience in this matter would be appreciated,will also keep you informed after tests.

[ili]

sorry one more thing,why is it that when i go away(vacation,cottage,any place of relaxation)my libido is very good,even before trt therapy,but with trt great.Could it be stress causing it,hope not cause it's only everyday normal stress in life,not any serious stress.Any ideas?

[ili]

One more question,am I primary or secondary? intilal lab work was:

sTSH- 1.80---------norm is0.35 -- 5.00 mu /l
LH---- 1. ---------norm 1------10 iu/l
DHEAS 4.0 -------norm 2.6--- 7.7 umol/l
FSH 1. ----------norm 1---- 14 iu/l
Prolactin 12. ------norm <18 ug/l
estadiol 88 ---------norm 50---218 pmol/l

My free test was 29.6 norm--37--81

What do you think?

Thanks

[zumper]

Secondary.(Low LH,FSH).You should benefit from HCG though.

[ili]

thanks zumper,for getting back to me,is secodary worse,than primary,or does it matter ?I know low test is low test,but is one worse to suffer from?

[Vforcer2]

I am going to see a urologist about this very issue next week since my wife and I decided to have some more children.

If you do a search on this sight you will find several men on TRT or on all out steriod cycles that have been able to impregnate their wives by adding HCG at around 250 iu x 3 days per week. However, everyone responds differently to HCG and if you are on TRT it could put your T levels way over the range as well as estradiol. If you are not on T therapy then it may boost your natural test levels up to an acceptable level as well as increase spermotagenesis. Just be aware that your estrogen levels will rise as well and will likely need aromatase inhibitors to manage it.

Other produces like FSH, HMG, and Clomid can be used as well.

[zumper]

Originally Posted by ili

thanks zumper,for getting back to me,is secodary worse,than primary,or does it matter ?I know low test is low test,but is one worse to suffer from?

IMO is worse to be primary cause the HPTA supposed to recover faster than the testicular function.If you have done MRI and is normal,check the other hormones such as thyroid.If all of the above are normal it should be a diet,lifestyle issue ,like in my case (secondary too).I am trying to say that a secondary can recover faster,until he brings his LH levels up.
Also he can benefit on HCG and antiestrogens as TRT.
Primary can use only synthetic T which makes fertility questionable.

[ili]

Thanks guys,appreciate the info,and let me know how it goes with the urologist,my appointment is end of november,this is good info for men who are still trying to conceive.Will keep you posted.

take care

[marianco]

Originally Posted by ili

One more question,am I primary or secondary? intilal lab work was:

sTSH- 1.80---------norm is0.35 -- 5.00 mu /l
LH---- 1. ---------norm 1------10 iu/l
DHEAS 4.0 -------norm 2.6--- 7.7 umol/l
FSH 1. ----------norm 1---- 14 iu/l
Prolactin 12. ------norm <18 ug/l
estadiol 88 ---------norm 50---218 pmol/l

My free test was 29.6 norm--37--81

What do you think?

Thanks

Testosterone replacement can reduce fertility by decreasing LH and FSH production.

HCG is an option when one wants to maintain fertility. Clomid is another - at least temporariliy - to increase sperm production.

TSH < 2.0 does not rule out hypothyroidism. Free T3 and Free T4 need to be done to determine if hypothyroidism type 1 is present. A history and physical exam is needed to determine if hypothyroidism is present, not matter what the type (e.g. type 2, etc.). Hypothyroidism reduces testosterone production.

Primary hypogonadism is when there is testicular failure to produce testosterone. When primary, there is no other choice but to do testosterone replacement (since HCG or Tamoxifen or Clomid wll no longer work well to stimulate testosterone production)

Secondary hypogonadism is when the testes can produce enough testosterone but due to other reasons (e.g. pituitary problems, other hormone problems, etc.), the signals to promote testosterone production are not adequate.

Stress does reduce sex drive. Sex is a rest-relaxation activity. Vacations are times people relax and rest. The neurotransmitters are in different levels of activity in rest-mode and fight-or-fight mode.

[ili]

Thanks doc,I appreciate your input,very good info,I will show my doctor,so we can get tests done on my thyroid,again i will keep everybody informed,especially those who still want kids,and info on matter.

Regards
ili

[marianco]

Originally Posted by marianco

Testosterone replacement can reduce fertility by decreasing LH and FSH production.

HCG is an option when one wants to maintain fertility. Clomid is another - at least temporariliy - to increase sperm production.

Additionally, sometimes HCG (which emulates LH) and the testosterone increase that results are not enough to stimulate sperm production. In that case Pergonal (which has LH and FSH) can be used to help stimulate sperm production.

[Vforcer2]

Interesting, the recommended beginning dosages for this type of treatment are 4000iu of HCG per week plus one amp of Pergonal(HMG) every other day for a minimum of 90-120 days uninterupted.

http://www.andrologyjournal.org/cgi/...er_pdf/3/2.pdf

[ili]

Very interesting,so first a trial with hcg,get tested for fertility,if no luck,add the hmg?how long with the hcg first,1 month 2 or 3?


Thanks

[marianco]

Originally Posted by ili

Very interesting,so first a trial with hcg,get tested for fertility,if no luck,add the hmg?how long with the hcg first,1 month 2 or 3?
Thanks

The best person to answer that question is a reproductive endocrinologist who treats male infertility.

How long to take HCG would depend highly on the results of the lab evaluation of sperm to see if improvement has occurred with HCG.

[Vforcer2]

It takes 71 days for a man to make good mature sperm, and I will naturally assume that is with fully functional testicles.

So, if starting from complete shutdown, I think it is safe to say the earliest would be 4 months, but it could be up to nearly 2 years depending on what the history of the man is (if he was using AAS prior to HRT).

I think a starting protocol such as Dr. Scally's would be a good starting place to speed things along and if that did not work, then HMG could be added.

Yesterday I had a terrible experience. I went to a Urologist recommended to me by a fertility clinic. His arrogance and ignorance were beyond belief. He told me:

1. If my T was 350ng/dl I had no reason at all to be on TRT. I told him about all my pre TRT symptoms and he responded ......."I don't care, your within the range of normal"

2. I screwed myself by going on TRT and I am now sterile, and have no chance of being fertile again.

3. I have no chance over ever getting a 39 year old woman pregnant.

We were at odds from the initial handshake. I was looking for a progressive physician and got the opposite. The consult went so bad that at least he did not charge me for it.

So be aware, most doctors are still in the stone age. Take studies with you proving what you want to do because some think once you have been TRT that you can't come back.