Semen analysis results after adding FSH to TRT and hCG

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Hey HealthMan , I’m thinking about getting a sperm analysis for myself. Do you know if I can get one at my regular doctors ( PCP ) , or do you have to go to a clinic for it?

This is my 7th week on TRT and fertility is very important to me. I have 1 kid, 1 on the way, but I want to have atleast one more.

Thanks for your advice and input.
 
Defy Medical TRT clinic doctor
AntCon said:
Hey HealthMan , I’m thinking about getting a sperm analysis for myself. Do you know if I can get one at my regular doctors ( PCP ) , or do you have to go to a clinic for it?

This is my 7th week on TRT and fertility is very important to me. I have 1 kid, 1 on the way, but I want to have atleast one more.

Thanks for your advice and input.
Click to expand...

Who has prescribed TRT for you? Your PCP? I would just ask the doctor that prescribed you the testosterone. At this point I would stay away from fertility doctors.
Also worth noting that it might take a bit longer to know the final effect of TRT on your fertility. 7 weeks might not be enough.
Out of curiosity what is your current protocol?
 
HealthMan said:
Who has prescribed TRT for you? Your PCP? I would just ask the doctor that prescribed you the testosterone. At this point I would stay away from fertility doctors.
Also worth noting that it might take a bit longer to know the final effect of TRT on your fertility. 7 weeks might not be enough.
Out of curiosity what is your current protocol?
Click to expand...

Hey thanks for the reply. My trt doc is Dr. Saya

Protocol is

60mg Test Cyp every 3.5 days
HCG 500iu every 3.5 days
0.25 mg Anastrozole every 3.5 days

Was your insurance able to cover the semen analysis test? If not was it costly?
 
AntCon said:
Hey thanks for the reply. My trt doc is Dr. Saya

Protocol is

60mg Test Cyp every 3.5 days
HCG 500iu every 3.5 days
0.25 mg Anastrozole every 3.5 days

Was your insurance able to cover the semen analysis test? If not was it costly?
Click to expand...

Insurance covered everything. I think discount labs offer semen analysis in case your insurance doesn’t cover (pretty sure it will).
Just ask doctor Saya you want to get a semen analysis done. If sperm count too low try adding FSH like i did.
 
HealthMan said:
Insurance covered everything. I think discount labs offer semen analysis in case your insurance doesn't cover (pretty sure it will).
Just ask doctor Saya you want to get a semen analysis done. If sperm count too low try adding FSH like i did.
Click to expand...

Semen analysis is about $200 through Discounted Labs and probably about the same through Defy. Healthman I think you got lucky your insurance covered it... I think in general, insurance will only cover a semen analysis for fertility reasons if you have been trying to get your lady pregnant unsuccessfully for more than 12 months. I had to pay out of pocket.
 
Kirk001 said:
Semen analysis is about $200 through Discounted Labs and probably about the same through Defy. Healthman I think you got lucky your insurance covered it... I think in general, insurance will only cover a semen analysis for fertility reasons if you have been trying to get your lady pregnant unsuccessfully for more than 12 months. I had to pay out of pocket.
Click to expand...
Weird. I had semen analysis done through 2 different insurance companies never had an issue. Did you call them?
I currently have Cigna and have done at least 4 semen analysis with them no problem.
 
My primary care doc didn't even want to place an order for a semen analysis until 12 mos of unsuccessful trying for a pregnancy. She said most insurance won't reimburse for it otherwise. But maybe if the reason for the test is framed differently... maybe if they say it's for hypogonadism versus for fertility it would be covered? I don't know.
 
Hi. Stumbled across site. Glad I did. Was on trt. No sperm. Went through long story at fertility clinic. They dont treat the Male though. But I learned that the follistim they gave her could produce sperm. I started using it because of this site.
I had a testicular extraction of sperm 3 yrs ago and urologist found no motile sperm.
Fertility Clinic called an hour saying they found 4 vials. They lied and used dead sperm and fertilized 20 eggs from wife...implanted 2 then all 20 died. There is a place in hell for thrm

After using hcg and follisitm for a few months I have motile sperm. I am sub fertile but I have a YO semen analyzer (Ebay $100) hooks up to certain cellphones. I saw them moving! This works
Also bought and 110 L cryo unit with auto LN refill so I can store my sperm with out having to pay $1600 / for 4 vials
Waiting for some parts

.My doc just prescribed merional 75 IU 3x week
which contains is 75 UI LH and 75 UI FSH. I though this was a good idea because of direct LH instead of stimulating leydig cells. My test is only 115 ish an hasn't really gone up. I've been on clomid for 2 mo and arimidex as well. Maybe my leydig cells are toast?
With The 75 lh and 75 fsh I would think sperm count should rise considerably. Could I add test back in so I can actually procreate? But once I quit the meds my fertility will drop to 0 again.


Https://www.canadadrugsonline.com/DrugMoreInfo6970.aspx
 
HealthMan said:
Weird. I had semen analysis done through 2 different insurance companies never had an issue. Did you call them?
I currently have Cigna and have done at least 4 semen analysis with them no problem.
Click to expand...
Cigna is awesome. In some states you get 25k of fertility treatment!
 
Mrj said:
Does the timeing for the testo injekt matter? Can i do testo hcg and hmg at same day or Should i pin testo on days i dont take hcg and Hmg?
Click to expand...
Hey if depending on brand most hmgs have 75 LH and 75 FSH. Hcg would be unnecessary in theory. Leydig cells release Luetenizing hormone.
 
Mrj said:
It will be S T T. So for Done one inject with 32,5mg t 500ie hcg and 75ie fsh and can tell my Mood lifted After only a couple hours and my energi is back. Have only gone one day but so far i feel great. Better then i did on all those years on nebido. Did the t shot subq with 30g 1/2. I Will do seman analys in 2-3 months, hope this Will Work.
Click to expand...
Mrj
Did you get a sperm analysis done? If yes it would be great if you could share your results to help others in the same situation
 
Yes i did. After 3months i got 5milion semens then i uped the dose to 150ie hmg 3 times a week hcg same dose. 3 months later toke another semen test. Resultat came back 8million/ml. Before the hmg i was 6 months on hcg mono. Semen test showed 0 semens on only hcg.
 
Mrj said:
Yes i did. After 3months i got 5milion semens then i uped the dose to 150ie hmg 3 times a week hcg same dose. 3 months later toke another semen test. Resultat came back 8million/ml. Before the hmg i was 6 months on hcg mono. Semen test showed 0 semens on only hcg.
Click to expand...

Hey everyone. First of all Healthman, Dni.labs, and Mrj, Glad to hear your numbers are coming back and you feel better, and fertility is there (for some so far at least). Im in a very similar boat to you. Just stopped high dose T in June after 10 years on. I immediately started on 2500iu HCG EOD and 25mg enclomiphene in July after reviewing studies on people in my situation. I ran labs after 90 days and started seeing Dr. Saya, who was fine with that amount based on the fact that fertility is my primary goal.

Labs were run through LabCorps:
TT 1125 (250-1100ng/dl)
FT 129.6 (46-224pg/ml)
BAT 266.5 (110-575ng/dl)
LH 1.1 (1.5-9.3Miu/ml)
FSH 4.1 (1.6-8Miu/ml)
DHEA 128 (106-464mcg/dl)
SBGH 48 (10-50nmol/L)
Estradiol Ultrasensitive: 10 ( <or=29pg/ml)

All other numbers were good. I was especially pleased with these labs only 90 days after stopping T, considering the length of time and dose. Dr. Saya continued my HCG at 2500 EOD, DHEA 50/day, FSH (if I need it at 75iu/MWF), and Adex 0.25mg MWF, and wants me to get a semen analysis and labs in 90 days.

So that said there are a few issues: I am finishing a masters now, so I have not had a chance to get the SA yet. While I don't feel terrible, my sex drive and energy is in the gutter! My strength and mood are fine, and I have had a noticeable increase in testicular size, but the lack of energy and libido are disconcerting. I know this can be from low the E2, as well as from stress finishing my degree. But I also know many people feel bad on SERMs in general, and while Dr. S, did not dislike the enclomiphene (in fact he prefers it to clomid) I feel like, after all, my time on high dose test, combined with your guy's accounts, FSH may be the way to go. Unfortunately I can't exactly recall what he said as far as lowering/removing the Enclomiphene so if anyone can suggest how to make the switch from Enclomiphene to Adex please let me know. Because it's a research chem there's really no literature on dosing equivalents that I could find. Should I stop the En and wait until I feel symptoms, or protect the receptors and just start the Adex about 4 days after stopping the En? Also, I'm curious what, if any, types and doses of antiestrogens you guys were/are running to keep E2 in check, especially on high regular doses of HCG? If I can get my libido back I'll be fine, and can wait it out until I know I am producing, but if I fix my E2 and my libido is still low, I would consider ramping up the FSH and adding a little T back in if he is ok with it. Obviously, these are hypotheticals, as I need to get the SA, but I definitely think I need to raise my E2 into the 20 range, and probably get off the SERM. I plan to get the SA this month, and hopefully Ill see some signs of life. But until then Id like your guys' feedback. If anyone has any input please let me know. I feel really positive reading this thread. Thanks.
 
HealthMan said:
View attachment 4658

So after 6 months of adding FSH to my TRT protocol I got a sperm analysis done.
A quick background. My fertility was normal before TRT and went to zero when I started TRT without HCG. Adding HCG 500 IU 2x a week my sperm analysis results were:

sperm count 2.1mm (normal >=20mm)
total sperm 7.2mm (normal >=40mm)

Subfertile with not great chances of getting my wife pregnant.

I tried to increase HCG to 500IU 3x a week but results were basically the same and it didnt make me feel good. So I asked Dr Saya if I could try FSH and he was ok with that. I have been taking 50IU 2x a week (less than the dosage prescribed... long story short my wife got pregnant and miscarried and we decided to hold off on another baby so i decided to use a much lower dosage just to save money and see if it would work).
So after 6 months on TRT with testosterone + HCG (500IU 2x a week) + FSH (50IU 2x a week) my new sperm analysis results are:

sperm count 15mm (normal >=20mm)
total sperm 52.5mm (normal >=40mm)

I am fertilile again! Thanks Dr Saya! The small FSH dosage worked!
So I am planning to keep using FSH in my protocol. At this dosage it is not that expensive.
Click to expand...

hi Healthman
i have a question...how was your LH and FSH numbers at the time you got your high sperm count?
thanks
pd. i have 5 months with trt, 500ui hcg + 50ui HMG
mon-wed-fri and tomorrow i will take the test.
 
eli0228 said:
hi Healthman
i have a question...how was your LH and FSH numbers at the time you got your high sperm count?
thanks
pd. i have 5 months with trt, 500ui hcg + 50ui HMG
mon-wed-fri and tomorrow i will take the test.
Click to expand...
LH given TRT will be suppressed (i didnt measure at the time but HCG/FSH have no impact on LH). I didn’t measure FSH either
 
remember low LH and FSH= no sperm and Hcg+ Fsh suppose increase the range... i make the LH and FSH test today..will post the result tomorrow...
 
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