TRT - HCG - FSH - Clomid? Dr. Saya?

[rkultra1]

So, I've been on TRT alone from 9/13 - 11/18. Felt absolutely amazing for about 2 years and then began chasing the dragon after a massive drop in mood and effect. I over respond to adex (.012 once a week puts me at 5 on the sensitive), SHBG hovers between 19 and 27 and T is in the 850-1000 range. Joined Defy in November of 18 and started .15ml daily test and 50iu HCG MWF. Feel great again, but now I want to plant another baby in my wife.

I have had two consults now with Dr. Saya and it's been good, but last one he authorized FSH for fertility, this was back in Feb I think. I just broke down and paid the $660 for 6 weeks of this stuff and feel like I need to get the most bang for my buck because like, I do pretty well for myself but over $600 is quite a bit when you add in the cost of everything else that I pay for as part of this protocol.

How can I maximize the effect of FSH on fertility and stretch is as far as it can go? Right now it's advised to use 75iu MWF, but at $600 for 1500IU...meh... I'm new to this medication and don't want to pay for an impromptu consult so let me get what advice I can here. Whats the least amount I can use and see results? I have an old script for Clomid and can dissolve them into microdoes, would this benefit me in increasing semen count? I have an at home lab and can test my own parameters so I can check whenever I need to. Help me out gents.

-Ryan

 

[rkultra1]

Let me add, semen count in very light.I see about 20-30 swimmers in any given slide at 400x and motility is weak. I've been plowing my way towards a third kid for 3 years with not a single connection so that's why I sprung for FSH. Help me my dudes.

 

[Dr Justin Saya MD]

Can stretch the FSH to 50iu TIW, but beyond that and it’s not really worth taking.

Clomid doesn’t often raise LH/FSH for those already HPTA suppressed on TRT, but occasionally can...everyone is unique. It will, however, often raise SHBG and the subjective response to the mixed agonist/antagonist estrogen receptor interaction can vary significantly from person to person. If deciding to give clomid a try include SHBG, LH/FSH in next batch of testing. You’re my fourth or fifth guy who (clinically) examines his own semen samples. I still find it just as intriguing as the first!

 

[rkultra1]

Can stretch the FSH to 50iu TIW, but beyond that and it’s not really worth taking.

Thank you kindly Sir. We will discuss this further at our next scheduled consult. Clomid and I have had a very bad relationship in the past, far worse than AI's, but I thought I could get it down to .05mg TIW and see what effect it has, adjust from there if it would help.

The late great Crisler spoke a lot on Metformin having multiple benefits (lengthy list), but I am familiar with the voodoo practice some fertility docs will employ where they get people on Met and they inexplicably conceive. Is there merit to this and worth trying or just me grasping at anything I can... like trying to get my wife to do a baking soda "rinse"..

BTW.. I hope this info is useful to others, even some time down the road. I'm not completely trying to have a one on one dialogue for my own benefit.

Thanks!

 

[HealthMan]

Just my case. HCG 500IU 2x a week + FSH 50IU 2x a week and my sperm count was normal. I might be an unicorn but just my experience.

 

[rkultra1]

Just my case. HCG 500IU 2x a week + FSH 50IU 2x a week and my sperm count was normal. I might be an unicorn but just my experience.

Maybe a unicorn.

Did you go from zero or low count to normal on this protocol?

 

[Sean Mosher]

So you're doing 30mg of Test daily?
Where does that put your FreeT out of curiosity?

 

[HealthMan]

Maybe a unicorn.

Did you go from zero or low count to normal on this protocol?

Yes. From zero to normal. But i will probably stop taking FSH. Defy increased the price quite a bit and it gets expensive fast. Just for the record my sperm count was very low with HCG only. So it was the FSH that made the difference

 

[rkultra1]

So you're doing 30mg of Test daily?
Where does that put your FreeT out of curiosity?

Serum 817
Free 25.2

 

[Dr Justin Saya MD]

Just my case. HCG 500IU 2x a week + FSH 50IU 2x a week and my sperm count was normal. I might be an unicorn but just my experience.

That’s a strong response. Certainly on the farther end of the bell curve.

 

[Dr Justin Saya MD]

Thank you kindly Sir. We will discuss this further at our next scheduled consult. Clomid and I have had a very bad relationship in the past, far worse than AI's, but I thought I could get it down to .05mg TIW and see what effect it has, adjust from there if it would help.

The late great Crisler spoke a lot on Metformin having multiple benefits (lengthy list), but I am familiar with the voodoo practice some fertility docs will employ where they get people on Met and they inexplicably conceive. Is there merit to this and worth trying or just me grasping at anything I can... like trying to get my wife to do a baking soda "rinse"..

BTW.. I hope this info is useful to others, even some time down the road. I'm not completely trying to have a one on one dialogue for my own benefit.

Thanks!

Wouldn’t have too high of hopes regarding metformin from a fertility perspective. With that said, there are other potential benefits and it is, as far as pharmaceuticals go, fairly well tolerated.

 

[Nelson Vergel]

By the way, to summon someone use their screen name like this @Dr Justin Saya MD

 

[Vince Carter]

Curious if you had tried increasing HCG dose and/or frequency and seen no improvement in your sperm? 50iu three times per week is a very weak dose as compared to most other strategies.

 

[rkultra1]

Curious if you had tried increasing HCG dose and/or frequency and seen no improvement in your sperm? 50iu three times per week is a very weak dose as compared to most other strategies.

I’m already at 1500mg a week. Much higher and E suffers greatly. Interesting thought though. I haven’t noticed much increase in testicular size, or, sustained increase. Sometimes they feel like grapes again and other times back to almonds. Makes me wonder if a previous varicocelle I had removed has returned honestly. I may have to go see a urologist again and see since I know that will mess with my production as well. Even before TRT it took over a year to get my wife pregnant he first time.

 

[Vince Carter]

I’m already at 1500mg a week. Much higher and E suffers greatly. Interesting thought though. I haven’t noticed much increase in testicular size, or, sustained increase. Sometimes they feel like grapes again and other times back to almonds. Makes me wonder if a previous varicocelle I had removed has returned honestly. I may have to go see a urologist again and see since I know that will mess with my production as well. Even before TRT it took over a year to get my wife pregnant he first time.

what?

 

[rkultra1]

what?

It’s 1500 units. 500iu MWF, missed a zero.

 

[Vince Carter]

ya you wrote 1500mg and it threw me off saying "mg"

 

[rkultra1]

Just an update. It doesn’t make much sense to me but between May 10 and May 27 my count went from below the detection line to 35 million. Scope imaging went from mostly mutated sperm, some dead, few perfect morphology and motility to the entire slide being packed with well formed active swimmers. I’ve been on HCG since November, FSH for a few weeks, FertiliAid multi vitamin for 6 months.

As of today my wife is pregnant with our third. Praying for a full term healthy baby!

 

[Nelson Vergel]

Congratulations !

So, adding the FSH did it. What was your dose of hCG?

 

[AdamYoung]

Just an update. It doesn’t make much sense to me but between May 10 and May 27 my count went from below the detection line to 35 million. Scope imaging went from mostly mutated sperm, some dead, few perfect morphology and motility to the entire slide being packed with well formed active swimmers. I’ve been on HCG since November, FSH for a few weeks, FertiliAid multi vitamin for 6 months.

As of today my wife is pregnant with our third. Praying for a full term healthy baby!

So what do u think made the trick? Is it HCG or FSH? Or both. Wondering what happens if i just use trt+fsh.