Do I need to come off TRT to use HCG for fertility?

[schaffer76]

Good Morning everyone,

I current receive TRT treatment and then do HCG sub Q 500iu twice weekly I’m addition to testosterone and anastrozole and cabergoline. If I wanted to get my wife pregnant, would I have to come off of TRT or does the HCG keep me fertile while being on TRT? Thanks for the help.

 

[Cataceous]

No guarantees, but many guys do maintain fertility when on TRT + hCG. See fertility rankings from Dr. Saya:

A *very* generalized ranking of relative fertilities (with top being most fertile):

1. Clomid/SERM treatment
2(A). HCG + HMG (or lyophilized FSH)
2(B). Baseline no treatment (no HPTA suppression via TRT, AAS, HCG mono, etc) - assuming no significant degree of primary/secondary/tertiary dysfunction.
3(A). HCG monotherapy (does in fact result in HPTA suppression, especially at higher doses, but *may* move up to #2 in select cases of SECONDARY/TERTIARY hypogonadism)
3(B). TRT + HCG (as we know many men are still able to maintain adequate fertility to conceive)
4. TRT/AAS with no concurrent HCG.

Link.

 

[Vince]

Semen analysis results after adding FSH to TRT and hCG

 

[schaffer76]

Thank you for the reply’s and help!

 

[madman]

Good Morning everyone,

I current receive TRT treatment and then do HCG sub Q 500iu twice weekly I’m addition to testosterone and anastrozole and cabergoline. If I wanted to get my wife pregnant, would I have to come off of TRT or does the HCG keep me fertile while being on TRT? Thanks for the help.

Low-dose hCG can prevent sterility in men prescribed testosterone (2019)

pg 1-3

Low-dose hCG can prevent sterility in men prescribed testosterone





Strategy for clinicians

To maintain fertility in men with hypogonadism prescribed testosterone, Lipshultz said, clinicians should first insist on a semen analysis before beginning testosterone treatment.

“Patients need to realize that 2% of all men are sterile,” Lipshultz said. “We need to know where the individual is before we introduce testosterone because our endpoint may not be able to be any better than pre-treatment level.”

If the man desires a future pregnancy, the clinician should prescribe hCG concurrent with testosterone therapy, typically at 500 U subcutaneous three times per week or 1,500 U once weekly if the patient wishes only to prevent testicular atrophy. The patient should cycle off of testosterone twice yearly, at a rate of 3,000 U three times per week for 4 weeks, adding 25 mg daily clomiphene therapy during that period, Lipshultz said. However, for men desiring a pregnancy, 3,000 U hCG three times per week should be prescribed in addition to clomiphene therapy. Clinicians should check the patient’s follicle-stimulating hormone (FSH) level and conduct a semen analysis after 4 months for men desiring pregnancy; if the FSH level is not sufficiently elevated, the clinician should discontinue clomiphene and instead introduce FSH concurrent with the hCG, he said.

“To date, we have not had any patients who did not return to baseline,” Lipshultz said, referring to the regimen. – by Regina Schaffer