Fertility/Change in Regimen

Pharma TRT
1

Seems I’ve hit a bump in the road in terms of my treatment. Although I have been working against some fatigue of late, I was holding off on doing anything about it until I completely beat this flu I’ve been fighting. Turns out I’m headed in a new direction anyway.

The reason is, I had my second consecutive semen analysis reveal a sperm count that is severely lower than pre-testosterone injections. I was still low, before - 11 million per mL, but since adding t-shots, it’s dropped to 2.9 million TOTAL count, less than 1 million per mL. This is with 300IU hCG 3x a week. So, for me specifically, anyway, hCG does not preseve my fertility in any way. My testicles didnt atrophy, so it did its job there, but maintaining my already low fertility was not something it could do.

When I started on hCG mono, it took my levels from low 300 to mid 600’s. I didn’t do any E2 control at the time, and the benefits of the increase disappeared after a few weeks, likely when estrogen caught up. The fertility doc is working with my t-doc and they’ve decided that while trying for a pregnancy, they are taking me off t-shots and leaving me on hCG. So, my questions:

I assume I should still be doing some E2 control - in fact, he wants me on letrozole now and not anastrozole - I’m unsure why, but he (Dr. Mohamed Mitwally) has pioneered a lot of studies using letrozole, so that’s probably part of it. Am I right in assuming I should still be doing some E2 control?

After temporarily removing t-shots from the equation, what can I expect? Will my levels go back down to the mid 600’s they were pre-t shots? The t-shots were introduced in May.

I am wondering if my sperm counts will improve as quickly as they dropped. Should be interesting.

This is all to avoid IVF/ICSI, of course. We will do that if we have to, but I could spend 10 grand on a lot of other things! :slight_smile:

2

You should be on testosterone, AI hCG and hMG if you are trying for a pregnancy.

3

[quote]Cymru wrote:
You should be on testosterone, AI hCG and hMG if you are trying for a pregnancy.[/quote]

I have heard that HMG helps with fertility as well, but I am unclear of its benefits/sides ratio…it would definitely be something to consider…have you discussed it at all with your doc yet? I know I would hate to have to give up a high T value that I had waited so long to achieve! :slight_smile:

4

Add a small dose of CLOMID 25mg daily is what I use with my TRT and no issues.

5

[quote]VTBalla34 wrote:

[quote]Cymru wrote:
You should be on testosterone, AI hCG and hMG if you are trying for a pregnancy.[/quote]

I have heard that HMG helps with fertility as well, but I am unclear of its benefits/sides ratio…it would definitely be something to consider…have you discussed it at all with your doc yet? I know I would hate to have to give up a high T value that I had waited so long to achieve! :)[/quote]

The fertility doc works in the same office as my testosterone guy. I am very lucky this way. They work together. The fertility doc plans on speaking to the t-doc. I am not a fan of having to give up the high T value, but sometimes we have to sacrifice things in life for a greater good. It’s only for 6 months anyway.

hMG is actually covered under my drug plan, which is surprising considering how much more expensive it is than hCG - in tersm of benefits/sides, I think the only difference between the two is hMG also mimics FSH, which is needed for sperm production.

I’m not sure how the t-doc will remove T from the equation. Do I just stop the shots and continue with the same hCG regiem - do I still use an AI, etc.

6

Why do you have to drop the Testosterone? Your body also need it for sperm production. Why not suggest adding the HMG or Clomid with your TRT until your successful in having a kid.

7

[quote]oscar31280 wrote:
Why do you have to drop the Testosterone? Your body also need it for sperm production. Why not suggest adding the HMG or Clomid with your TRT until your successful in having a kid.[/quote]

Well, maybe that’s what will end up happening. The two doctors are going to confer and let me know. I just work here :slight_smile:

8

[quote]NeelyDan wrote:

[quote]VTBalla34 wrote:

[quote]Cymru wrote:
You should be on testosterone, AI hCG and hMG if you are trying for a pregnancy.[/quote]

I have heard that HMG helps with fertility as well, but I am unclear of its benefits/sides ratio…it would definitely be something to consider…have you discussed it at all with your doc yet? I know I would hate to have to give up a high T value that I had waited so long to achieve! :)[/quote]

The fertility doc works in the same office as my testosterone guy. I am very lucky this way. They work together. The fertility doc plans on speaking to the t-doc. I am not a fan of having to give up the high T value, but sometimes we have to sacrifice things in life for a greater good. It’s only for 6 months anyway.

hMG is actually covered under my drug plan, which is surprising considering how much more expensive it is than hCG - in tersm of benefits/sides, I think the only difference between the two is hMG also mimics FSH, which is needed for sperm production.

I’m not sure how the t-doc will remove T from the equation. Do I just stop the shots and continue with the same hCG regiem - do I still use an AI, etc.

hMG and hCG will be equally effective in the production of sperm - with or without your testosterone. You should persuade your Dr to maintain your testosterone script. An AI to counter estrogen would be essential.
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