Interesting discussion.
@JRos895, maybe you went through this, but I am curious how you ended up on monotherapy? I did it a long time ago and eventually added TRT. But, I have always used hCG.
I did not previously go through this, and am happy to share.
I’m in my mid twenties and I’ve always been very concerned about fertility, especially since my baseline LH/FSH (with no HRT of any sort ever until that baseline test) was near zero.
I originally decided to go with T+HCG (1000iu) a week. Given my concerns about fertility, I did a semen analysis on this protocol, which ultimately came back very poor. This is likely because I was likely infertile in the first place from the low LH/FSH at baseline (or perhaps because the Empower HCG I was using as the T adjunct was weak…?)
An often overlooked facet of the Lipshultz T+HCG study and protocol is that low dose HCG may often
maintain semen parameters, but may not
induce fertility when one is infertile in the first place. Higher doses of HCG are often needed to induce spermatogenesis for secondary hypo infertile men. I often hear people saying that there’s no benefit to HCG Mono over T+HCG since both are suppressive but that’s absolutely not true if you’re trying to induce fertility.
Thus, the reason I went onto HCG mono was two fold: (1) to hopefully induce my fertility so I can freeze sperm right away if my semen parameters increase and (2) to hopefully induce my fertility so that if I switch to the low dose HCG +T protocol (which I probably will do), the protocol may successfully maintain the fertility once induced.
All in all, I don’t expect to be on the HCG mono long term and am using it as a short term fertility strategy.