So I have been on TRT for 5 years. Diagnosed with low T at 24. Levels under 100ng/ml. Numerous doctors couldnt figure out why. Put off trt for a few years but started cypionate about 5 years ago. After a few dosage changes i wound up on 200ml weekly which i am still on. Recent tests showed azoospermia. Now married and trying to have kids. My doctor prescribed hcg along with clomid. Told me to stop test and start 1500iu twice weekly. I have always lifted throughout all of this. My questions are.
Do I taper down the test first to get off or just stop and switch to the hcg?
If i cant produce test naturally then why wouldnt test along with the hcg make more sense. (I have seen 3 urolgists and all say u need to be off test for hcg to work)
Will i lose muscle mass being off the test and just using the hcg?
Recent labs show total t being around 600-700. Lh and fsh completly shut off.
After all ive read you guys seemed to be more knowledgeable than any of the doctors ive seen.
Are you under pressure to get your wife pregnant? I might lower to 150 mg/wk as a start, and use 300 iu 3X or EOD as a start.
Don’t expect to be fertile in a month. Expect it in 6 months to a year. For now practice the reproductive act as often as you can so when the time comes you are ready.
IMO, clomid could help, but I would start with just HCG. If that didn’t work I would try HMG, or adding FSH to your HCG protocol before using clomid.
These urologists are wrong, HCG will work in conjunction with TRT. If TRT+HCG doesn’t work, add FSH injections.
The clomid route can present with a dilemma, clomid can cause ED and low libido so it may be difficult to get the wife pregnant if you have little to no desire for sex let alone be able to get an erection.
hCG therapy can help preserve spermatogenesis in men undergoing TRT by maintaining intratesticular testosterone levels.
Yes i kind of am under pressure lol. Especially with being 35. My doc did say it would take upwards of 6 months. I just didnt understand why they say to stop the trt. It makes no sense especially in my case when i wasnt able to naturally produce test even before starting the trt years ago. Is the 1500 iu twice a week too high of a starting dosage?
I think doing 500iu eod would get you the same results with less likelihood of side effects. I would probably start just with HCG (research indicates it is pretty effective). If that doesn’t work, I would add FSH. If that doesn’t work, you could go off and use clomid for awhile. If that doesn’t work, you were most likely infertile to start with.