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Really Disheartening Fertility News From Doctor

Needmassquick

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This is a continuation of this thread https://www.professionalmuscle.com/forums/index.php?threads/still-infertile.168260/

I just got my semen analysis back and after 4 months of HCG and FSH and coming off testosterone I'm azoospermic. I didn't want to delay so I pulled out all the stops early, adding the FSH and taking away the testosterone. My leydig cells seem to be responding very well. After 2 months my total testosterone was 550 and now after 4 months my total is 850. My sertoli cells don't seem to be responding.

I've been taking ~1000iu HCG + 75iu FSH 3x per week. My blood work has been done on a Friday morning, after a Thursday morning dose of these medications. In both tests my LH has been undetectable (makes sense) and my FSH has been 2.7 (range 1.5-12.4). I do not know how high the FSH would be if I tested the day of injection.

Here is the very disheartening aspect:
Me: I know it can take time, I've heard you can get detectable levels before you get testicular size back. Is that your experience?
Doc: I don't think you'll get the size back.
Me: None?
Doc: You can see that in adolescents but generally not in adults
Me: Wait, do you mean I can get normal levels of sperm back and not see testicular size come back?
Doc: No, I don't think you'll get normal levels back
Me: What? Isn't that the point? Then what is the goal?
Doc: Well I'm hoping you can get levels up to a point where you can get IVF done
Me: I'm so confused. I've seen dozens of studies showing a return of normal sperm
Doc: I have too, I've seen them, but I don't think that will happen. Your body seems to be resistant. I've seen people come back just by going off of testosterone or going off and adding clomiphene. You're taking medications to hasten it and we don't see any response.
Me: So, we're just trying to get enough to possibly do IUI?
Doc: No, we can't do IUI. For intra uterine insemination you need at least 10 million.
Me: So we're just trying to get detectable levels for IVF??
Doc: If we see no sperm at all there is a surgery where you go into the testicles and hope to find some viable sperm under a microscope.
Me: Should I up the doses?
Doc: No, you're already taking the recommended amount


This was completely shocking to me. This guy has to be around 70 and I'm hoping he is just wrong. At one point he couldn't think of the name for Sertoli cells and just said "the...uh...sperm producing tissue" but I could be grasping for straws there, he's obviously been doing this for a very long time. I didn't mention that I've also read dozens and dozens of anecdotes on the forums but I of course have. Dr. Thomas O'Connor and Dr. Rand McClain have both said in their videos that they have 100% success rate with JUST HCG, hell McClain doesn't even have his patients come off TRT (O'Connor does).

I know GotGame left the forums but has in depth experience with this, if anyone who still talks to him could pass this along I'd be very grateful. Any insights would be great. My wife is going to be crushed when she hears I'm still at zero.
 

Needmassquick

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I have a bunch of HCG in my fridge that I didn't want to use as it's not from my pharmacy, but if going to an even higher dose of HCG would help I would consider it. Also my estradiol is getting out of range so I'm a little hesitant to up the HCG (and thus my testosterone and estradiol as well)

I feel like my FSH levels should potentially be higher too but I am using the dose everyone seems to recommend both anecdotally and in studies (75iu 3x/week) and I'm already paying $1150 per month on these drugs :( $925 of which is coming from the FSH
 

warlock

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Sorry to hear what you're going through. I wouldn't lose hope yet and, instead would ask for a second opinion before you give up.
 

jay_dub

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Have you looked into adding HMG to the protocol?
 

Matsuo Munefusa

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Sorry man but I would stay the course a little longer. You can also search WCBB forum and get a message through to GG - he said he’s reachable there.
 

danieltx

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Did you have any sperm testing done prior to ever using testosterone and other PEDs?

I ask because like you've seen the vast majority can recover sperm production enough to conceive even with long-term steroid use. It's possible your sperm had issues before you ever touched anything. Don't beat yourself up over it thinking it's all your fault.
 

NEMSZ

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My understanding is HMG is just HCG+FSH, which I'm already taking

No man, I told you in the other thread;

HMG is equal parts LH AND FSH.. You need both to stimulate Sperm production, HCG acts as an LH mimic in stimulating intra testicular testosterone production to stimulate sperm production..

Ive been reading studies and forums like crazy the past few months as well.

I don’t think you should lose hope though, I think you should honestly try the HMG route with HCG... That is the protocol I’ve seen work time and time again...

I’ll PM you some things...
 

Needmassquick

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Did you have any sperm testing done prior to ever using testosterone and other PEDs?

I ask because like you've seen the vast majority can recover sperm production enough to conceive even with long-term steroid use. It's possible your sperm had issues before you ever touched anything. Don't beat yourself up over it thinking it's all your fault.

I did not, but I would be very surprised if there were prior issues. My urologist said he estimated my testicular size to be 8cc and normal is 15cc. They are absolutely smaller than they were before gear, maybe half the size they used to be. My dad never had issues, my uncles never had issues, my brother was a sperm donor and had high levels, etc so I really don't think there were prior concerns but I was suppressed for 8 years
 

Needmassquick

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No man, I told you in the other thread;

HMG is equal parts LH AND FSH.. You need both to stimulate Sperm production, HCG acts as an LH mimic in stimulating intra testicular testosterone production to stimulate sperm production..

Ive been reading studies and forums like crazy the past few months as well.

I don’t think you should lose hope though, I think you should honestly try the HMG route with HCG... That is the protocol I’ve seen work time and time again...

I’ll PM you some things...

I appreciate the response but aren't we saying the same thing? You're saying HMG is LH+FSH.....I am already taking HCG (an LH mimic) and FSH. So I'm not seeing how HMG would be any better?
 

NEMSZ

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I appreciate the response but aren't we saying the same thing? You're saying HMG is LH+FSH.....I am already taking HCG (an LH mimic) and FSH. So I'm not seeing how HMG would be any better?

I have no real study backed reason to believe this but I think the body needs actual LH in the system for then the HCG to do it’s job efficiently with the LH/FSH... I could be totally wrong..

I’m just being positive and see room for another route; every single protocol I’ve seen with success was HCG and HMG... Not HCG and FSH... I would try to add in the HMG at a good dose and keep trying..

And check your PM lol
 

Needmassquick

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I have no real study backed reason to believe this but I think the body needs actual LH in the system for then the HCG to do it’s job efficiently with the LH/FSH... I could be totally wrong..

I’m just being positive and see room for another route; every single protocol I’ve seen with success was HCG and HMG... Not HCG and FSH... I would try to add in the HMG at a good dose and keep trying..

And check your PM lol
https://pubmed.ncbi.nlm.nih.gov/15726772/ check this out

OK thanks will check now
 

Anabolic_Beast

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This is a continuation of this thread https://www.professionalmuscle.com/forums/index.php?threads/still-infertile.168260/

I just got my semen analysis back and after 4 months of HCG and FSH and coming off testosterone I'm azoospermic. I didn't want to delay so I pulled out all the stops early, adding the FSH and taking away the testosterone. My leydig cells seem to be responding very well. After 2 months my total testosterone was 550 and now after 4 months my total is 850. My sertoli cells don't seem to be responding.

I've been taking ~1000iu HCG + 75iu FSH 3x per week. My blood work has been done on a Friday morning, after a Thursday morning dose of these medications. In both tests my LH has been undetectable (makes sense) and my FSH has been 2.7 (range 1.5-12.4). I do not know how high the FSH would be if I tested the day of injection.

Here is the very disheartening aspect:
Me: I know it can take time, I've heard you can get detectable levels before you get testicular size back. Is that your experience?
Doc: I don't think you'll get the size back.
Me: None?
Doc: You can see that in adolescents but generally not in adults
Me: Wait, do you mean I can get normal levels of sperm back and not see testicular size come back?
Doc: No, I don't think you'll get normal levels back
Me: What? Isn't that the point? Then what is the goal?
Doc: Well I'm hoping you can get levels up to a point where you can get IVF done
Me: I'm so confused. I've seen dozens of studies showing a return of normal sperm
Doc: I have too, I've seen them, but I don't think that will happen. Your body seems to be resistant. I've seen people come back just by going off of testosterone or going off and adding clomiphene. You're taking medications to hasten it and we don't see any response.
Me: So, we're just trying to get enough to possibly do IUI?
Doc: No, we can't do IUI. For intra uterine insemination you need at least 10 million.
Me: So we're just trying to get detectable levels for IVF??
Doc: If we see no sperm at all there is a surgery where you go into the testicles and hope to find some viable sperm under a microscope.
Me: Should I up the doses?
Doc: No, you're already taking the recommended amount


This was completely shocking to me. This guy has to be around 70 and I'm hoping he is just wrong. At one point he couldn't think of the name for Sertoli cells and just said "the...uh...sperm producing tissue" but I could be grasping for straws there, he's obviously been doing this for a very long time. I didn't mention that I've also read dozens and dozens of anecdotes on the forums but I of course have. Dr. Thomas O'Connor and Dr. Rand McClain have both said in their videos that they have 100% success rate with JUST HCG, hell McClain doesn't even have his patients come off TRT (O'Connor does).

I know GotGame left the forums but has in depth experience with this, if anyone who still talks to him could pass this along I'd be very grateful. Any insights would be great. My wife is going to be crushed when she hears I'm still at zero.
Don't let this doctor (or any other doctors) out there discourage you and rob you of your hope with their negativity and grim outlook. I don't want to turn into a doctor basher (and will keep my opinion about them to myself) but I avoid them like the plaque nowadays (all of them). Many many bodybuilders have successfully conceived at high doses (or any doses really) of test (with or without hcg+hmg). But if you want to try something...stay on test cruise and just ride out the HCG that you have and get the HMG if you can afford it..otherwise just test and hcg and a lot of time..effort..willpower and more effort in all aspects of the game of conception (and of course..maintaining your gains and feeling great while at the process of it). There's a lot we don't know..but it could be critical that the body needs testosterone (whether natural OR synthetic) in that cocktail mix to get the boys cooking again. I know Dave Palumbo would agree with me and many others. With this kind of stuff...Bro science prevails over doctors for me...all the way.
Bottom line...never give up...ever and just keep changing your dosing/medicine until you fix the issue and have fun at the process. You'll be fine and God willing..it will be easy for you and your wife.
 

Sides

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This is a continuation of this thread https://www.professionalmuscle.com/forums/index.php?threads/still-infertile.168260/

I just got my semen analysis back and after 4 months of HCG and FSH and coming off testosterone I'm azoospermic. I didn't want to delay so I pulled out all the stops early, adding the FSH and taking away the testosterone. My leydig cells seem to be responding very well. After 2 months my total testosterone was 550 and now after 4 months my total is 850. My sertoli cells don't seem to be responding.

I've been taking ~1000iu HCG + 75iu FSH 3x per week. My blood work has been done on a Friday morning, after a Thursday morning dose of these medications. In both tests my LH has been undetectable (makes sense) and my FSH has been 2.7 (range 1.5-12.4). I do not know how high the FSH would be if I tested the day of injection.

Here is the very disheartening aspect:
Me: I know it can take time, I've heard you can get detectable levels before you get testicular size back. Is that your experience?
Doc: I don't think you'll get the size back.
Me: None?
Doc: You can see that in adolescents but generally not in adults
Me: Wait, do you mean I can get normal levels of sperm back and not see testicular size come back?
Doc: No, I don't think you'll get normal levels back
Me: What? Isn't that the point? Then what is the goal?
Doc: Well I'm hoping you can get levels up to a point where you can get IVF done
Me: I'm so confused. I've seen dozens of studies showing a return of normal sperm
Doc: I have too, I've seen them, but I don't think that will happen. Your body seems to be resistant. I've seen people come back just by going off of testosterone or going off and adding clomiphene. You're taking medications to hasten it and we don't see any response.
Me: So, we're just trying to get enough to possibly do IUI?
Doc: No, we can't do IUI. For intra uterine insemination you need at least 10 million.
Me: So we're just trying to get detectable levels for IVF??
Doc: If we see no sperm at all there is a surgery where you go into the testicles and hope to find some viable sperm under a microscope.
Me: Should I up the doses?
Doc: No, you're already taking the recommended amount


This was completely shocking to me. This guy has to be around 70 and I'm hoping he is just wrong. At one point he couldn't think of the name for Sertoli cells and just said "the...uh...sperm producing tissue" but I could be grasping for straws there, he's obviously been doing this for a very long time. I didn't mention that I've also read dozens and dozens of anecdotes on the forums but I of course have. Dr. Thomas O'Connor and Dr. Rand McClain have both said in their videos that they have 100% success rate with JUST HCG, hell McClain doesn't even have his patients come off TRT (O'Connor does).

I know GotGame left the forums but has in depth experience with this, if anyone who still talks to him could pass this along I'd be very grateful. Any insights would be great. My wife is going to be crushed when she hears I'm still at zero.

No offense to septuagenarians everywhere, or old doctors in general, but the problem here is that your doctor is old, stuck in his ways, and an idiot for telling you that after only four months of trying.

Like we discussed before, a sperm cycle is approximately 2.5 months in the body, and it takes time to wake a dormant system up after 8 years of being on test. You are just now seeing the results of what you were doing in the end of April. It is going to take another 2.5 months to see the results of what you are doing right now. It's way, way too early to give up hope yet.

As I've said before, my own fertility journey took eleven months, and contrary to the advice of my fertility doctor, I never went off test. The first 7 months were just Test + HCG, then I added HMG and eventually FSH for the last 4 months, before my wife became pregnant with our baby daughter.

My baby daughter is 19 months old now, big and happy and healthy and smart, and way ahead, at least a year ahead, of the learning curve for her age. She knows her alphabet and numbers already, reads words from books or off my t-shirts, tells you when it's time for her diaper to be changed, and she talks my ears off about Sesame Street and Paw Patrol and Blues Clues. She runs around the house or the playground all day, eats real food, not baby food, and tells me she loves me every night when her mother takes her upstairs to go to bed.

Imagine if I had given up after only four months, or listened to my fertility doctor? He's a morbidly obese tub of guts who refused to prescribe me HMG or FSH because they are "funny drugs", wanted me to get off testosterone, and never thought my protocol would work. When I went back to him with the ultrasound pictures of my infant daughter in her mother's womb, he was flabbergasted and didn't know what to say except to mumble congratulations. The fat clown couldn't admit he was wrong. Fat ignorant fuckwad. And this is a guy who is a well-respected fertility doctor who is revered in the local medical community, who referred me to him.

Don't get me wrong, there are many good doctors out there. But there are also many ignorant, arrogant, overeducated assholes who haven't bothered to keep up with the scientific literature since they graduated from medical school. And very, very few doctors know ANYTHING AT ALL about people like us, our little community of steroid users/abusers.

Rant over, but my point is, your doctor clearly doesn't know shit about people like us. It may be that you have pre-existing fertility issues or that your system is resistant to recovery, but it's way too early to say that yet.

Stay the course with what you are doing, or add test back in if you want to do so. As GotGame and others have stated, if you are using HCG and HMG or FSH, you are bypassing the normal negative feedback to the pituitary, so being on test is not a problem. GotGame recovered his fertility while on TRT, and so did I and many other men.

As stated, HMG is just a mixture of FSH and LH. HCG is a long-acting analogue to LH in the body; it accomplishes the same task, but the half-life of LH in the body is very short (a few hours), so it's an advantage to use HCG so that the Leydig cells are always receiving stimulation to produce high intra-testicular levels of testosterone, important for producing optimal levels of sperm.

The other more important factor is the Sertoli cells, which are stimulated by FSH. You can use either HMG or FSH for this; as far as I can see there's no particular advantage to using one or the other. I wish there was a long-acting version of FSH, but to the best of my knowledge such a thing does not exist. The important thing is that your Sertoli cells are receiving frequent stimulation from FSH, regardless of the source, so frequent small injections are best. The only reason larger less-frequent injections are given in some protocols is for reasons of adherence; most normal people would never stick to a protocol requiring daily or twice-daily injections. But frequent small injections have been shown to work best.

HCG to stimulate the Leydig cells, and FSH or HMG to stimulate the Sertoli cells, and possibly test for libido or to further stimulate the Sertoli cells (adding test is debatable, but it didn't hurt me or GotGame or many others.)

This, time and consistency will give you your best chances of having a child. But it will take time for the results to show up.

Get your prescriptions from your doctor, but ignore his advice, or at least keep it in the proper perspective. Your doctor may be a perfectly fine doctor for normal people, but you and I are not normal people. We are a special population with unique characteristics, so listen to people in our community who have been there themselves and done that. Experience is always the best teacher.

Best wishes and prayers as always, and let me know if I can help out in any way. I've been there and done that, so I certainly don't know everything, but I must know something.

My baby daughter says hi. Someday I hope your own baby will be saying hi back to us.
 

Black Beard

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Try HMG. HMG and HCG are not the same at all.

HMG = LH+FSH = Your natural gonadotropins that makes your balls produce testosterone and sperm

HCG = A gonadotropin in the same family of hormones as LH/FSH however, it comes from pregnant women. It's more akin to LH but much less potent at doing what it does for men.


If your labwork shows bottom range FSH, maybe you could benefit from an increase in dose AND introducing LH in the form of HMG.


Worst case scenario, in vitro fertilization is an option, but some clinicians have been able to enhance HCG/HMG therapy by adding a SERM like clomiphene/nolvadex to the mix. I have seen some guys with nuked testes from decades of AAS abuse have kids with these stacks. There is hope.

Most important, and i'm sure you know this, make sure you are ejaculating into your partner only during the fertility window which is about 5 days before ovulation until ovulation day. That's around day 9-14 of her menstrual cycle, day 1 being when her period starts, give or take.
 

Matsuo Munefusa

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Try HMG. HMG and HCG are not the same at all.

HMG = LH+FSH = Your natural gonadotropins that makes your balls produce testosterone and sperm

HCG = A gonadotropin in the same family of hormones as LH/FSH however, it comes from pregnant women. It's more akin to LH but much less potent at doing what it does for men.


If your labwork shows bottom range FSH, maybe you could benefit from an increase in dose AND introducing LH in the form of HMG.


Worst case scenario, in vitro fertilization is an option, but some clinicians have been able to enhance HCG/HMG therapy by adding a SERM like clomiphene/nolvadex to the mix. I have seen some guys with nuked testes from decades of AAS abuse have kids with these stacks. There is hope.

Most important, and i'm sure you know this, make sure you are ejaculating into your partner only during the fertility window which is about 5 days before ovulation until ovulation day. That's around day 9-14 of her menstrual cycle, day 1 being when her period starts, give or take.
We mentioned clomid last time. He didn’t seem super interested in it because on paper he couldn’t make sense of why it would work. Problem is they don’t really know jack shit about our bodies. We’re all just fucking monkeys.

I have seen clomid pump my balls up and thicken my loads/increase load size and intensify orgasms. Don’t need a study to support that.
 

Black Beard

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We mentioned clomid last time. He didn’t seem super interested in it because on paper he couldn’t make sense of why it would work. Problem is they don’t really know jack shit about our bodies. We’re all just fucking monkeys.

I have seen clomid pump my balls up and thicken my loads/increase load size and intensify orgasms. Don’t need a study to support that.
It tricks your brain into thinking you need more LH/FSH, and some study i read showed that it can increase the efficacy of HCG/HMG (nolvadex in this case).

Here is one paper regarding nolvadex desensitizing pituitary to the hormone that increases LH secretion: https://pubmed.ncbi.nlm.nih.gov/640052/

I first learned about this from a user here @Swifto
 

Kaladryn

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It's not uncommon at all for people to be infertile and unresponsive to therapy, people who do not even use testosterone, ever. Infertility rates in men are double digits on average, and close to half of these people have physical blockages causing the issue.

While I wish you the best of luck and I think you should get a second opinion, there is a good chance your current doctor is correct and knows what he is talking about.

I would NOT go with any of the drug related suggestions here, I would get a second opinion from a good doctor.
 

deadliver

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My wife and I were trying for close to 4 years. I came completely off of everything for two years then tried clomid, then hcg monotherapy, then combo, every thing probably mentioned on this thread.. we were honestly about to give up.
Fertility docs said I was screwed.
What I’m about to say is not medical advice or even a suggestion. But I know that Ben Chow did something similar and had a kid, and I got my advice from the same person he did. Run test as high as I could tolerate it (as close to 2g as possible, I got to 1800mg a week) hcg @1500iu 3x a week and HMG 3x a week on alternate days at 75iu. We were pregnant within 6 weeks.
I don’t really post here ever, but I searched the crap out of this forum and anywhere else I could when we were at our wits end. So if this does help even one person going through what we went through then it’s a win.
Also that is the highest I have ever run gear. Lol. Biggest cycle ever and it had nothing to do with bodybuilding.
 

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