HCG and Fertility

Pharma / TRT Testosterone Replacement
1 
I am one year into TRT and although my wife and I thought we were done having kids, she now wants to try for a third child.  My endo would not perscribe me HCG to keep my boys alive.  They do not seem to have shrunk very much over the year.  I asked my wife and she confirmed that they are similar in size to what they have always been and I haven't had any pulling up towards my body of the sac.

My wife is an RN and would handle all injections for me. We are considering obtaining HCG via an alternate source than the doctor and administering it to get my nuts fired up.
My question for you would be; Will the administration of 250iu eod get my boys active and put us in a position to produce another child? Do I need to be careful where I obtain the HCG from? Is there a better way to go about this?

I appreciate any and all help.

2

You need hCG, but you might need more FSH to get the sperm count up. This naturally lead to consideration of using a SERM that can create high LH and FSH, just what you need. Clomid has been around for a long time and has been used for fertility for men and women. So there is a lot of info out there. However, clomid can have deep estrogenic sides. Nolvadex is a better option in terms of avoiding estrogenic side effects.

So now you have two choices. SERMs are easier to obtain than hCG for domestic non-legal sources. hCG can be mailed in from overseas. But there are some legal concerns as some States have criminalized hCG by putting it in the same class of substances as anabolic steroids.

What form of TRT are you using. Lab numbers, ranges?

3

when I was 28 here were the tests. I’m 30 now.

Date: 7/23/2008
Testosterone - 214.1 (no range given only “*” saying it was low)
S-TSH - 2.82 (.35-5.00)
Free T3 - 3.3 (2.3-4.20)
Free T4- 1.2 (.7-1.5)

29 years old after going sober for six months:
Date: 9/14/2009
FSH - 2.9 (1.4 - 18.1)
LH - 4.4 * no range given, but it had an “*” by it indicating it was low.
Prolactin - 7.3 (2.1 - 17.7)
Testosterone - 362.6 (280-1100)
Free Test was at 65 (35-155normal range).

After two weeks of using 5g of androgel
Free Testosterone - 89
Total Testosterone - 449 (NORMAL 350-1200)
BIOAVAILABLE- 252
TSH - 1.81 (NORMAL .5 TO 5.0)
BLOOD SUGAR-82 ( NORMAL 70 TO 150)
B12- 660 NORMAL (200-900)
SHBG BINDING GOBULIN - 29 NORMAL (6-60)

After this I went on IM injections. 100mg/week of test cyp.
3 months in:
Total Testosterone - 846 (NORMAL 350-1200)
Free Testosterone - 92
estradiol: 65 pg/ml (Normal <60pg/ml)

6 month checkup:
Total Testosterone - 1140 (NORMAL 350-1200)
Free Testosteron - 130

Measurements: 6’2" 215lbs. Waist size: 37" Chest: 46" Hips: 40" Neck: 16.5"
Been struggling with weight my entire life (Fresh year of H.S. 220lbs @ 5’8" tall)

One more thing to note: Before I went on T, I had my doc run a acth test on me and here were the results of that. He said he was reluctant to ever diagnose adrenal insufficiency so I took his word and started the T.
ACTH (adrenocorticotropic hormone) stimulation test at 14.1 (normal was over 20)

Thanks for helping.

4

[quote]igloo72 wrote:
I am one year into TRT and although my wife and I thought we were done having kids, she now wants to try for a third child. My endo would not perscribe me HCG to keep my boys alive. They do not seem to have shrunk very much over the year. I asked my wife and she confirmed that they are similar in size to what they have always been and I haven’t had any pulling up towards my body of the sac.

My wife is an RN and would handle all injections for me. We are considering obtaining HCG via an alternate source than the doctor and administering it to get my nuts fired up.
My question for you would be; Will the administration of 250iu eod get my boys active and put us in a position to produce another child? Do I need to be careful where I obtain the HCG from? Is there a better way to go about this?

I appreciate any and all help.[/quote]

In the presence of 900IU hCG weekly on top of 100mg test-eth, my sperm counts dropped from an already low 11 million per mL to about 1 million per mL.

hCG isn’t always the answer, bear in mind. My guy wants me taking hMG next, I think.

5

[quote]NeelyDan wrote:
In the presence of 900IU hCG weekly on top of 100mg test-eth, my sperm counts dropped from an already low 11 million per mL to about 1 million per mL.

hCG isn’t always the answer, bear in mind. My guy wants me taking hMG next, I think.

[/quote]

I’ve read about HMG too. I think novalex that was recommended would be a good place to start since it is pretty easy to get my hands on without a perscription.

6

so what is your current complete treatment program? all vitamins, supplements, medications, etc.

currently I see out of control E2 with no steps taken to reduce it and weekly T-shots making the situation worse and giving you hormone swings.

14 as the starting reading on the ACTH test is not bad really. 10 or less is not good. Was that your initial reading? what were the other two results for 1/2 hour and one hour?

What do your thyroid numbers look like now? Your TSH of 2.8 two years ago, and 1.8 10 months ago is potentially troubling. You really need to check your free T4, free T3, and reverse T3.

7

[quote]PureChance wrote:
so what is your current complete treatment program? all vitamins, supplements, medications, etc.

currently I see out of control E2 with no steps taken to reduce it and weekly T-shots making the situation worse and giving you hormone swings.

14 as the starting reading on the ACTH test is not bad really. 10 or less is not good. Was that your initial reading? what were the other two results for 1/2 hour and one hour?

What do your thyroid numbers look like now? Your TSH of 2.8 two years ago, and 1.8 10 months ago is potentially troubling. You really need to check your free T4, free T3, and reverse T3.[/quote]

They only gave me the one measurement and I interperted it as being the reading after the ACTH was injected. My waking body temp and all day body temp was around 96-97 normally, this may have been caused by fifteen years + of distance running. I have had several T3,T4, TSH tests done over the years and always come back in the low normal range.

I am taking a half mg of arimidex twice a week, but didn’t start until I got the E2 test since I didn’t want to take a medication if I didn’t need it.
I take calcium magnesium 150mg ed, a sourse one daily multi ed, zinc 100mg ed, vitamin C 2000% DV ed, buproprion 150mg 2x/day, 100mg DHEA 5x/week (not consistent).

My doc refuses to perscribe me any of the ancillary protocols with TRT. I am considering shelling out more money to see an anti aging specialist to get a full panel and saliva test done. I would have to go off my TRT and all other meds for a period of time before starting this though, correct?

8

no need to stop what you are on - just get the tests with your current treatment program.

no E2 tests when on Arimidex?

Any thought to changing your Test shots to E3D?

the stim test is 3 separate readings. Check out ACTH Stim Test on wikipedia.

you could also try calling around to compounding pharmacies and asking for referrals.

your doctor won’t even do a sperm test to see if HCG is warranted for fertility? yikes…

good supplements - you may also want to look to adding Vitamin D3 6,000iu daily.

9

Can you add ranges to your fT3, fT4 thyroid lab results? You can [Edit] your post.

Your low body temps suggest that you have thyroid problems, and that would also be a strong contributor to fat gain or inability to loose fat. Check waking temps. Ask for a low dose T4 or dessicated thyroid trial prescription. See if you can get waking body temp near 97.8F

Your 6 month VS 3 month inject T level gain can be from lab timing effects if that was not consistent.

10

[quote]PureChance wrote:
no need to stop what you are on - just get the tests with your current treatment program.

no E2 tests when on Arimidex?

Any thought to changing your Test shots to E3D?

the stim test is 3 separate readings. Check out ACTH Stim Test on wikipedia.

you could also try calling around to compounding pharmacies and asking for referrals.

your doctor won’t even do a sperm test to see if HCG is warranted for fertility? yikes…

good supplements - you may also want to look to adding Vitamin D3 6,000iu daily.[/quote]

He was going to test E2 again, but he forgot to write it on the blood work up. FYI, the doc didn’t perscribe me arimidex, I got that on my own after the first high E2 reading. I asked him about it and he did not want to deviate from his old school medicine approach.

I also went to 50mg 2x/week injections for two months and noticed no difference.

I asked my endo about compounding gels and he said they aren’t FDA approved and he won’t perscribe them. He won’t perscribe me anything for fertility, gyno or any other side effects that come from T replacement. He said if we get bad sides then we need to lower the dose, he also said that not being able to have kids is a side effect.

I forgot to put in there I do take D3 5000 iu in the morning and 25mg melatonin at night. I did try Estrobalance as well with DIN.

[quote]KSman wrote:
Can you add ranges to your fT3, fT4 thyroid lab results? You can [Edit] your post.

Your low body temps suggest that you have thyroid problems, and that would also be a strong contributor to fat gain or inability to loose fat. Check waking temps. Ask for a low dose T4 or dessicated thyroid trial prescription. See if you can get waking body temp near 97.8F

Your 6 month VS 3 month inject T level gain can be from lab timing effects if that was not consistent.[/quote]

I updated what I could with what I have. I need to send a fax to the hospital in the morning to get all my test results from the last 5 years mailed to me so I can get more detail.

With the way my current endo is handling my situation, would you suggest I seek out an alternative? I live near Green Bay, WI and there is not much here to choose from in HRT. Any recommendations? I feel good, strong, a bit bloated, and very excited with the wife. I’m just feeling as though I am short changing myself. I only feel this way becauase of what I read out there and others experiences with the process.

11

if you’re not on estrogen control then shots E3D or every week may not make that much of a difference.

Yes, I would recommend finding a new doc - check out the doc finding sticky. You are the customer. It is your body, not his. he is simply a consultant with some specialized knowledge, but at the end of the day, it is your decision. Your life. If he won’t work with you, then try and find one that will.

doctors do not “forget” to run the tests that they want to. They “forget” to order the tests that they don’t want to run in the first place.

are you sure about the 25mg Melatonin dose? the usual is 1 to 3mg. per the wikipedia “Large doses of melatonin can even be counterproductive: Lewy et al.[87] provide support to the “idea that too much melatonin may spill over onto the wrong zone of the melatonin phase-response curve” (PRC). In one of their blind subjects, 0.5 mg of melatonin was effective while 20 mg was not.[87]”

12

[quote]PureChance wrote:
if you’re not on estrogen control then shots E3D or every week may not make that much of a difference.

Yes, I would recommend finding a new doc - check out the doc finding sticky. You are the customer. It is your body, not his. he is simply a consultant with some specialized knowledge, but at the end of the day, it is your decision. Your life. If he won’t work with you, then try and find one that will.

doctors do not “forget” to run the tests that they want to. They “forget” to order the tests that they don’t want to run in the first place.

are you sure about the 25mg Melatonin dose? the usual is 1 to 3mg. per the wikipedia “Large doses of melatonin can even be counterproductive: Lewy et al.[87] provide support to the “idea that too much melatonin may spill over onto the wrong zone of the melatonin phase-response curve” (PRC). In one of their blind subjects, 0.5 mg of melatonin was effective while 20 mg was not.[87]”

[/quote]

I was incorrect. It is Schiff Melatonin Plus 3mg w/ 25mg Theanine. I must have read the 25mg off the label.

On the subject of new doctor. I did auto financing for a gal that worked in a compounding pharmacy and she e-mailed me information about a doc that worked with the compounding pharmacy very often and was very willing to learn about HRT and new ways of doing it. She is a 40minute drive from me and not covered by my insurance. This would be much more cost efficient than it would be to see an anti aging doctor.

Great info in that finding a doctor and tests to request and things to not test for stickies. I am very greatful that I have found this forum.

13

[quote]KSman wrote:
You need hCG, but you might need more FSH to get the sperm count up. This naturally lead to consideration of using a SERM that can create high LH and FSH, just what you need. Clomid has been around for a long time and has been used for fertility for men and women. So there is a lot of info out there. However, clomid can have deep estrogenic sides. Nolvadex is a better option in terms of avoiding estrogenic side effects.

So now you have two choices. SERMs are easier to obtain than hCG for domestic non-legal sources. hCG can be mailed in from overseas. But there are some legal concerns as some States have criminalized hCG by putting it in the same class of substances as anabolic steroids.

What form of TRT are you using. Lab numbers, ranges?[/quote]

KSMan,
I want to know if it is valid that an antidepressant like Wellbutrin(Buproprion) that I am taking will negate Nolvadex from having any effect. What I have read about this is as follows and I don’t know if its bullshit or not.

Here is what I have read.

One more thing for any of you on Anti-depressants, Toremifene will not be effected by SSRIs like Nolva will.

For those of you guys on Anti-Ds who have no idea what I am talking about, Nolvadex uses an enzyme â??CYP2D6â?² to convert itself into a more useful form that our bodies can use. Unfortunately many antidepressants also use this same CYP2D6 enzyme, thus you have two medications competing for the same pathway.

The problem? Antidepressants have priority on the CYP2D6 enzyme therefore can render Nolvadex to be nearly useless, which could cause serious side effects during our PCT such as Gynecomastia. If youâ??re on an antidepressant and intend on using Nolvadex as your PCT, itâ??s important for you to know which antidepressants will cause issue and if youâ??re on an antidepressant that will inhibit Nolvadex from being functional. Most should know that anti-depressants lower testosterone, so adding that fact to this makes it even more important. The following is a list of anti-depressants that are strong to moderate inhibitors of Nolvadex:

Wellbutrin
Prozac
Paxil
Cymbalta
Zoloft

There are a few others but these are the bigger brands IMO.

Again, another reason to use, or at least try Toremifene.

14

I have the order for nolva on the way and want to make sure I’m not throwing money out the window.

15

Yes, different drugs have processing demands on the liver. Some drugs are more reactive and some are higher doses. You adjust AI to manage any changes in E2 and I don’t know that anything cancels the SERM effects of any SERM. If you manage E2, while on any drug, gyno will not be an issue. What you read about this may not have been in the context of TRT with E2 management. In a non TRT context, where AI use is not used, these are valid concerns. In any case the idea that a breast cancer drug cannot prevent or deal with gyno seams to be a hard argument to follow.

Yes, nolvadex needs to be processed by the liver to work properly. However, if you are doing E2 labs and adjusting your AI dose, it all comes out in the wash. More nolvadex might be required. But given that standard doses of nolvadex may be overkill, the issue might not be a big deal.

16

Got my labs from last few years and am going to post up seperately. I did start with a new doctor 45 min drive from me and they are getting all my medical data forwarded to them.

11/27/2007
Free T3 3.3 (2.3-4.2)
Free T4 1.2 (0.7-1.5
Thyroid Stimulating Hormone 3.48 (0.35-5.00)

7/23/2008
Thyroid Stimulating Hormone 2.82 (0.35-5.00)
Testosterone Total-Male 214.1 (300-1,080)

9/4/2008
FSH 2.9 (1.4-18.1)
LH 4.4 (no range given)
Prolactin 7.3 (2.1 - 17.7)
Testosterone Total-Male 362.6 (280-1,100)

6/27/2009
Thyroid Stimulating Hormone 2.71 (0.35-5.00)
SHBG 28 (no range given)
Testosterone Free 65 (no range given)
Testosterone % Free 2%
Testosterone Total-Male 330 (300-1,080)

7/2/2009 ACTH Test
Cortisol Baseline 8:40am 14.1 (3.0-23.0)
Cortisol Post IV Dose 30min 17.6 (norm >18)
*This is what I thought, it seemed that my cortisol didn’t spike like it should, but doctor dismissed it)

9/1/2009 Started Testosterone (Androgel 5g/day)

12/16/2009 Before visit with endocrinologist, switched to injections 1x/wk after this visit
Thyroid Stimulating Hormone 1.81 (0.35-5.00)
Testosterone, Bioavailable 252 (131-682)
SHBG 29 (11-80)
Testosterone Free 89 (47-244
Testosterone % Free 2.0 (1.6-2.9)
Testosterone Total-Male 449 (300-1,080)

2/13/2010 First checkup with Endo
SHBG 32 (no range given)
Testosterone Free 177 (no range given)
Testosterone % Free 2.2 (no range given)
Testosterone Total-Male 812 (no range given)
Estradiol 58 (no range given)
PSA 0.45 (no range given)
GOT/AST 52 (14-50)
GPT/ALT 62 (21-72)
Hemoglobin 15.6 (13.0-17.0)
Hematocrit 44.4 (39-51)

8/13/2010 SECOND CHECKUP WITH ENDO - LOWERED TEST DOSE FROM 100mg/wk to 80mg/wk
Protein, Total 7.1 (6.4-8.2)
Albumin 4.1 (3.4-5.0)
Alkaline Phosphatase 89 (50-136)
GOT/AST 37 (15-37)
GPT/ALT 50 (30-65)
Hemoglobin 17.4 (13.0-17.0)
Hematocrit 48.4 (39.0-51.0)
PSA 0.61 (0.00-4.00)
Testosterone,bioavailable 759 (131-682)
SHBG 25 (11-80)
Testosterone,free 266 (47-244)
Testosterone % Free 2.4 (1.6-2.9)
Testosterone 1105 (300-1,080)

17

[quote]KSman wrote:
You need hCG, but you might need more FSH to get the sperm count up. This naturally lead to consideration of using a SERM that can create high LH and FSH, just what you need. Clomid has been around for a long time and has been used for fertility for men and women. So there is a lot of info out there. However, clomid can have deep estrogenic sides. Nolvadex is a better option in terms of avoiding estrogenic side effects.

So now you have two choices. SERMs are easier to obtain than hCG for domestic non-legal sources. hCG can be mailed in from overseas. But there are some legal concerns as some States have criminalized hCG by putting it in the same class of substances as anabolic steroids.

What form of TRT are you using. Lab numbers, ranges?[/quote]

It’s actually far more practical and safer and less of a hassle to do this:

  1. See a urologist who deals with fertility problems.
  2. Have him/her prescribe HCG or clomid. Neither medication is expensive with or without insurance.
18

The real problem is there are few doctors who have such interests or skills.

Labs 08/13/2010: T numbers look great. But timing of labs after prior injection has a big influence. AST/ALT are a bit elevated? Is this from muscle soreness or something else? Were you using any anastrozole then?

Feeling bloated is a sign of elevated E2. From your prior E2=58, you do have a problem. Elevated E2 can cause mood problems and other symptom of hypogonadism, even with high normal T numbers.

I hope that your new doc works out.

19

Then I guess I just happen to be in a place where there are more than enough doctors who deal with this.

20

[quote]KSman wrote:
The real problem is there are few doctors who have such interests or skills.

Labs 08/13/2010: T numbers look great. But timing of labs after prior injection has a big influence. AST/ALT are a bit elevated? Is this from muscle soreness or something else? Were you using any anastrozole then?

Feeling bloated is a sign of elevated E2. From your prior E2=58, you do have a problem. Elevated E2 can cause mood problems and other symptom of hypogonadism, even with high normal T numbers.

I hope that your new doc works out.[/quote]

I weight train 3x/week to failure and run 3x/week. Its from that I am sure.
Timing was 4 days after shot given in the morning for testing. Always same time.
I started anastrozole after the E2 was tested. I take .5mg 2x/week now. My E2 was not retested. I will make sure that it is retested next visit.