TRT fertility longterm?

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littlepiggy

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im thinking about going to a doc for TRT, but fertility is extremely important to me. as i dont have a family yet.

i've some studies which say that HCG helps keep men on TRT fertile or at-least prevent aszoospermia (0 sperm count) but i couldnt see how long they treated the subjects for.

https://www.ncbi.nlm.nih.gov/pubmed/23260550

no information on pre trt VS trt +HCG was listed, perhaps its just me being unfamiliar with how to use that website to see more info on the studies...

i thought i'd ask some questions here and some of you more knowledgeable people could help fill in the gaps in my knowlege


  • is HCG + TRT a good longterm solution to maintain fertility?
  • if your sperm count does drop to 0 on trt will coming off improve it, or is it permanent?
  • how big of a risk of becoming infertile if taking TRT + HCG?

if any of you can refer me to some other good studies i can read that would be nice too.
 
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im thinking about going to a doc for TRT, but fertility is extremely important to me. as i dont have a family yet.

i've some studies which say that HCG helps keep men on TRT fertile or at-least prevent aszoospermia (0 sperm count) but i couldnt see how long they treated the subjects for.

https://www.ncbi.nlm.nih.gov/pubmed/23260550

no information on pre trt VS trt +HCG was listed, perhaps its just me being unfamiliar with how to use that website to see more info on the studies...

i thought i'd ask some questions here and some of you more knowledgeable people could help fill in the gaps in my knowlege


  • is HCG + TRT a good longterm solution to maintain fertility?
  • if your sperm count does drop to 0 on trt will coming off improve it, or is it permanent?
  • how big of a risk of becoming infertile if taking TRT + HCG?

if any of you can refer me to some other good studies i can read that would be nice too.


  • is HCG + TRT a good longterm solution to maintain fertility?

Yes, I believe that the use of HCG + TRT is a good option to maintain fertility over a long period of time.


  • if your sperm count does drop to 0 on trt will coming off improve it, or is it permanent?

That is something we do not know, but it will depend on how long you are infertile, I think the more time passes the more difficult recovery is.


  • how big of a risk of becoming infertile if taking TRT + HCG?
I believe that if you use the TRT + HCG protocol the risks are few to become infertile.


Now I am in the same situation as you, I am on TRT and I am young and wish to have family in the future, but my protocol besides using HCG + TRT I also use HMG, HMG is FSH so ask your doctor about the use of HMG, the problem is that HMG is expensive but you could use it from time to time to maintain fertility.
 
Are you dealing with primary or secondary hypogonadism? If it is the latter, I'd agree with Vince and discuss the possibility of a Clomid restart protocol with your doctor as an alternative to traditional TRT.
 
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In my case HCG with my TRT was not able to maitain fertility. My sperm count plummet to just a few million per ml. Now i have added FSH to the mix. However I am not planning to have kids at the moment but I want to be fertile in case that changes.
If fertility is really important to you I would consider a SERM (clomid or tamoxifene) if you are secondary like Vince and Coastwatchet said. You can also freeze your sperm.
Sometimes treatment with a SERM does not improve symptoms and in my case actually makes me feel miserable but everyone is different.
In my opinion if you start TRT with HCG (ideally 500IU EOD) and after a couple of months get a sperm count done and that shows a big drop in sperm count (important to get a baseline sperm test before starting any treatment) if you were to stop TRT and add a SERM your sperm count should be able to recover in a couple of months if you are secondary. If money is not an issue you can start TRT with HCG and FSH/HMG. Then your chances of remaining fertile will increase substantially.
In short. If i were you I would;
- Get baseline sperm count done
- If secondary try a SERM first
- If a SERM doesnt work well for you bank some sperm and go full TRT with HCG 500IU EOD (if money is not an issue add FSH or HMG to your protocol)
- Get a sperm count done every month to track how TRT is affecting your fertility. If you sperm levels drop to below a certain level (usually 20mm per ml) or if motility, forward progression etc are negatively compromised stop TRT and do a restart protocol and you should be good to go again.
 
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