Can I stop TRT and just switch to HCG+FSH for a few months (and be done w/TRT etc for good) instead of taking SERMS?

[Stoak]

I am stopping TRT to regain my fertility and I have been to 2 docs (urologist and endo) and both left me with questions. After TRT 1.5 years I had zero swimmers. Wife wants another baby so I decided to stop TRT (also for a couple other reasons - I couldn't fix my chronically low SHBG/hair loss).

My urologist told me to take Clomid for 4 weeks at 50mg ED which is a bit too high IMO... so my plan had been to inject 1000HCG E3dD for 3 weeks since my last inject on Sep 6, and then start Clomid (so last shot, 3 weeks HCG at 1000iu E3D then start clomid at 25mg EOD for 4 weeks). I got a second opinion from and endocrinologist who has actually published papers on testicular failure and she told me to simply "do nothing" and let my body return to homeostasis on its own. My uro asked his partner who is better versed in fertility and his response was "he needs HCG+FSH but a cheaper alternative is Clomid."

The MAIN MAIN MAIN question I have is - can I stop TRT and simply inject HCG+rFSH for a few months, stop and recover my baseline levels of testosterone and endogenous gonadotropin production (assuming it is going to happen) that way instead of taking Clomid? Do we just use Clomid instead of HCG+rFSH for recovery bc it is cheaper? Nobody can seem to answer this for me. Will HCG+rFSH continue to prevent the return to endogenous gonadotropin and testosterone production or will it help?

I have to say the last 3 weeks of HCG at 1000iu E3D while the test cyp has been clearing have been the best my libido has been in years... I'm afraid to lose it w/SERMS. I know my test levels are in the gutter bc I have lost 7 pounds and I'm waking up feeling like I need 10 hours of sleep, but my libido is great for some reason.

 

[madman]

I am stopping TRT to regain my fertility and I have been to 2 docs (urologist and endo) and both left me with questions. After TRT 1.5 years I had zero swimmers. Wife wants another baby so I decided to stop TRT (also for a couple other reasons - I couldn't fix my chronically low SHBG/hair loss).

My urologist told me to take Clomid for 4 weeks at 50mg ED which is a bit too high IMO... so my plan had been to inject 1000HCG E3dD for 3 weeks since my last inject on Sep 6, and then start Clomid (so last shot, 3 weeks HCG at 1000iu E3D then start clomid at 25mg EOD for 4 weeks). I got a second opinion from and endocrinologist who has actually published papers on testicular failure and she told me to simply "do nothing" and let my body return to homeostasis on its own. My uro asked his partner who is better versed in fertility and his response was "he needs HCG+FSH but a cheaper alternative is Clomid."

The MAIN MAIN MAIN question I have is - can I stop TRT and simply inject HCG+rFSH for a few months, stop and recover my baseline levels of testosterone and endogenous gonadotropin production (assuming it is going to happen) that way instead of taking Clomid? Do we just use Clomid instead of HCG+rFSH for recovery bc it is cheaper? Nobody can seem to answer this for me. Will HCG+rFSH continue to prevent the return to endogenous gonadotropin and testosterone production or will it help?

I have to say the last 3 weeks of HCG at 1000iu E3D while the test cyp has been clearing have been the best my libido has been in years... I'm afraid to lose it w/SERMS. I know my test levels are in the gutter bc I have lost 7 pounds and I'm waking up feeling like I need 10 hours of sleep, but my libido is great for some reason.

If $$$ is no issue I would just stick with the hCG + rFSH.

Once you stop T levels will return to baseline.

FSH and hCG dual therapy may result in the more rapid recovery of sperm to the ejaculate

024 Dual Therapy with rFSH and HCG Results in a Significantly Shorter Time to Return of Spermatogenesis than Combination HCG and Clomiphene (2021) K. Campbell, J. Sullivan, R. Valero Carrion, J. Kraus, B. Stocks, A. Lawrence, L. Lipshultz Introduction: The use of testosterone replacement...

www.excelmale.com

Conclusions

Our results reiterate that FSH in combination with hCG may be considered as an alternative to combination hCG and clomiphene in the treatment of testosterone-induced azoospermia. FSH and hCG dual therapy may result in the more rapid recovery of sperm to the ejaculate being three times faster in the FSH group. Additionally, patients who have failed dual therapy with hCG and clomiphene should be considered for subsequent FSH.

 

[JimGainz]

You can definitely do what you are proposing but you should research restart protocols a little bit more carefully. I think your hCG dose is a little bit high. Maybe try something like 250 to 300 every other day for a few weeks, then add the Clomid at the dose you mentioned above: 25 mg every other day – or 12.5 every day for 4 weeks

 

[Deleted member 42882]

Wife wants another baby...

Oh well, if that's what she wants, I guess you don't have a choice. LOL.

 

[Jay Ara]

I did exactly like that.
stopped TRT, added FSH first and then later HCG.
my protocol was FSH 300 iu eod, HCG 1500 eod.
I went from 0 to 70million in 5 months.
worked for me, no significant side effects, I was much better than natural, no pct, etc…
good luck
Jay

 

[Stoak]

I had my labwork done... LH and FSH.

LH - .9
FSH 2.8

My Estradiol came back <19pg/mL - it doesn't seem his lab is very sensitive and I think there is still a testosterone test coming (I may be wrong).

This was 31 days since my last injection of 80mg test cyp and 14 days since my last HCG 1000iu inject. I should have started Clomid 2 weeks ago, but delayed bc I wasn't sure what I was doing for the recovery. I finally spoke to a 2nd urologist and he said HCG+rhFSH would keep my natural ability to make gonadotropins shut down. He advised my best path forward if I didn't want to stay on medication for as long as it takes to conceive again is Clomid for 4 weeks 25mg EOD. So I started the Clomid yesterday and have follow up in a month.

Seems at this point 2.8 FSH seems like a good sign and maybe my LH is really low bc I continued HCG until 2 weeks ago. I may not need bazooka drugs to get things going again from a fertility perspective.

 

[Stoak]

My testosterone test came back

70 ng/dl and free T 15pg/ml

 

[Jay Ara]

My testosterone test came back

70 ng/dl and free T 15pg/ml

How do you feel?

 

[Stoak]

How do you feel?

Everything hurts. I've lost 12 pounds from 2020 to 190. My penis still works but my sex drive isn't really there (I've continued taking 5mg of Cialis which I always have taken dailu for over a year). I'm sleeping fine... I am still making it to the gym but I'm getting a bit weaker. The one thing I have noticed mostly is I'm tired when I wake up and I have a job that requires 30k steps per day. My feet are killing me. They didn't hurt before.

 

[Jay Ara]

I understand, I have been there myself.

Don’t forget that is for a bigger reason!

Stay strong and good luck on your journey!

All the best to you!

 

[Stoak]

I thought I'd give an update on this... this has been a complete and total nightmare.

Since I had my last shot in early September, I have had 2 colds, a breakthough Covid case, a broken pinky toe in 2 spots, plantar fasciitis on the other foot I'm dealing with now, and I have now lost 18 pounds in less than 2 months (most of this occurred in the last 4 weeks). 203 to 185.

I don't know if these illnesses are coincidental or what. Everything hurts. I can barely make it thru the night sleeping bc my lower back hurts so bad. I also hadn't had heart palpitations in years but they seem to have returned. I get these PACs which are supposedly benign but are happening sometimes now every few beats (feels like a flip). I didn't have these at all on TRT/HRT etc. I'm guessing it is the Clomid so I have stopped it after 3 weeks. I also have really dry eyes when I wake up in the morning. Like peeling my eyelid off the eye dry. Never had that before. I see the urologist for a follow up in 2 weeks. Hoping for good news on the hormone front but I doubt it. I don't have much of a sex drive although I am getting nocturnal erections most nights and have had sex w/my wife a few times w/o issue.

I feel stupid bc the Uro offered HCG to me instead of Clomid and I reckon I would have been much better off on HCG therapy instead of Clomid.

 

[Systemlord]

All you needed was TRT and HCG.

 

[Stoak]

All you needed was TRT and HCG.

You're wrong. I had been on HCG and I still had zero sperm.

 

[Jay Ara]

HCG + FSH worked pretty well for me!
but keep in mind that you may need higher dose due to restart process and that may take more than 3 months to give you measurable results.
keep up with the plan, you can make it.
it is hard I know, but you can do it brother.
All the best and good luck
Jay

 

[shroud778]

HCG and FSH can also work with TRT. Daughter is one next week and was only achieved because of adding FSH to the protocol EOD and increasing HCG in the first few weeks to help restore fertility. Wife was pregnant is less than 3 months

 

[Stoak]

HCG and FSH can also work with TRT. Daughter is one next week and was only achieved because of adding FSH to the protocol EOD and increasing HCG in the first few weeks to help restore fertility. Wife was pregnant is less than 3 months

I had seen this was possible but I couldn't get it prescribed. Trust me, I tried. And I wanted to not drag this out very long bc my wife was giving me shit about a timetable (that's a different conversation).

Both urologists that I saw treat people for fertility... not just vasectomies and BPH, but specialize in fertility and hypogonadism told me my best course was to stop the TRT. The first doctor said my options were HCG+FSH after quitting TRT and the second doctor told me my options were 1000iu HCG EOD after quitting TRT (bloowdowrk in a month SA in 3 months to see if we needed to add drugs) or I could take Clomid if I wanted to have another option of potentially not going back on TRT... he told me using HCG monotherapy would cause my own gonadotropin production to remain shut down.

I took Clomid bc I had been on HCG for 1.5 years and I thought my recovery would be relatively easy to get back to 300-350ng/dl (I'm still relatively young at 40). We will see when I get bloodwork done Nov 12. I also was feeling a bit "done" w/HRT bc I was having some prostatitis which may or may not have been related and some small gyno... and my libido was f'd from the deca I had used a couple of times (probably also why HCG on TRT didn't work work me - too low dose + deca).

It's not easy to just walk into a doctor's office and tell them what to prescribe. I've tried that and I can't get rFSH on the black market... only HMG and that's 50$ per 75iu and it's still a roll of the dice.

 

[Stoak]

I got bloods back from November 11. My last shot was September 8 of 80mg test cyp. I did 3 weeks of Clomid at 25mg EOD starting Oct 8 and 1000iu HCG EOD leading up to that after my last shot. This is 2 weeks after ending Clomid therapy and 2 months after my last shot.

Total test 331ng/dl
Free test 64 pg
Estradiol 30
SHBG 29
LH 2.83
FSH 3

I'm exactly where I was before TRT. I have a semen analysis in 4 weeks. I don't really have any doubts I will be regaining my fertility to prior levels. I don't have much of a sex drive and the Clomid was giving me tons of heart PACs which is why I stopped. Seems like 3 weeks may have been enough.

 

[Jay Ara]

I got bloods back from November 11. My last shot was September 8 of 80mg test cyp. I did 3 weeks of Clomid at 25mg EOD starting Oct 8 and 1000iu HCG EOD leading up to that after my last shot. This is 2 weeks after ending Clomid therapy and 2 months after my last shot.

Total test 331ng/dl
Free test 64 pg
Estradiol 30
SHBG 29
LH 2.83
FSH 3

I'm exactly where I was before TRT. I have a semen analysis in 4 weeks. I don't really have any doubts I will be regaining my fertility to prior levels. I don't have much of a sex drive and the Clomid was giving me tons of heart PACs which is why I stopped. Seems like 3 weeks may have been enough.

 

[Jay Ara]

All the best to you @Stoak
Regarding sex drive, you may try some Maca Suplements and also LongJack, they supposed to be good for Testosterone but if helps with energy during this process it may be worth to consider.

 

[Stoak]

I got bloods back from November 11. My last shot was September 8 of 80mg test cyp. I did 3 weeks of Clomid at 25mg EOD starting Oct 8 and 1000iu HCG EOD leading up to that after my last shot. This is 2 weeks after ending Clomid therapy and 2 months after my last shot.

Total test 331ng/dl
Free test 64 pg
Estradiol 30
SHBG 29
LH 2.83
FSH 3

I'm exactly where I was before TRT. I have a semen analysis in 4 weeks. I don't really have any doubts I will be regaining my fertility to prior levels. I don't have much of a sex drive and the Clomid was giving me tons of heart PACs which is why I stopped. Seems like 3 weeks may have been enough.

I thought I would update this. I lost 40 pounds after stopping TRT (I did fasting diet as well so that accelerated it). Since stopping that diet I have regained 15 pounds but still down about 25 pounds from TRT levels.

I never got a follow up semen analysis due to a variety of reasons (multiple Covid cases in my house etc... was convinced I would be fertile again soon), but didn't need to bc my wife became pregnant. We started trying in February and she is 7 weeks now. We saw the heartbeat this week, so it took 3 months of trying (a total of 6-7 months from my last testosterone shot and keep in mind I WAS COMPLETELY STERILE ZERO SPERM) and I really think it took longer bc she was mistiming her ovulation.

I don't know where my levels are at the moment, but my urologist has prescribed me the drugs again to resume therapy (I just cannot seem to get Pregnyl at my pharmacy due to shortages). The biggest thing I have noticed is that my sex drive isn't great. I get nocturnal erections frequently but I don't feel like my sex drive is healthy. Otherwise I feel fine... it's actually kind of nice not to shed so much hair nor have acne. I also don't stink like I did on TRT (my armpits smelled and now they don't... pretty much ever it is weird). I'm kind of on the fence about resuming... I don't feel like a zombie, but would rather have a better sex drive and be incline pressing 275 for reps again lol.