Is TRT basically a guarantee for not keeping fertility? I started TRT due to low normal free T and high SHBG with some low t symptoms but I am concerned about fertility since I am 28 years old. I do not want to take HCG as it makes me feel bad and basically makes TRT not work for me. Is there any chance I can keep my fertility while just taking testosterone ? Or is there another option or anything else I can take besides HCG to stay somewhat fertile on TRT?
TRT and Fertility
- Thread starter Rhino 2.0
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Vince
Super Moderator
Chances are pretty low, the only way to know for sure is by getting you sperm tested.
madman
Super Moderator
The hpta will be shutdown when using exogenous testosterone and the only option to maintain fertility would be through the addition of hCG which will maintain ITT (intra-testicular testosterone).
New frontiers in fertility preservation: a hypothesis on fertility optimization in men with hypergonadotrophic hypogonadism
Abstract: Strategies exist that can mitigate the risk of causing iatrogenic infertility when men require testosterone replacement therapy (TRT). This article reviews the current medical therapies that preserve spermatogenesis when TRT is indicated. Furthermore, we highlight the re-emerging...
www.excelmale.com
*High intratesticular testosterone (ITT) levels maintain the spermatogenic process and prevent germ cell death. Low ITT levels result in an impaired blood-testis barrier permitting immune cells to enter the seminiferous tubules and attack autoantigenic germ cells. Low intratesticular testosterone levels also block the conversion of round spermatids to elongating spermatogonia and prevent spermiation, leading to phagocytosis of spermatids
by Sertoli cells.
*It is well established that exogenous testosterone therapy causes azoospermia in the majority of men. Exogenous testosterone’s contraceptive effect occurs through its suppression of the HPG axis, preventing LH and FSH release and their respective gonadal functions. Studies examining the reproductive outcomes and rates of azoospermia development of various testosterone treatment modalities show less detrimental effects with testosterone patches [24% rate of azoospermia] compared to intramuscular injections of testosterone enanthate, which result in up to a 98% rate of combined azoospermia and oligozoospermia (≤3 million/cc) after 1 year of therapy.
Novel methods of treating hypogonadal symptoms and keeping men fertile include the use of nasal testosterone and resetting the HPG axis with TRT and controlled administration of HCG. While preliminary results suggest that these methods may increase success for fertility treatments, more extensive research is needed to demonstrate the efficacy and safety of these therapies. The most recent evidence provides hope for the future of male fertility in patients that require TRT.
Alternatives to trt would be Natesto or clomid/enclomiphene.
You could look into Natesto as you have already tried Clomid/Enclomiphene which you did not like...
madman
Super Moderator
Adding to what @Vince stated.....Chances are pretty low, the only way to for sure is by getting your sperm tested.
www.excelmale.com
Every man should have a semen analysis pre-trt.
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.”
Do I need to come off TRT to use HCG for fertility?
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.
www.excelmale.com
Every man should have a semen analysis pre-trt.
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.”
calmcalmcalm
Member
You’re young to be on TRT. What is your idea of low normal values???
If u have concerns about fertility then you should NOT take Exogenous testosterone. you can do more harm then good. Get your semen analysis done then go from there. Then maybe get on Clomid or Hcg or both as either one will keep fertility alive and well. Sounds like you’ve received some terrible advice in past.
I started TRT ( Test Cyp and HcG ) at 42 1/2 years old. Turned 45 2 months ago. Anyway been on the entire time. I took HcG 50 units a week the entire time to preserve fertility while on test. Just found out wife is pregnant. We are doing IVF so having fertility issues was a concern of mine when we started taking about a baby while I was on TRT. Anyway, HcG seems to do the trick for me.
You got away with only taking 50 iu a week or did you mean 500iu a week?
I got a semen analysis done after 2 months of HCG and the count was almost zero.
The fertility clinic doctor told me that it takes at least 3 months for fertility to recover at all, since the lifespan of semen is around that time.
Nelson Vergel
Founder, ExcelMale.com
Metabolic Syndrome and Reproduction
Metabolic syndrome (MetS) and infertility are two afflictions with a high prevalence in the general population. MetS is a global health problem increasing worldwide, while infertility affects up to 12% of men. Despite the high prevalence of these conditions, the possible impact of MetS on male...
www.mdpi.com
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