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Really Disheartening Fertility News From Doctor

Flex500

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Any gyno at that level of HCG per week? Not using Clomid at all?

No issue but I never really have. I'll have to look at my bloodwork and see what my e2 levels were I don't remember but it must not have been too insane if I can't remember.
 

Needmassquick

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No issue but I never really have. I'll have to look at my bloodwork and see what my e2 levels were I don't remember but it must not have been too insane if I can't remember.
How were you taking the 5000iu of HCG and 150 HMG per week?
 

Needmassquick

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The one doctor is willing to prescribe me clomid but said he "would prefer to add enclomiphene - one of the two isomers of Clomid, and the one that appears to have fewer if any side effects. I recommend starting with 12.5mg, but we can start with 25mg if preferred - I just want to avoid OVER suppressing estrogen reception."

any thoughts on that? I've read about enclomiphene is a few studies but don't know much about it, usually it's just briefly mentioned
 

Needmassquick

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Search enclomiphene and GG’s posts. I think he had good things to say.
Will do.

I've now read 4 studies on Enclomiphene and they all have positive things to say about it but here https://pubmed.ncbi.nlm.nih.gov/25044085/ they note

"It also deserves noting that most men (9 of 12) who were oligospermic at the time of drug initiation, remain so regardless of treatment. This last observation gives no comfort to those men with low sperm counts who wish to regain fertility with enclomiphene, at least within the 3-month duration of this study."

Despite seeing significant increases in LH and FSH they saw no improvements in sperm count after 3 months compared to placebo.

This one https://pubmed.ncbi.nlm.nih.gov/23530575/ did show an increase but only relative to taking testosterone. There was no placebo so of course clomid/enclomiphene will show better sperm counts than taking testosterone.

It is interesting that almost all of the studies on clomid/enclomiphene show increases in LH/FSH yet only some show increases in sperm, and very few show increases in actual pregnancy.
 

Needmassquick

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Search enclomiphene and GG’s posts. I think he had good things to say.
Thanks for the suggestion. He didn't have many posts on it but here is what he had to say on the topic:

I have not met anyone who restored there LH and FSH levels taking clomid while on TRT. My sample size is probably about 20-ish. I personally do not think it will overcome TRT injections. I have seen clomid overcome the negative feedback from HCG even when HCG has put the test into normal range.

your options on TRT are pretty simple.

If starting TRT and want to preserve you take HCG.

If on TRT and dont want to come off you can start taking HCG and wait a few months ( maybe 4-5) and see if you are responding with an SA. I think something like 50% of guys will respond from HCG alone. If you havent responded then add in FSH. that could take 6 or more months. Once production comes back online you can likely maintain for a bit on hcg alone.

Dont mess with SERMs. In my opinion its not gonna work.

If you do decided to come off TRT id look into enclomiphene.


I will be checking my serum FSH levels in two weeks after taking a 75iu shot of menopur. I want to see how that registers 24 hours post. I basically wanna see if i need a full 75iu ( or maybe more) to get into the mid range or if i can get by with less like 37.5 iu
 

Matsuo Munefusa

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Hmmm damn try checking swifto posts maybe. Somebody wrote about it that I remembered respecting.

Have you done google:
“site: professionalmuscle.com enclomiphene”
 

Alistair*

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@Sides You mentioned splitting your HMG dose in half and taking it everyday rather than EOD, I’d like to do this but my HMG pamphlet reads to inject immediately after it is reconstituted. Did you you do any type of blood work to see if the second dose 24 hours later was still good? I’ve read HCG is good for 60 days in the fridge after recon.
 

Alistair*

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Guys, these threads gives guys like me hope that all is not lost. I’d like to test my LH and FSH post HMG injection. Did I read correctly that you want to do the blood test 24 hours post injection?
 

NEMSZ

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@Sides You mentioned splitting your HMG dose in half and taking it everyday rather than EOD, I’d like to do this but my HMG pamphlet reads to inject immediately after it is reconstituted. Did you you do any type of blood work to see if the second dose 24 hours later was still good? I’ve read HCG is good for 60 days in the fridge after recon.

HMG doesn’t last very long in the blood, I think it peaks about 3-5 hours later and then it’s a steep drop off after that..

I have 150iu vials of HMG and do 75iu and store the rest in the fridge, and yes I’ve done blood work on that 2nd dose, precisely because I read the same thing you did on the pamphlet, and my FSH was at 2.0 25 hours later.. So on the low end of normal but still in range, which was to be expected honestly...
 

Alistair*

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@NEMSZ good feedback. I too have 150 iu HMG and have been doing it all in one shot EOD and HCG on the off days. I’m ready to get very aggressive with my treatment and plan to add 75 iu of FSH on the opposite days of the 150 HMG and splitting my doses of HCG and pinning it everyday with the HMG or FSH.

Since HMG does last a bit in the fridge, I think I’ll try splitting the 150 into two shots, 12 hours apart. That’s a lot of shots but I’m willing to do what’s necessary to get the job done.

How long post injection should I wait to have blood work done for FSH and LH? 24 hours?
 

Alistair*

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HMG doesn’t last very long in the blood, I think it peaks about 3-5 hours later and then it’s a steep drop off after that..

I have 150iu vials of HMG and do 75iu and store the rest in the fridge, and yes I’ve done blood work on that 2nd dose, precisely because I read the same thing you did on the pamphlet, and my FSH was at 2.0 25 hours later.. So on the low end of normal but still in range, which was to be expected honestly...
To back up what you said about your blood work of the second dose of HMH, I found by searching a company that makes a multi dose vial of HMG and it’s good for 28 days after mixing (up to 28 days at room temperature (not more than 25°C).). But I would still put it in the fridge.

So you take 75 iu of HMG everyday or EOD? I’m currently alternating the whole 150 iu dose EOD with splitting into 75iu and dosing twice a day about 10 hour apart, EOD. Reason I’m alternating is because the 2 sticks EOD adds up to a lot of pinning considering I’m pinning 60mg of test prop EOD as well. My glutes are nothing but a pin cushion.
 

NEMSZ

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To back up what you said about your blood work of the second dose of HMH, I found by searching a company that makes a multi dose vial of HMG and it’s good for 28 days after mixing (up to 28 days at room temperature (not more than 25°C).). But I would still put it in the fridge.

So you take 75 iu of HMG everyday or EOD? I’m currently alternating the whole 150 iu dose EOD with splitting into 75iu and dosing twice a day about 10 hour apart, EOD. Reason I’m alternating is because the 2 sticks EOD adds up to a lot of pinning considering I’m pinning 60mg of test prop EOD as well. My glutes are nothing but a pin cushion.

Yea these things aren’t as delicate as people make them out to be... I do put mine in the fridge though as well..

I do 75iu EOD, if I could afford it I’d do it ED but let’s see what this protocol does on its own, I’ve seen people regain fertility on much less aggressive protocols lol
 

Needmassquick

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I've been on enclomiphene 25mg ED for just over a week now. Bumped up the FSH to 150iu 3x per week a couple of weeks ago. Other than a slightly higher libido I can't say I've noticed much. Praying for a positive change.
 

Pissbrain259

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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.

The is anchoring with complete BULLSHIT.
 

Alistair*

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Researching I found this and never heard it before: for the fertility challenged male, DO NOT use LUBE during sex. Most sex lubes and even saliva causes up to a 50% reduction in sperm motility. For guys with no fertility issues, lube didn’t make much difference in pregnancy rates but for guys on the lower end of sperm, using lube is a bad idea.
 

Alistair*

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I also had no idea CoQ10 was good for sperm. I have now added 200mg a day to my regimen.
 

Flex500

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Researching I found this and never heard it before: for the fertility challenged male, DO NOT use LUBE during sex. Most sex lubes and even saliva causes up to a 50% reduction in sperm motility. For guys with no fertility issues, lube didn’t make much difference in pregnancy rates but for guys on the lower end of sperm, using lube is a bad idea.

Yes for sure no regular lube! That said, they actually make lube specifically for conceiving that is supposed to help motility. At worst, it appears to be neutral. At best, it appears to actually help. Quite expensive though! It can be a good help if you are not having strong erections being off testosterone and "go time" means "go time"...like ASAP when that erection hits lol. The one we have is called "pre-seed".
 

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