Testosterone and Fertlity

[butterflyswapster]

So, I am 27M and I have been diagoned with 1.21ng/ml Total T. My GP says he will do my tests again to confirm and then send me to the specialist for therapy(perhaps). My major concern is fertility(I want kids someday!).I've read that we need to combne TRT with HCG to maintain fertility and have a few questions:

1. how does one calculate how much HCG will result in how much natural T production?
2. If HCG promotes natural T production-why do people combine it with TRT,why not just take HCG?
3. Also, if one wants to remain fertile, how to know how much HCG is to be mixed with the TRT(in case people want to take TRT as well).Any study/calculator?
4. Connected to number 3,I've read that HCG keeps fertility but Ive also read when planning to conceive add HMG/clomid? What's the purpose of hmg/clomid.IF Hcg keeps you fertile , why add these ?

 

[HealthMan]

Your questions were already replied in different threads but basically:

1) there isn’t a formula. It depends if you are primary or secondary and to which extent. There is one study that shows thar 250IU EOD got intra testicular testosterone levels back to 93% of baseline (after testosterone being chemically supressed)
2) HCG only works if you are secondary. Also sometimes the amount of HCG if you need to bring testosterone to upper range levels can cause high estradiol difficult to control with an AI. And some people simply don’t do well on HCG monotherapy
3) The only study on this used 500IU EOD. But everyone is different and HCG might not work to keep fertility in some cases
4) HCG mimics LH. Long story short for optimal spermatogenisis you need LH and FSH. Hence sometimes the need for FSH (HMG contains both LH and FSH) or clomid (without TRT) to increase both LH and FSH

 

[butterflyswapster]

Thanks for your reply. What do you mean by primary/secondary?
Also-so to remain fertile a dosage of TRT+HCG+FSH is required.The combination/dosage will be something which will be decided on trials? My main worry is to remain fertile and am looking for suggestions! I am still young, a student and need to marry /get kids some day! I'm on my masters and still have to get my first proper job..All this is freaking me out! How do I remain fertile and have noraml erections like a guy below 30 years age!

 

[HealthMan]

I don’t want to be difficult but if you are considering TRT you should do a little bit of research. There is plenty of information in the web about primary vs secondary hypogonadism. In terms of dosage there aren’t really studies that looks at TRT + HCG + FSH. For me 500IU HCG and 50IU FSH twice a week did the trick. I would say that 500IU HCG + 75IU FSH EOD should work very well if you were fertile before TRT. But again you may wanna use the lowest dosage possible. And keep in mind FSH is expensive

 

[butterflyswapster]

I don’t want to be difficult but if you are considering TRT you should do a little bit of research. There is plenty of information in the web about primary vs secondary hypogonadism. In terms of dosage there aren’t really studies that looks at TRT + HCG + FSH. For me 500IU HCG and 50IU FSH twice a week did the trick. I would say that 500IU HCG + 75IU FSH EOD should work very well if you were fertile before TRT. But again you may wanna use the lowest dosage possible. And keep in mind FSH is expensive

Thanks for your time and valuable response.I'm trying to learn as much as I can.My GP is doing the blood tests again just to confirm.Even he's shocked and after checking my testes and chest(gynae),everything seems normal.However,if the values are low again,he will send me to the specialist(who will decide what to do).I've never been on TRT and before starting anything I'm reading about all this and trying to gain perspective from all the experienced people like you.This is something I cant discuss with family and friends actually ,so I am confused what's happening in my life. I don't want prostate cancer/ gynaecomastia and still want to have kids.I'll go prepared to the specialist with all this information-before proceeding.I've read that if you start all this therapy you need to do this for the rest of your life! Anyways, were there any side effects when you started the therapy. Also,any other suggestions to someone who has never been on therapy?

 

[HealthMan]

You have a few options:
1) Try to naturally increase your testosterone levels (check medications you are taking, life style, sleep quality , diet, etc)
2) Clomid. That fails for most but given your age might be worth trying. This won’t negatively affect your fertility
3) HCG monotherapy. Some people do great others don’t. More fertility “friendly”
4) TRT + HCG. And add FSH for fertility if necessary

Remember to have a sperm analysis before starting any treatment. If you want to be 100% conservative bank sperm. Most likely not necessarily but if the cost is not a problem it is extra insurance.
About possible side effects please check other threads here. Plenty of information