How to Improve Sperm Quality, LH, FSH and Testosterone in Infertile Men
- Thread starter Nelson Vergel
- Start date
maxadvance
Active Member
Is HMG and FSH the same or interchangeable?
3000 IU HCG EOD
25-50 mg Clomid ED
(2) After 2-3 months, conduct second semen analysis:
IF fertility isn't achieved, replace Clomid with FSH @ 75-150 IU EOD
This is close to what I proposed at the thread start albeit skipping the clomid option and trying a lesser dose of hcg whilst remaining on TRT.
Ive moved to EOD hcg now to align with EOD hmg, so it just about the right (minimum) hcg dose to achieve desired result with minimal side issues. 500 iu is the safest dose but it is enough to restore fertility
25-50 mg Clomid ED
(2) After 2-3 months, conduct second semen analysis:
IF fertility isn't achieved, replace Clomid with FSH @ 75-150 IU EOD
This is close to what I proposed at the thread start albeit skipping the clomid option and trying a lesser dose of hcg whilst remaining on TRT.
Ive moved to EOD hcg now to align with EOD hmg, so it just about the right (minimum) hcg dose to achieve desired result with minimal side issues. 500 iu is the safest dose but it is enough to restore fertility
I agree. 3000 units of HCG EOD plus Clomid would be an emotional nightmare for me. If I absolutely had to get off T to restore fertilty, I would bump this down to 1000 units EOD and skip past Clomid and go right to FSH.
I don't disagree at all. Sounds like a good plan.
Wanted to share this excerpt from an interview with Dr. Lipshultz:
-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.
Low-dose hCG can prevent sterility in men prescribed testosterone Page 2
The article itself is a good read.
Hi, everyone... I've been posting to this thread for probably six months now. I'd like some guidance as I have another update and would like an opinion before we have a follow up appointment next week.
Hubby started on HCG monotherapy (1500IU/3Xweek) in July. He had a follow up SA and bloodwork in late September and his SA results showed 4 million/ml with low morph and motility. Testosterone was 368.
Andrologist upped his HCG to 2000 IU/3X week and added Clomid 50 mg/every other day. He spent about two weeks on the Clomid but felt crappy, so she decided he could discontinue that.
So after four months of 2000IU/3X week on HCG, he had more follow up bloodwork and an SA. Bloodwork showed a total test of 260 and with LH at 1.1 and FSH at .6. His SA was still super low at 13 million/ml and still crappy morph and motility.
We've been trying for a baby for nearly 2 years now. Hubby is frustrated and we need to figure something out. We had a baby naturally only three years ago, so we know his body is able... we are just trying to figure this out.
Hoping you experts can help answer a few questions for me.
1. Why would his test DROP that much on a higher HCG dose? He said he feels decent (still lacks libido though), so we were both extremely surprised by this number.
2. Would adding the Clomid back help? He said he will do it if this will help his test and SA parameters.
3. Based on his bloodwork, would adding FSH or HMG give him the boost in sperm that he's looking for? At this point we would just like to regain enough to be able to be IUI candidates because at this point natural conception is pretty much impossible.
Any takeaways from this? I want more info for this appointment. We have spent way too much time on treatments that just aren't working and he's getting depressed about his infertility. Let me know if you all have any suggestions. TIA.
****ETA**** I should add that we have been tracking his sperm under our own microscope at home, so we can kind of see when he has influxes in count or even major issues with motility. I can see plenty of free swimmers, but I knew his count was still low (although I didn't realize it was only 13 million/ml-- i was thinking 25-30 million based on past observations). I haven't noticed any major differences in count between November and now. It has been very steady and doesn't seem to be improving anymore.
Hubby started on HCG monotherapy (1500IU/3Xweek) in July. He had a follow up SA and bloodwork in late September and his SA results showed 4 million/ml with low morph and motility. Testosterone was 368.
Andrologist upped his HCG to 2000 IU/3X week and added Clomid 50 mg/every other day. He spent about two weeks on the Clomid but felt crappy, so she decided he could discontinue that.
So after four months of 2000IU/3X week on HCG, he had more follow up bloodwork and an SA. Bloodwork showed a total test of 260 and with LH at 1.1 and FSH at .6. His SA was still super low at 13 million/ml and still crappy morph and motility.
We've been trying for a baby for nearly 2 years now. Hubby is frustrated and we need to figure something out. We had a baby naturally only three years ago, so we know his body is able... we are just trying to figure this out.
Hoping you experts can help answer a few questions for me.
1. Why would his test DROP that much on a higher HCG dose? He said he feels decent (still lacks libido though), so we were both extremely surprised by this number.
2. Would adding the Clomid back help? He said he will do it if this will help his test and SA parameters.
3. Based on his bloodwork, would adding FSH or HMG give him the boost in sperm that he's looking for? At this point we would just like to regain enough to be able to be IUI candidates because at this point natural conception is pretty much impossible.
Any takeaways from this? I want more info for this appointment. We have spent way too much time on treatments that just aren't working and he's getting depressed about his infertility. Let me know if you all have any suggestions. TIA.
****ETA**** I should add that we have been tracking his sperm under our own microscope at home, so we can kind of see when he has influxes in count or even major issues with motility. I can see plenty of free swimmers, but I knew his count was still low (although I didn't realize it was only 13 million/ml-- i was thinking 25-30 million based on past observations). I haven't noticed any major differences in count between November and now. It has been very steady and doesn't seem to be improving anymore.
Here is my take on what has happened with your husband:
1. Why would his test DROP that much on a higher HCG dose? He said he feels decent (still lacks libido though), so we were both extremely surprised by this number.
This could be due to any number of things. (1) Timing of the assay (2) Desensitization of the LH receptors due to the dosage (3) E2 increase due to dosage increase (4) Sleep/diet/exercise/stress
2. Would adding the Clomid back help? He said he will do it if this will help his test and SA parameters.
If he felt bad on Clomid, as many men report that they do, then starting Clomid back would simply reduce quality of life while potentially adding to his sperm production. However, there is a better option (FSH or HMG).
3. Based on his bloodwork, would adding FSH or HMG give him the boost in sperm that he's looking for? At this point we would just like to regain enough to be able to be IUI candidates because at this point natural conception is pretty much impossible.
Adding FSH, according to Dr. Larry Lipschultz at the Baylor College of Medicine (one of the leading urologists in the US), is advisable at this point.
https://www.healio.com/endocrinolog...erility-in-men-prescribed-testosterone?page=2
-Strategy for clinicians (Excerpt from Dr. Larry Lipshultz)
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.
Thanks, both of you.
I have been pushing for FSH for six months and his doctor won't prescribe. She said she'd "consider it" if he was still low once his test levels came back up. We are point blank asking for it this time. I want him to be able to get back on test so we can put an end to this baby stuff. I'm also about to turn 36 so we don't have long to wait. We are both tired of waiting for FSH so if she won't prescribe, we will probably end up leaving and going to Defy or ordering it ourselves from overseas. I don't know why she is so against him using it (cost aside). Sigh.
Thanks, guys.
I have been pushing for FSH for six months and his doctor won't prescribe. She said she'd "consider it" if he was still low once his test levels came back up. We are point blank asking for it this time. I want him to be able to get back on test so we can put an end to this baby stuff. I'm also about to turn 36 so we don't have long to wait. We are both tired of waiting for FSH so if she won't prescribe, we will probably end up leaving and going to Defy or ordering it ourselves from overseas. I don't know why she is so against him using it (cost aside). Sigh.
Thanks, guys.
It’s a risk buying through your own sources. Will they deliver? Is the content of the vial precisely what it is claimed to be?
But for cost and expediency I took that risk but tried to mitigate where I could by using suppliers with a track record and using a commercial platform and credit card that affords some protection.
But for cost and expediency I took that risk but tried to mitigate where I could by using suppliers with a track record and using a commercial platform and credit card that affords some protection.
I just saw this post! Congratulations! May I ask how old your wife is??? I just had my first, a daughter at 46. My wife is 41.
Nelson Vergel
Founder, ExcelMale.com
Be aware of this. Deadline for comments Feb 15, 2020
Your Access to More Economical hCG and FSH May End- Send Comments to the FDA
Your Access to More Economical hCG and FSH May End- Send Comments to the FDA
Nelson Vergel
Founder, ExcelMale.com
Be aware of this. Deadline for comments Feb 15, 2020
Your Access to More Economical hCG and FSH May End- Send Comments to the FDA
Your Access to More Economical hCG and FSH May End- Send Comments to the FDA
Holy crap. How did I not know about this? I am now officially stressed as hell. I wish I had heard about this sooner. I left a comment.
Last edited:
@DS3 (or anyone who is knowledgeable), i just now had time to go over the parts of this post that I’d missed during the month or two I was off and am left with a burning question:
If LH receptors have been desensitized, is there a way to cycle them so that they turn back on? I just did a “DIY semen analysis” tonight and I am confident that along with hubby’s falling test numbers, his sperm count is falling as well. Two months ago i absolutely saw more than i currently see. Two months ago we took a “home” semen analysis that tells you if you have 20 million/ml or more (WHO standard lower reference range of normal) and he got a positive result. Something is going on and I’m now suspecting desensitization.
Is there any way to combat this? And if This IS the case, i worry that adding an additional 3000 units of HCG a week could just make it worse, even with adding FSH as well.
What’s the best way to cycle and give those LH receptors a break?! Can this be fixed? And if it IS LH desensitization, would adding FSH to the increased HCG (3000 units 2x week combined with 75 units of FSH 3x a week) still help?
I’m convinced something is going on here as I’ve seen his count decline over the last six weeks.
Dcalicotte03
Member
I admit, I have dabbled in the under ground labs for test ect but I have never seen anything for UG fsh. I’m I interested where you’re getting the fsh Bc it is getting very pricey for me. Even going through empower
Dcalicotte03
Member
Wow. Congrats. I Have yet to be that fortunate
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