Semen analysis results after adding FSH to TRT and hCG

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Great study on using HCG, HMG, and FSH to treat azoospermia due to male hypogonadotropic hypogonadism: A total of 137 MHH patients (congenital in 79 patients, acquired in 42 patients and adult‐onset in 16 patients) were collected from 16 clinical centers in Japan. A total of 33 of these patients did not meet the study inclusion criteria and were excluded. Three treatments were investigated in the present study: (i) hCG monotherapy; (ii) hCG + hMG combination therapy; and (iii) hCG + rhFSH combination therapy. If spermatogenesis was not induced after treatment with hCG monotherapy or hCG + hMG combination therapy, hCG + rhFSH was used as a second‐line treatment.

FSH + HCG HMG.jpg


Investigation of treatment for azoospermia due to male hypogonadotropic hypogonadism in Japan
 
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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.

@HealthMan sorry to revive this old thread, but how long were you able to use the FSH before you noticed it’s effects diminishing? I’m trying the same route as you, except 75iu x2 a week. That would give me a little over two months worth. But if the FSH doesn’t last that long I would rather just increase the dose vs wasting half of the vial. Thanks
 
@HealthMan sorry to revive this old thread, but how long were you able to use the FSH before you noticed it’s effects diminishing? I’m trying the same route as you, except 75iu x2 a week. That would give me a little over two months worth. But if the FSH doesn’t last that long I would rather just increase the dose vs wasting half of the vial. Thanks
You mean before reaching plateau in terms of sperm count increase? Unfortunately i dont know the answer to that because i stopped taking it after my wife and i decided we didn’t want another child. So i stopped FSH and didn’t test it anymore.
But FSH takes time to work. If i were you i would stick to your dosage then have a sperm analysts in the next month or so and another one 2-3 months later before deciding to change your dosage. If you are in a hurry to get your partner pregnant then i would do a sperm test right away and depending on the results talk to your doctor and take FSH EOD or at least 3x a week to speed up things
 
You mean before reaching plateau in terms of sperm count increase? Unfortunately i dont know the answer to that because i stopped taking it after my wife and i decided we didn’t want another child. So i stopped FSH and didn’t test it anymore.
But FSH takes time to work. If i were you i would stick to your dosage then have a sperm analysts in the next month or so and another one 2-3 months later before deciding to change your dosage. If you are in a hurry to get your partner pregnant then i would do a sperm test right away and depending on the results talk to your doctor and take FSH EOD or at least 3x a week to speed up things

no, sorry, I meant how long did your actual vial last before the effects start to diminish? It sounds like you were making each vial last a few months? Did you notice any diminished effects after awhile, as it maybe got less potent, or was it fine?
 
no, sorry, I meant how long did your actual vial last before the effects start to diminish? It sounds like you were making each vial last a few months? Did you notice any diminished effects after awhile, as it maybe got less potent, or was it fine?
Difficult to say because other than increase in sperm count I didn’t feel much from FSH. But if i am not mistaken when i got the analysis done it was at the end of one vial. So i doubt a few months will decrease it effectiveness but couldn’t know for sure
 
Just sharing my results:

Dezember 26th = No sperm found

February 22nd = 1.6 million/ml with only 36% mobility

March 22nd = 4millions/ml with 62% progressive mobility

March 25th = 70million/ml with 71% progressive mobility

Somebody my think that the last result is an error but, anyway we can see that my results improved a lot and we may conceive naturally anytime soon.

My current protocol is:
HCG (Choriomon 2000) - M,W,F
FSH (GonalF) 300iU - T,T,S

I'm having an appointment with my Andrologist to discuss about my path to go back to TRT as I will preserve my fertility with frozen samples.

I may consider to keep HCG and/or FSH (lower doses) together with TRT to try to conceive naturally, otherwise IVF is an option.

God bless you all
Regards,
Jay
 
Old thread I know but I wonder if adding HMG to HCG therapy after being on TRT for over 15 years will work. Also while continuing to stay on TRT throughout. Holding my breath.
 
Old thread I know but I wonder if adding HMG to HCG therapy after being on TRT for over 15 years will work. Also while continuing to stay on TRT throughout. Holding my breath.
Only way to find out is trying. Have you been on HCG all this time you have been using testosterone?
 
Did y’all notice an increase in serum testosterone levels by adding FSH?
Nope
As I have issues with my testeis I did not observe high levels of testosterone with high dosage of HCG.
FSH should have an influence on spermogenizsis only as far as I’m aware.

Cheers
Jay
 
Menopur or GonalF as far as I'm aware.

There is also HMG but I do not know the standard names.

Good luck!
I’m aware of the names, but can’t find a pharmacy that has these… they said they stopped since most of these peptides are now considered biologics
 
I’m aware of the names, but can’t find a pharmacy that has these… they said they stopped since most of these peptides are now considered biologics
Where are you based? I’m based in Switzerland and with a prescription I can have access to GonalF for example.
 
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