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Doing the impossible.

John99Test

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I’ve been on TRT for over 15 years. No HCG. I started HCG at the beginning of the year but went off for two months because of a congenital heart issue that was found. The all clear has been given to resume my fertility protocol. As expected, I’m azoospermic at the moment. I will resume HCG twice a week (500iu each shot) and continue my TRT (100mg split 50/50 during the week). I will do this until May of next year at which point I will add HMG at 75iu either twice or three times a week. The goal is to achieve fertility by September 2023. Life is interesting. Because of my congenital heart defect I’m now a candidate for IVF since they need to see if the embryo would have the same defect. So I really only need to get my fertility up enough to successfully complete the IVF procedure. What do you guys think? 9 months of HCG and then 4 months of additional HMG on top of it. I will not be going off of TRT. It should be an interesting little experiment to say the least.
 
Yes, I would use clomid. I feel it helps. A member here (his name escapes me) showed studies that clomid does boost fertility even on trt
 
What's the rationale for low dose hCG and waiting nearly a year to use hMG? I shared a practical protocol for restimulating the HPG axis & spermatogenesis here: [link]
Mostly because HCG is cheap and HMG is expensive. I figured I’d run HCG for months and then at the end 2-3 months use HMG
 
Yes, I would use clomid. I feel it helps. A member here (his name escapes me) showed studies that clomid does boost fertility even on trt
I was always told not to use Clomid while on TRT. Guess I was wrong.
 
Mostly because HCG is cheap and HMG is expensive. I figured I’d run HCG for months and then at the end 2-3 months use HMG
That's a strongly supporting rationale (financial expense; the one that stands out as particularly relevant). Another consideration, too, is that it's virtually impossible to verify hMG authenticity as Jano won't test for it (apparently the assay is difficult to run and can lead to inconsistent results).

HCG (as long-acting LH) stimulates Leydig cell T biosynthesis/steroidogenesis & maintains some (but not full) spermatogenesis. Importantly, higher doses of exogenous hCG (used alone), by stimulating T biosynthesis/steroidogenesis, serves to more fully suppress FSH (because T feeds back negatively on its synthesis). So, moderate hCG doses (e.g., 500 IU e.o.d./q.o.d.) might more optimally (though not fully, because of the insufficiency of FSH concentrations) maintain (but likely not restimulate fully suppressed) spermatogenesis vs. higher doses... It's a delicate system, the HPG axis given its pulsatility and sensitivity to negative feedback.
 
That's a strongly supporting rationale (financial expense; the one that stands out as particularly relevant). Another consideration, too, is that it's virtually impossible to verify hMG authenticity as Jano won't test for it (apparently the assay is difficult to run and can lead to inconsistent results).

HCG (as long-acting LH) stimulates Leydig cell T biosynthesis/steroidogenesis & maintains some (but not full) spermatogenesis. Importantly, higher doses of exogenous hCG (used alone), by stimulating T biosynthesis/steroidogenesis, serves to more fully suppress FSH (because T feeds back negatively on its synthesis). So, moderate hCG doses (e.g., 500 IU e.o.d./q.o.d.) might more optimally (though not fully, because of the insufficiency of FSH concentrations) maintain (but likely not restimulate fully suppressed) spermatogenesis vs. higher doses... It's a delicate system, the HPG axis given its pulsatility and sensitivity to negative feedback.
so HCG and something like GONAL F (FSH) would be ideal?
 

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