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

Needmassquick

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You need to give the body time to multiply leydig cells before stimulating them or you will just desensitize the receptors. Sure many people can stay on TRT while doing fertility treatments, but that is because they still have enough leydig cells left to begin with.

Can you explain where you're getting this from? I don't mean to be argumentative, it just gets so frustrating hearing so many different things and spending so much time and money so far with no results. I've heard from Dr. Crisler, Dr. McClain, and Dr. O'Connor that leydig cell desensitization is a total myth and there's no proof of it. I've read dozens of studies now on HCG, HCG+FSH, and clomid for fertility and have come across nothing regarding leydig cell desensitization. Everything I've come across has shown superior results with higher doses, and I've never once heard a protocol suggesting one needs to come off for a long period of time before starting HCG and FSH nor have I seen any evidence of this.

I have heard of people saying that for those who want to restart it can be beneficial to do a few weeks of HCG to stimulate the leydig cells, then do clomid to restart the pituitary, but that's an entirely separate issue.
 

Needmassquick

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Adding in Clomid is not in line with the purpose of this protocol. If you were to attemp a restart hCG would be run, then adding in Clomid and then phasing out hCG. Finally the Clomid would be phased out. Then after evaluation possibly a second round.

I know, and as I said above to Kaladryn it's frustrating because there are so many different people giving advice on a forum, then you question things and people get pissed shouting "ok so you know everything then? When are you even here then?". I said many times that my endocrinologist, my urologist, GotGame, and others have said that Clomid is of no benefit when already taking HCG and FSH. But others argued that "we don't know everything" and "why wouldn't you try it if nothing else is working?". So since it won't hurt at least and there are studies showing clomid/enclomiphene further increase LH and FSH even in the presence of HCG I decided to add it in. So now I'm doing 1200iu HCG + 150iu FSH 3x per week and 25mg enclomiphene every day.
 

Kaladryn

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We are talking about two different things here, leydig cell desensitization and laydig cell atrophy, they are completely different. If they are completely atrophied it doesn't matter if they are desensitized or not (if that is even a thing).

This was my first hit on google: https://pubmed.ncbi.nlm.nih.gov/3197648/
 

Needmassquick

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We are talking about two different things here, leydig cell desensitization and laydig cell atrophy, they are completely different. If they are completely atrophied it doesn't matter if they are desensitized or not (if that is even a thing).

This was my first hit on google: https://pubmed.ncbi.nlm.nih.gov/3197648/

I understand they are different but you said above "You need to give the body time to multiply leydig cells before stimulating them or you will just desensitize the receptors". That is the part I'm questioning, what evidence is there that starting HCG/FSH earlier will desensitize receptors? And what evidence is there that they will multiply while doing nothing for 6-12+ months?

Lastly, I had a strong response to HCG, at 1200iu 3x per week my total test was in the mid 800s. In some studies they needed to get up to 3000+iu 3x per week just to get testosterone in range. Surely that testosterone is being produced by the leydig cells, as I'm not on TRT, so would this not be clear proof I have the leydig cells necessary as they responded almost immediately to the HCG? It's the sertoli cells not producing sperm that I'm concerned about.
 

Kaladryn

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Oh yeah you are correct, sperm production is from a totally different location, but I would expect it to work in the same.

I've been doing HCG since the 90s and many friends and clients of mine have also, we all notice a HUGE reduction in effect over time, especially with megadoses (1000iu+ is a megadose imo). Even doing doses like 250iu on a daily basis start to have diminishing returns over time. There are so many possible causes, desensitization, downregulation, cobinding factors, etc. Whatever the case, many doctors have talked about this as well.

Regardless, if you are non-responsive to traditional fertilization therapy on TRT, the next step is to go off TRT, wait, and then try traditional fertilization therapy again.
 

Needmassquick

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Oh yeah you are correct, sperm production is from a totally different location, but I would expect it to work in the same.

I've been doing HCG since the 90s and many friends and clients of mine have also, we all notice a HUGE reduction in effect over time, especially with megadoses (1000iu+ is a megadose imo). Even doing doses like 250iu on a daily basis start to have diminishing returns over time. There are so many possible causes, desensitization, downregulation, cobinding factors, etc. Whatever the case, many doctors have talked about this as well.

Regardless, if you are non-responsive to traditional fertilization therapy on TRT, the next step is to go off TRT, wait, and then try traditional fertilization therapy again.

That is interesting, how long did it take for you and your clients to notice that reduction in effect? What sort of effects diminished?

Regarding your last statement, I immediately went off TRT (was on 70mg) when I wanted to become fertile. I was on for 8 years roughly. I've been off the TRT for 6 months, have been on 1200iu HCG 3x per week for 6 months, 75-150iu r-FSH 3x per week for 5 months, and 25mg enclomiphene ED for about 1 month. Taking 1-2g l-carnitine daily as well now for sperm motility though I'm sure that's a very minimal player. I'm doing everything I can possibly think of and that has been recommended. My libido is very high, no sexual issues, and total testosterone is in the 800s. Is there anything there you would change?
 

Kaladryn

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Kaladryn

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Hey not to pester but any thoughts on my above post? Given I AM off TRT would you change anything else given what I mentioned?
If nothing else is working (many people have no trouble while on TRT) I would go off everything for an extended period of time, optimize health, and then repeat fertility treatments. I guess the alternative is to do the surgery, which may also fail, but I would try going off everything first. Another option would be to use rFSH alone. Honestly, it seems to me the way fertility docs go at it is a crapshoot...

Note that I'm no expert in this area, this is just what makes sense to me from a biochemistry standpoint. You might want to discuss these options with your fertility doctor, they may have similar suggestions with more insight than I can give.
 

Needmassquick

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If nothing else is working (many people have no trouble while on TRT) I would go off everything for an extended period of time, optimize health, and then repeat fertility treatments. I guess the alternative is to do the surgery, which may also fail, but I would try going off everything first. Another option would be to use rFSH alone. Honestly, it seems to me the way fertility docs go at it is a crapshoot...

Note that I'm no expert in this area, this is just what makes sense to me from a biochemistry standpoint. You might want to discuss these options with your fertility doctor, they may have similar suggestions with more insight than I can give.

To be clear, and I only mention this again because you've mentioned a few times going off TRT, but I AM off of TRT and have been off TRT for almost 7 months now.

What would make you suggest rFSH alone? I've never heard this ever

I appreciate the honesty. And yea the surgery is scary considering that's a last ditch option that might not even work. The OP of this thread not having success even with that is concerning.
 

John99Test

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Anyone familiar with the micro dose Triptorelin protocol? Super interesting. They give it to pedophiles to essentially chemically castrate them buy overstimulation. However, at a micro dose (100MCG) NOT MG, it’s supposed to jumpstart your system.
 

bodybuilder8806

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I can't speak on using R-Fsh, but HMG worked great. I've been on trt for about 15 years now no HCG, and I started HCG 200iu/day and HMG 75iu 2 x week and was fertile within about 5-6 months. The source you're getting your more difficult to find compounds like r-Fsh and HMG can probably play a huge factor as well.
 

Needmassquick

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I can't speak on using R-Fsh, but HMG worked great. I've been on trt for about 15 years now no HCG, and I started HCG 200iu/day and HMG 75iu 2 x week and was fertile within about 5-6 months. The source you're getting your more difficult to find compounds like r-Fsh and HMG can probably play a huge factor as well.

Did your testicles shrink while you were on TRT, and did they increase while on HCG+Hmg? Your story is very common, which is why I'm surprised by the difficulty I'm having. You were on such a low dose of HCG and HMG as well.

I scheduled my next semen analysis in 2 weeks. It will be 7 months at that point.
 

bodybuilder8806

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Did your testicles shrink while you were on TRT, and did they increase while on HCG+Hmg? Your story is very common, which is why I'm surprised by the difficulty I'm having. You were on such a low dose of HCG and HMG as well.

I scheduled my next semen analysis in 2 weeks. It will be 7 months at that point.
Definitely had shrinkage and wasn't fertile during the whole time on trt with no HCG or HMG.
 

Needmassquick

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Definitely had shrinkage and wasn't fertile during the whole time on trt with no HCG or HMG.
You mentioned you were fertile in 5-6 months. I assume this was concluded based on a semen analysis or getting your partner pregnant? Did your testicles increase in size at that point or did they remain smaller?
 

bodybuilder8806

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You mentioned you were fertile in 5-6 months. I assume this was concluded based on a semen analysis or getting your partner pregnant? Did your testicles increase in size at that point or did they remain smaller?
Yes my wife became pregnant about 5 months after starting treatment. The reason I say 5-6 months is because of not knowing the date she became pregnant 100%. Testicle volume did increase some as well.
 

John99Test

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Yes my wife became pregnant about 5 months after starting treatment. The reason I say 5-6 months is because of not knowing the date she became pregnant 100%. Testicle volume did increase some as well.
Assuming you went off the TRT while doing this yes?
 

bellicose

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I had to go off completely for 1 full year and do almost 3 full months off HMG to get things fired back up after years of AAS abuse.
 

Needmassquick

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I had to go off completely for 1 full year and do almost 3 full months off HMG to get things fired back up after years of AAS abuse.

What made you decide to go off everything for a full year rather than try HMG sooner?
 

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