any update?
HPTA Restart Plan 2022
- Thread starter Johnny Test
- Start date
Johnny Test
Active Member
Hey friends. Sorry for the delay. So I’ve been following the above protocol religiously since Jan 1. LH and FSH are below 0.1 (ie. negligible). Going to now increase to 500ius twice a week. We’ve decided to postpone trying for a kid until September 2023. Do you guys think I should just continue this protocol until then? Then possibly going much higher on the HCG and then adding HMG closer to when we start trying?
have you started HMG at all? how about clomid?
Johnny Test
Active Member
No not yet. Since we aren’t planning on trying for a kid until next September (2023) I’m thinking it may not be time to throw the kitchen sink at it. I thought the slow and steady route of 500ius twice a week until we’re ready to start might be the way to go. Going off Test cold turkey is not an option. I have a heart issue that would he exacerbated if my test level dropped to nothing. Fertility needs to be regained while staying on TRT or not at all.
Johnny Test
Active Member
Do you think i should keep on the 500ius twice a week for the next year and see where I am?
Definitely yes. I think you have been on testosterone for a long time and without HCG, the testicles stopped working for a long time and atrophied, it is very difficult to recover it, if you really can. So if you want fertility, your case is not like using a condom when you don't want to have children and removing the condom when you want to have children. You have to constantly work on it, keeping your HCG in the right dose and for a long time, it's a matter of time and persistence... don't hesitate or you won't be able to have it when you want.
If you don't want to father now, but next year, keep your TRT and 500 IU 3 times a week and that will probably give your testicles time to recover to some extent.
Then, for the date you want, I guess it's best to increase HCG 1000 IU 3x/week plus HMG 75mg 3x/week, with or without TRT.
Johnny Test
Active Member
Awesome. Thank you so much for this.
This is the expected result for LH and FSH when you're on a nontrivial dose of testosterone. Even hCG monotherapy can suppress these hormones. In short, don't expect to regain HPTA function unless treatment is limited to SERMs and/or AIs. Nonetheless, many guys regain fertility without restoring HPTA function. HCG is taking the place of LH anyway. HMG would provide some FSH. Dr. Saya's fertility rankings are below. I'd guess that TRT+hCG+hMG is close to 3(A).
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.
HCG Monotherapy to Clomid Ratio For Fertility
HCG Monotherapy to Clomid Ratio For Fertility
www.peaktestosterone.com
Johnny Test
Active Member
I was hoping you’d weigh in. Thank you so much. What do you mean nontrivial by the way? Low dose?
By "nontrivial dose" I mean one that puts serum levels anywhere near the normal range. It's not well quantified that I know of, and probably varies quite a bit between individuals. Nonetheless, it has been shown that non-pulsatile delivery of testosterone is considerably more suppressive of the HPTA than natural pulsatile delivery. In other words, it takes less exogenous testosterone to exert negative feedback—suppression—on LH compared to what's produced naturally. An example made up purely for illustration: Ignoring diurnal variation, suppose a typical young guy has total testosterone of 700 ng/dL due to daily production of 7 mg of testosterone. This means that negative feedback on LH becomes significant around the serum level of 700 ng/dL. Now suppose you inject 4 mg of testosterone daily into this guy. You might well see complete suppression of LH and a serum level of only 400 ng/dL.
T
tareload
Guest
Examples for fun:
Hourly Intraday testosterone profiles in young eugonadal (healthy functional) men (1973-1983)
https://forums.t-nation.com/t/24-hour-tt-profiles-in-young-eugondal-healthy-functional-men-1970s-1980s/277585 Enjoy. There's no way I am copying these graphs again so sorry you have to view this on another site. I reached way back for you guys. 1970s-1980s back when we had "REAL" men...
www.excelmale.com
Johnny Test
Active Member
Interesting. Gotcha. I guess time will tell. Hoping that if I stay on 400-500iu twice a week for another 18 months, then add HMG, I’ll be able to impregnate my wife. I don’t have any illusions of really recovering my HPTA, only just create enough sperm to have a child. Thanks again.
Johnny Test
Active Member
Providing an update. I went off of HCG for two months because of a congenital heart issue that was found. The all clear has been given to resume my fertility protocol. As expected, I’m azoospermic at the moment. I will resume HCG twice a week (500iu each shot) and continue my TRT (100mg split 50/50 during the week). I will do this until May of next year at which point I will add HMG at 75iu either twice or three times a week. The goal is to achieve fertility by September 2023. Life is interesting. Because of my congenital heart defect I’m now a candidate for IVF since they need to see if the embryo would have the same defect. So I really only need to get my fertility up enough to successfully complete the IVF procedure. What do you guys think? 9 months of HCG and then 4 months of additional HMG on top of it. I will not be going off of TRT. It should be an interesting little experiment to say the least.
Johnny Test
Active Member
Any idea what these black dots indicate?
If I were you.. If the HMG doesnt work. Id get off of TRT and take Enclomophene and HMG together until I regained fertility
Johnny Test
Active Member
Should I be using Clomid with my HCG? I don’t really know how to incorporate it into this protocol. Can anyone help? @Cataceous perhaps?
Taking Clomid with TRT is usually pointless. Even taking Clomid with hCG alone is questionable and probably little different from hCG monotherapy. If you can stand it then Clomid alone is best for fertility.
Johnny Test
Active Member
What’s bout my protocol above. 500iu HCG twice a week then 3 months before add HMG 75iu a few times a week in addition to the HCG?
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