Off TRT for 2 Months, Considering Restart While Trying for a Baby – Need Input

Pharma / TRT
1

Hi everyone, I would like your input as I am off TRT for 2 months exactly and would like to get back on. I am 34 and have been on TRT for 4 years at 160mg while taking HCG every year except for the last one. I decided to quit cold turkey as my wife (30 years old) and I want to have our first kid. We both can get pregnant because she got pregnant last year when we did it without protection, but unfortunately, she had a miscarriage at week 6.

I came off TRT because I went to a fertility doctor, did a semen analysis, and they couldn’t find any sperm in the sample. He said it would be almost impossible for me to get back to baseline. I got a second opinion from a functional doctor to get back to optimal levels as fast as possible. My protocol has been Clomid 25mg a day, HCG 1000 IU every other day, and rFSH 75 IU every other day.

It’s been two months exactly since my last SA, and as you can see, I have recovered some sperm. My question is that mentally and physically, I feel lethargic, and it’s been affecting my work. I am considering going back to a low dose of TRT plus everything else I’m taking. I am thinking of 100mg Test Cypionate per week, 25mg Clomid daily, HCG 1000 IU every other day, and rFSH 75 IU every other day.

I’ve heard some people say that as long as I am taking rFSH with HCG, my total sperm count will keep going up, which is also what Jay Campbell and Dave Lee said. I am wondering if anyone has had experience with this and what your thoughts are?

I’m leaving the results from my last SA below. Thanks for all the help!

Macroscopic Analysis:

• Volume: 3.9 ml (Reference: ≥1.4 ml)
• Color: Opalescent • Viscosity: Normal
• Liquefaction Time: 30 minutes (Complete within 60 minutes)
• pH: 7.5 (Reference: ≥7.2)

Microscopic Analysis:

• Sperm Concentration: 10 million/ml (Reference: ≥16 million/ml)
• Total Sperm Count: 39 million/sample (Reference: ≥39 million/sample)
• Motility A (Progressive): 0%
• Motility B (Non-progressive): 47%
• Motility C (Slow): 10%
• Immotile Sperm (D): 43% (Reference: ≤54%)
• Total Motility (A+B+C): 57% (Reference: ≥42%)
• Motile Sperm Count: 18.33 million/sample
• Round Cells: 0.20 million/ml
• Debris: No • Leukocytes: Not detected (Reference: ≤1 million/ml)
• Aggregation: None
• Vitality: Not assessed (Reference: ≥54%)

Morphology:

• Normal Forms: 2.7% (Reference: ≥4%)
• Abnormal Forms: 97.3%
• Head Defects: 75.3%
• Neck Defects: 37.3%
• Tail Defects: 46%

Sperm Capacitation (Post-Wash):

• Initial Volume: 1.5 ml
• Final Volume: 0.3 ml
• Concentration: 19 million/ml
• Motility A (Progressive): 21%
• Motility B (Non-progressive): 63%
• Motility C (Slow): 5%
• Recovery Rate: 26.12% (Reference: ≥10%)
• Recovered Motile Sperm Count: 4.788 million/ml (Reference: ≥3 million/ml)

Conclusion:

• Predominant abnormality: Head and tail defects.
• Diagnosis: Oligoteratozoospermia (low sperm count with abnormal forms).

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I have two kids from taking HCG for 1000 IU thrice per week with 100 mg testosterone cypionate per week.

I do not know why you’d take three drugs for fertility. What do you mean by functional doctor? Even clomid for 25 mg a day by itself can treat low T and fertility.

Coming off TRT doesn’t improve fertility in hypogonadal men.

See the HCG thread.

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Thank you so much for your response. There are a few reasons for my current treatment plan. The main reason I take HCG is because it mimics LH, and I also use rFSH (Gonal-F) to signal my brain to produce sperm. I take Clomid to raise my testosterone levels since I’m currently off TRT.

I’m considering restarting testosterone at 100 mg this week and discontinuing Clomid, while continuing with HCG and rFSH.

Being off TRT has been challenging, as I’ve been experiencing ED and a lack of sexual arousal, even when taking tadalafil and sildenafil.

1 Like
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You can take HCG all by itself. A friend of mine who goes to my doctor just had his second child with HCG monotherapy at 9,000 IU per week.

Clomid can be used by itself.

Both can restore T to normal values.

What kind of doctor do you see? My doctor is a urologist and a former chairman of urology at a hospital. I have never heard of a case in which he would prescribe three medications for fertility.