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HELP! Still shooting blanks after 3 years on hCG and 9 months on hCG + Clomid

Thappy

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That's a huge jump. Unfortunately i'm at 0million... literally zero. I'm completely shut off. It's not a matter of having low sperm, I literally have zero. 6 or 7 semen analysis over 4 years and also a MESA surgery (last week) where they surgically extracted fluid from my balls and analyzed it. No luck. When I got on TRT I immediately noticed testicular atrophy. it's never gone away in the 6 years of TRT and 4 years of hCG. There will be a few occasions where I will notice they are big again but that lasts a day tops. then back to shriveled grapes. Something isn't right. I'm convinced it's the hCG. I don't have the same reaction to it as everyone else has stated. i'm off it now and on clomid by itself. We'll see how I'm doing in a couple months.

i was at 0 then introduced hcg and clomid and nolva, that got it up to 15000(basically nothing the dr said) then got on hmg with hcg and the rose to 100mill. had sex 3 times around ovulation period(around 4 weeks after starting HMG) then did the sperm test 2 weeks after that got 100mill around the same time found out she was pregnant.
 

nastyn8

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i was at 0 then introduced hcg and clomid and nolva, that got it up to 15000(basically nothing the dr said) then got on hmg with hcg and the rose to 100mill. had sex 3 times around ovulation period(around 4 weeks after starting HMG) then did the sperm test 2 weeks after that got 100mill around the same time found out she was pregnant.

Holy shit! Hearing this pisses me off because I would constantly tell my doctor that I want to be put on hMG and his response was that my bloodwork looked great and I didn't need to add anything. It's hard to argue that because my LH and FSH levels were right smack in the middle of normal, and my test levels were coming back in the high 600s. So from that perspective, the hCG+clomid was doing its job. I just wasn't, and still am not producing semen. I asked him multiple times about hMG and his response we typically that he didn't know a lot about it. So then I asked about gonal-f and he said since my levels were fine, I didn't need to add anything else. It's hard to argue that. I have an appointment with him next week for the surgery post op review and discuss next steps. I'm not really sure what i'm going to ask him. He is already talking about donor sperm. I'm not ready to move forward with that approach because I feel like we're missing something. I have a son already who is 10. I know for a fact at one point I was working just fine. Fast forward thru 7 years of TRT and almost 4 years of hCG and i'm completely shut down. I know we're missing something but I need to be able to tell him what exactly that is, and then defend it once he says "we've tried everything". Maybe I'll ask for a second opinion... it just sucks getting this far down the road only to find out that another doctor may have the right solution for me.
 

John99Test

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Holy shit! Hearing this pisses me off because I would constantly tell my doctor that I want to be put on hMG and his response was that my bloodwork looked great and I didn't need to add anything. It's hard to argue that because my LH and FSH levels were right smack in the middle of normal, and my test levels were coming back in the high 600s. So from that perspective, the hCG+clomid was doing its job. I just wasn't, and still am not producing semen. I asked him multiple times about hMG and his response we typically that he didn't know a lot about it. So then I asked about gonal-f and he said since my levels were fine, I didn't need to add anything else. It's hard to argue that. I have an appointment with him next week for the surgery post op review and discuss next steps. I'm not really sure what i'm going to ask him. He is already talking about donor sperm. I'm not ready to move forward with that approach because I feel like we're missing something. I have a son already who is 10. I know for a fact at one point I was working just fine. Fast forward thru 7 years of TRT and almost 4 years of hCG and i'm completely shut down. I know we're missing something but I need to be able to tell him what exactly that is, and then defend it once he says "we've tried everything". Maybe I'll ask for a second opinion... it just sucks getting this far down the road only to find out that another doctor may have the right solution for me.

Bro. $&@! the doc. They really don’t know shit when it comes to this area (I mean with past AAS use) Go get HMG through clearsky and add it to the mix. Don’t rely on an idiot that really doesn’t have any stake in the game. This is your life and you want kids. Be proactive, reach out to clearsky, get HMG sent to your house and take matters into your hands. You got this brother.
 

John99Test

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Holy shit! Hearing this pisses me off because I would constantly tell my doctor that I want to be put on hMG and his response was that my bloodwork looked great and I didn't need to add anything. It's hard to argue that because my LH and FSH levels were right smack in the middle of normal, and my test levels were coming back in the high 600s. So from that perspective, the hCG+clomid was doing its job. I just wasn't, and still am not producing semen. I asked him multiple times about hMG and his response we typically that he didn't know a lot about it. So then I asked about gonal-f and he said since my levels were fine, I didn't need to add anything else. It's hard to argue that. I have an appointment with him next week for the surgery post op review and discuss next steps. I'm not really sure what i'm going to ask him. He is already talking about donor sperm. I'm not ready to move forward with that approach because I feel like we're missing something. I have a son already who is 10. I know for a fact at one point I was working just fine. Fast forward thru 7 years of TRT and almost 4 years of hCG and i'm completely shut down. I know we're missing something but I need to be able to tell him what exactly that is, and then defend it once he says "we've tried everything". Maybe I'll ask for a second opinion... it just sucks getting this far down the road only to find out that another doctor may have the right solution for me.

Also I’m not a rep for clearsky or anything like that. Wanna make that 100% clear. However, all the hCG and HMG and Clomid I got from them is 100% good to go. Just sharing my experience. It’s not cheap but if you can have a kid it’s worth it in the long run.
 

beast405

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Man if anything is going to get sperm count up it will be hmg for sure !!
 

bad rad

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Holy shit! Hearing this pisses me off because I would constantly tell my doctor that I want to be put on hMG and his response was that my bloodwork looked great and I didn't need to add anything. It's hard to argue that because my LH and FSH levels were right smack in the middle of normal, and my test levels were coming back in the high 600s. So from that perspective, the hCG+clomid was doing its job. I just wasn't, and still am not producing semen. I asked him multiple times about hMG and his response we typically that he didn't know a lot about it. So then I asked about gonal-f and he said since my levels were fine, I didn't need to add anything else. It's hard to argue that. I have an appointment with him next week for the surgery post op review and discuss next steps. I'm not really sure what i'm going to ask him. He is already talking about donor sperm. I'm not ready to move forward with that approach because I feel like we're missing something. I have a son already who is 10. I know for a fact at one point I was working just fine. Fast forward thru 7 years of TRT and almost 4 years of hCG and i'm completely shut down. I know we're missing something but I need to be able to tell him what exactly that is, and then defend it once he says "we've tried everything". Maybe I'll ask for a second opinion... it just sucks getting this far down the road only to find out that another doctor may have the right solution for me.
Based off everything you've done and your blood work I think your Leydig and Sertoli cells are fried at this point. They've been so bombarded with huge hCG doses it shut them down. There's a little anecdotal evidence that IGF R3 will increase their sensitivity. I'd stay on Clomid only for a month and retest your blood work to see where your ground truth HPTA is.
 

bad rad

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There's evidence that Proviron will increase fertility independent of all other HPTA hormones. I posted a study in the alternate TRT thread.
 

Dial_tone

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First time on the board in a long time, since I generally only get on when I need something. What is Clearsky and how do you reach them?
 

beast405

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What surgery are you having done?

I have a similar history of AAS use. Tried unsuccessfully to get my wife pregnant for years. We tried everything. Got so frustrating it stated to put a major strain on our relationship. Finally made an appointment with an established IVF clinic. My wife checked out fine. I was the problem. My semen analysis showed azoospermia. Plus the very few that were around showed terrible motility/morphology. Specialists there said only way was through ICSI due to my horrible #'s.

IVF techniques have greatly improved the chances of individuals such as yourself having a child. I have 2 very healthy daughters today both conceived through IVF with ICSI. In fact our second daughter was a stored embryo from the first ICSI fertilization thawed out and inserted 5 years later.
My lady and I just did our first embryo transfer last week but it failed. We are going to transfer two next time we do it. Fingers crossed it works this time!!
 

beast405

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What surgery are you having done?

I have a similar history of AAS use. Tried unsuccessfully to get my wife pregnant for years. We tried everything. Got so frustrating it stated to put a major strain on our relationship. Finally made an appointment with an established IVF clinic. My wife checked out fine. I was the problem. My semen analysis showed azoospermia. Plus the very few that were around showed terrible motility/morphology. Specialists there said only way was through ICSI due to my horrible #'s.

IVF techniques have greatly improved the chances of individuals such as yourself having a child. I have 2 very healthy daughters today both conceived through IVF with ICSI. In fact our second daughter was a stored embryo from the first ICSI fertilization thawed out and inserted 5 years later.
And we are doing ivf with icsi too
 

provimed50

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I'd run:

100 MG Test C / Week
250-500 HCG EOD
75 HMG EOD
NO CLOMID
 

nastyn8

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There's evidence that Proviron will increase fertility independent of all other HPTA hormones. I posted a study in the alternate TRT thread.

I finally decided to chart out all my lab work over the last 4 years and it's pretty clear that my FSH levers were never in the right range. Here is the chart - https://ibb.co/w0rFHGj
I FINALLY got my doctor to prescribe Gonal-F for me. I'm just waiting on the insurance part of it now... which is currently at almost a month and counting.

Since my surgery on Oct 6th, i've been on clomid only. I feel like garbage, but my LH and FSH numbers look good. Obviously the low T and high e2 are the reasons I feel like absolute shit. I think once I get the gonal insurance situation sorted out i'm going hCG 500iu 3x + clomid 50mg 3x + gonal 150iu 3x + anastrozole .25mg once a week. Hopefully that gets me in the sweet spot.
 

pickapeck

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From my reading of your case your doc is a complete incompetent. Get another doc. He doesn't even know basicas and is treating your nut sack like a pinata. You need another fertility expert for this to work.
 

provimed50

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Run the basics mate, I was a noob too and listened what the dumb doc said, I got a shitload of useless information and "help". Steroids off, Clomid and Arimidex in and I'm fertile after weeks. BULLSHIT.

Since I talk with a few advanced guys here, especially @Sides, I know what and how it really works.

TRT + HMG + HCG

(TRT only if needed)
 

Sides

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I finally decided to chart out all my lab work over the last 4 years and it's pretty clear that my FSH levers were never in the right range. Here is the chart - https://ibb.co/w0rFHGj
I FINALLY got my doctor to prescribe Gonal-F for me. I'm just waiting on the insurance part of it now... which is currently at almost a month and counting.

Since my surgery on Oct 6th, i've been on clomid only. I feel like garbage, but my LH and FSH numbers look good. Obviously the low T and high e2 are the reasons I feel like absolute shit. I think once I get the gonal insurance situation sorted out i'm going hCG 500iu 3x + clomid 50mg 3x + gonal 150iu 3x + anastrozole .25mg once a week. Hopefully that gets me in the sweet spot.

Here's my opinion, and what worked for me, as a well-educated layman, but not a medical professional:

To be honest, Clomid is a crap drug. It raises FSH and LH and total testosterone, so your numbers look good on paper. But it also raises SHBG, leaving you with less free testosterone, so with that and the emotional side effects, most men feel terrible on Clomid, even if their numbers look good. For me personally, Clomid raised my SHBG extremely high (over 120, when the normal range is between 30-50), and I felt horrible until I cut it out.

From my own example, I have been on testosterone and other steroids for over 28 years now. Coming off test was never an option for me. I was azoospermatic (zero sperm) when I began my fertility protocol. The first seven months, I was only on 200-300mg Test per week, 50mg Clomid, 25mg Proviron, and HCG. This only raised my sperm count to 7 million/ml TMC. Then I added in HMG, against my fertility doctor's wishes, and over the next four months my sperm count went up to 31 million/ml TMC, and my wife was pregnant. Our baby daughter is almost a year old now, big (98th percentile in height and weight) and happy and healthy, and toddling all around the house getting into trouble LOL. But she is an incredible blessing to us, and we are happy to have her.

What worked for me was:

200-300mg Test per week
500iu HCG every other day
30-60iu HMG every day (FSH and LH have very short half-lives in the body)
25mg Proviron per day

Your doctor is an idiot, but he is a useful idiot if he will prescribe HCG and FSH (Gonal-F) to you. Gonal-F is very expensive, but if insurance will cover it for you (rare that they cover it for men's fertility), then you are truly blessed. My doctor is a "fertility expert" very well-recommended in the area, but he wouldn't prescribe HMG to me, and if I had followed his very conservative advice, I never would have had my daughter. So do what you feel to be right. Sadly, doctors are often too afraid of liability to be useful; at least that is what I have found in my journey through life. A good doctor is rare, but worth their weight in gold.

How is your libido now? If it's poor, then I would add test back in at whatever TRT level you feel comfortable doing. If you are using FSH and HCG, then you are not producing your own hormones, you are injecting them from a bottle. So you are bypassing the usual negative feedback from the pituitary if you decide to use exogenous testosterone, and it will not negatively impact your fertility. I used test all the way through my protocol, and still recovered my fertility, so if it worked for me and many other men, it will probably work for you as well, barring any other pre-existing fertility conditions.

Daily or even twice-daily injections of HMG and FSH have been shown to work best in studies, due to the short half-lives of FSH and LH. EOD or twice-weekly injections are typically prescribed because normal people hate injections and won't comply with a protocol of frequent shots. EOD or twice per week will definitely work, but as with many things, small frequent daily injections work even better. But that's up to you, what you can afford, and what you are willing to do for success.

I'm not you, but if I were you, I would modify your plan to:

TRT dose of testosterone
500iu HCG EOD
150iu Gonal-F EOD (if you can afford it)
No AI unless you need it

Best of luck to you, and I will be praying for your success! If I could do it, you can do it as well! Have faith and keep trying!
 

John99Test

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Registered
Joined
Feb 6, 2008
Messages
512
Here's my opinion, and what worked for me, as a well-educated layman, but not a medical professional:

To be honest, Clomid is a crap drug. It raises FSH and LH and total testosterone, so your numbers look good on paper. But it also raises SHBG, leaving you with less free testosterone, so with that and the emotional side effects, most men feel terrible on Clomid, even if their numbers look good. For me personally, Clomid raised my SHBG extremely high (over 120, when the normal range is between 30-50), and I felt horrible until I cut it out.

From my own example, I have been on testosterone and other steroids for over 28 years now. Coming off test was never an option for me. I was azoospermatic (zero sperm) when I began my fertility protocol. The first seven months, I was only on 200-300mg Test per week, 50mg Clomid, 25mg Proviron, and HCG. This only raised my sperm count to 7 million/ml TMC. Then I added in HMG, against my fertility doctor's wishes, and over the next four months my sperm count went up to 31 million/ml TMC, and my wife was pregnant. Our baby daughter is almost a year old now, big (98th percentile in height and weight) and happy and healthy, and toddling all around the house getting into trouble LOL. But she is an incredible blessing to us, and we are happy to have her.

What worked for me was:

200-300mg Test per week
500iu HCG every other day
30-60iu HMG every day (FSH and LH have very short half-lives in the body)
25mg Proviron per day

Your doctor is an idiot, but he is a useful idiot if he will prescribe HCG and FSH (Gonal-F) to you. Gonal-F is very expensive, but if insurance will cover it for you (rare that they cover it for men's fertility), then you are truly blessed. My doctor is a "fertility expert" very well-recommended in the area, but he wouldn't prescribe HMG to me, and if I had followed his very conservative advice, I never would have had my daughter. So do what you feel to be right. Sadly, doctors are often too afraid of liability to be useful; at least that is what I have found in my journey through life. A good doctor is rare, but worth their weight in gold.

How is your libido now? If it's poor, then I would add test back in at whatever TRT level you feel comfortable doing. If you are using FSH and HCG, then you are not producing your own hormones, you are injecting them from a bottle. So you are bypassing the usual negative feedback from the pituitary if you decide to use exogenous testosterone, and it will not negatively impact your fertility. I used test all the way through my protocol, and still recovered my fertility, so if it worked for me and many other men, it will probably work for you as well, barring any other pre-existing fertility conditions.

Daily or even twice-daily injections of HMG and FSH have been shown to work best in studies, due to the short half-lives of FSH and LH. EOD or twice-weekly injections are typically prescribed because normal people hate injections and won't comply with a protocol of frequent shots. EOD or twice per week will definitely work, but as with many things, small frequent daily injections work even better. But that's up to you, what you can afford, and what you are willing to do for success.

I'm not you, but if I were you, I would modify your plan to:

TRT dose of testosterone
500iu HCG EOD
150iu Gonal-F EOD (if you can afford it)
No AI unless you need it

Best of luck to you, and I will be praying for your success! If I could do it, you can do it as well! Have faith and keep trying!

This is an epic post and I’m in the same boat. I’m going to use this protocol. Will start next year when we’re ready to have kids. I was under the impression I MUST go cold turkey on the exogenous test. That was the plan plus 2000-3000 HCG three times a week with HMG at 75ius the other days. Then 25mg clomid per day. I always felt that was too much HCG per week. Glad to hear this worked for you and you didn’t have to come off! That’s the truly amazing part about it. Awesome.
 

Thappy

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This is an epic post and I’m in the same boat. I’m going to use this protocol. Will start next year when we’re ready to have kids. I was under the impression I MUST go cold turkey on the exogenous test. That was the plan plus 2000-3000 HCG three times a week with HMG at 75ius the other days. Then 25mg clomid per day. I always felt that was too much HCG per week. Glad to hear this worked for you and you didn’t have to come off! That’s the truly amazing part about it. Awesome.

I used half that HMG dose 3 times a week and worked very quickly.

If i have another kid i would look at staying on test and not taking clomid as the combination of the two really messed with me mentally
 

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