My doctor who I saw suggested that I go in HCG and Gonadorellin before I get on TRT. I am in my mid 20’s and from the results I got from a urologist, I have very low semen for my age. Is there any chance of messing up my fertility if I were to get on TRT while injecting HCG and Gonadorellin? Also would my testosterone raise if I were to get only on HCG and Gonadorellin? This is my first post here and I am a newbie to this whole experience.
I also don’t want people to bash my current doctor as he could have easily slapped me on Testosterone without checking for my semen count, and also checking me for a pituitary adenoma. I am happy that I found him as a doctor instead of some doctor who runs a prescription mill. Below are my blood results.
According to conducted research, HCG can help maintain sperm production. From the following paper:
"Exogenous steroid use impairs spermatogenesis by promoting negative feedback on both the hypothalamus and pituitary gland […]
This altering of the hypothalamus-pituitary-gonadal (HPG) axis and drop of intratesticular testosterone can lead to azoospermia within 10 weeks of starting TRT […]
hCG therapy can help preserve spermatogenesis in men undergoing TRT by maintaining intratesticular testosterone levels. It was has been shown that follicle stimulating hormone (FSH) alone cannot initiate or maintain spermatogenesis in hypogonadal men leading to the discovery of the importance of intratesticular testosterone in spermatogenesis. In healthy eugonadal men selected to undergo TRT it was shown that their intratesticular testosterone levels dropped by 94%. However, in those who received 250 IU SC every other day along with TRT their intratesticular testosterone levels only dropped 7%. Additionally, in men who received TRT and 500 IU of hCG every other day an increase in intratesticular testosterone by 26% was observed.
[…] hCG is a safe and efficacious alternative or adjunct to TRT in men desiring to preserve fertility while treating their hypogonadism. hCG can also be used help restore spermatogenesis in men hypogonadal hypogonadism or steroid induced impairment of spermatogenesis."
You could get a sample of your semen frozen just to be on the safe side, as there is no 100% guarantee.
Yes, some men never return to baseline sperm parameters after going on TRT, but most do. Best to go on FSH injections since it’s FSH that stimulates sperm production, freeze sperm and maybe then consider TRT and HCG.
The HCG and/or TRT will suppress the HPTA and therefore FSH secreted by the pituitary gland.
Clomid is another option, which increases LH and FSH, only you may not feel very well on clomid as the side effect profile is rather poor.
Unless you have diabetes, the low SHBG may make TRT more challenging and large and even moderately large injection will hammer SHBG down into the single digits.
For this reason I recommend topical gels or creams from compounding pharmacies since topicals have little to no effect on SHBG. Jatenzo may be another option, an oral T capsule taken twice daily and recommended starting dosage @ 237 mg twice daily.
The Jatenzo will suppress your SHBG by up to 40% though.
Low SHBG values is strongly associated with metabolic syndrome, inflammation and MS is one cause for secondary hypogonadism, diabetes and obesity being the other two.
Typically if you have a pituitary adenoma, prolactin would be elevated and can even lower testosterone.
Thank you! I am obese and I lost 100 pounds before and I can’t lose any more weight. I am saying this based off what was said about my SHBG. I didn’t understand that my SHBG was low based off the test registering that I was in range. Also I had an MRI that came back negative for a pituitary adenoma.
I see thank you for your reply! Basically I was told that I didn’t have enough sperm in my semen so I would start with Gonadorellin and HCG before getting on TRT but honestly my test is so low I want to get better. It is annoying that I can’t use Testosterone but I am not sure if HCG alone with raise my Testosterone.
Thank you again. But my doctor’s main concern is me not being able to have children again even if I currently don’t want children so he is afraid of putting me on TRT before raising my sperm levels. Would Testosterone hinder my sperm levels even if I was on both HCG and Gonadorellin at the same time?