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Still Infertile

Flex500

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What is your dose of TRT? I know many will argue TRT is just as healthy as fully natural but I think the data is still ambigous there.

I was surprised to find that going from 100-150mg TRT down to just HCG/HMG did not seem to benefit my lipids. 2mg of arimidex per week did drop my HDL but surprisingly it's no better now natural compared to 100-150mg TRT + 1mg arimidex. LDL and Trigs are about the same as well.

Pretty low...I'm prescribed like 160 (or maybe it's 180 I don't even remember) but I usually stick to 120mgs a week or even down to 100. Interestingly my test levels right now on the HCG are like 900 (that's obviously artificially boosting my bodies production) and on my 100mgs of trt I'm at like 700-900. My estrogen is quite high right now though but I feel like a million bucks.

It's probably right that if test levels are similar there is no health benefits from being on or off trt vs hcg I just think I'm accustomed to doing this so I do. My crit levels also stay a bit lower on the hcg vs trt. This year it is for the distinct purpose of getting my wife pregnant :)
 

Needmassquick

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Pretty low...I'm prescribed like 160 (or maybe it's 180 I don't even remember) but I usually stick to 120mgs a week or even down to 100. Interestingly my test levels right now on the HCG are like 900 (that's obviously artificially boosting my bodies production) and on my 100mgs of trt I'm at like 700-900. My estrogen is quite high right now though but I feel like a million bucks.

It's probably right that if test levels are similar there is no health benefits from being on or off trt vs hcg I just think I'm accustomed to doing this so I do. My crit levels also stay a bit lower on the hcg vs trt. This year it is for the distinct purpose of getting my wife pregnant :)

Interesting about the hematocrit being lower on HCG. Alternatively, it seems you and I are both experiencing relatively higher estrogen for a given testosterone level with HCG vs TRT. For example, at 500ng/dl on TRT and no AI my E2 is probably around 20-25 but on this HCG it's 35. Still fine, not a level I would take an AI but I can feel the increased sensitivity to my nipples which is annoying and probably a little more water weight.
 

Needmassquick

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No updates yet, but for anyone seeing this can someone explain how an AI or clomid is supposed to help if you're already taking LH/FSH or HCG/HMG? Dave Palumbo and others here recommend adding clomid but how can this help? My doctor suggested it wouldn't and mechanistically I'm not seeing how either an AI or clomid could help. It could help with pituitary function but isn't that going to be fully shut down by exogenous LH/FSH anyway?

I am considering taking low dose AI again just to help with estrogen control, as long as it won't hurt anything
 

Alistair*

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I can just tell you that an AI will not hurt anything as long as you are keeping estrogen in a good range of not too high or too low. I myself have to take a hefty dose of letrozol to help with the huge amount of estrogen from HCG use.

Letrozol was shown in studies to increase FSH in low testosterone men who were not taking TRT. So it may help things if you are completely off of TRT. I’m still on TRT so I don’t believe it’s of any benefit to me for more FSH.
 

NEMSZ

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No updates yet, but for anyone seeing this can someone explain how an AI or clomid is supposed to help if you're already taking LH/FSH or HCG/HMG? Dave Palumbo and others here recommend adding clomid but how can this help? My doctor suggested it wouldn't and mechanistically I'm not seeing how either an AI or clomid could help. It could help with pituitary function but isn't that going to be fully shut down by exogenous LH/FSH anyway?

I am considering taking low dose AI again just to help with estrogen control, as long as it won't hurt anything

I don’t fully understand it either, why they would recommend clomid on top of HCG/HMG.. I think it’s typical bodybuilder mentality of throw the kitchen sink at it “just in case” lol..

To my understanding, and I’ve done as much research as I can, asked people with similar situations who’ve been successful and my own doctor;

HMG has FSH and LH in it, so ultimately it bypasses the pituitary’s need to produce these hormones.. What does Clomid do? It stimulates the pituitary to make these hormones... But didn’t we just bypass that? Exactly... lol

Now from what I researched, HMG has a better direct effect on FSH on blood work, and I recently did my own blood work (yesterday actually) and I did a shot of 75iu HMG on Monday and yesterday did bloods at about 24 hours post injection and my FSH levels were in range but on the lower end, but my LH levels were bottomed out...

From what I’ve researched, FSH peaks at a later time and for slightly longer than the LH when using HMG So some people just check for FSH levels.. For example I read that the LH peaks within like an hour but FSH can be detected at peak levels within the hour to about 8 hours and then drops off..

Also, HCG stimulates and mimics LH (from what I understand) more directly, so it works better with that combination... I didn’t inject any HCG for this blood work, but I’ll be doing bloodwork again in about 2 weeks with HCG and HMG injected before so I can see where both levels are, perhaps doing it 12 hours after injection to get closer to peak levels... I’m starting to think these medications would work a lot better with daily injections instead of EOD as many protocols suggest...

Also, if estrogen is an issue, I don’t think taking an AI will be an issue or interfere with anything.... But again, I think that comes with the fact most people do 1500-2000iu+ injections a couple times a week when maybe 500iu ED can work just fine and get levels where they need to be, causing a smaller peak and trough so reducing side effects more and getting better positive effects...

I mean, if it works with Testosterone then why not with these Meds??
 

Reload

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Was in my mid 30's and had been more or less on a perpetual cycle since I was 18 when my wife and I started trying to conceive.
Same issue your going through, azoospermia. I tried just about everything for 2+ years but could never get my #'s high enough to get pregnant.
Finally went and talked with a fertility clinic. About a year later my wife and I became parents to a healthy baby girl through invetro plus ICSI. ICSI was the ONLY way we were going to get pregnant
The clinic froze/stored the other viable embryos from the procedure. 4 years later we inserted the two remaining embryos and had another girl.
Just know that there are options. Hopefully you won't have to resort to this level of assistance but the technology is available.
 

Needmassquick

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I can just tell you that an AI will not hurt anything as long as you are keeping estrogen in a good range of not too high or too low. I myself have to take a hefty dose of letrozol to help with the huge amount of estrogen from HCG use.

Letrozol was shown in studies to increase FSH in low testosterone men who were not taking TRT. So it may help things if you are completely off of TRT. I’m still on TRT so I don’t believe it’s of any benefit to me for more FSH.

My understanding is that estrogen is pretty suppressive of pituitary output so if that's the case it makes sense that an AI would help in that case. I'm sure you're correct that since you're on TRT it won't have that benefit. I would guess that since I'm on exogenous HCG and FSH it similarly would not help pituitary output but maybe it would help slightly. I can't see how it would hurt and it would be nice to be a little less bloated.

I don’t fully understand it either, why they would recommend clomid on top of HCG/HMG.. I think it’s typical bodybuilder mentality of throw the kitchen sink at it “just in case” lol..

To my understanding, and I’ve done as much research as I can, asked people with similar situations who’ve been successful and my own doctor;

HMG has FSH and LH in it, so ultimately it bypasses the pituitary’s need to produce these hormones.. What does Clomid do? It stimulates the pituitary to make these hormones... But didn’t we just bypass that? Exactly... lol

Now from what I researched, HMG has a better direct effect on FSH on blood work, and I recently did my own blood work (yesterday actually) and I did a shot of 75iu HMG on Monday and yesterday did bloods at about 24 hours post injection and my FSH levels were in range but on the lower end, but my LH levels were bottomed out...

From what I’ve researched, FSH peaks at a later time and for slightly longer than the LH when using HMG So some people just check for FSH levels.. For example I read that the LH peaks within like an hour but FSH can be detected at peak levels within the hour to about 8 hours and then drops off..

Also, HCG stimulates and mimics LH (from what I understand) more directly, so it works better with that combination... I didn’t inject any HCG for this blood work, but I’ll be doing bloodwork again in about 2 weeks with HCG and HMG injected before so I can see where both levels are, perhaps doing it 12 hours after injection to get closer to peak levels... I’m starting to think these medications would work a lot better with daily injections instead of EOD as many protocols suggest...

Also, if estrogen is an issue, I don’t think taking an AI will be an issue or interfere with anything.... But again, I think that comes with the fact most people do 1500-2000iu+ injections a couple times a week when maybe 500iu ED can work just fine and get levels where they need to be, causing a smaller peak and trough so reducing side effects more and getting better positive effects...

I mean, if it works with Testosterone then why not with these Meds??

Great post, thank you. Last time I got blood work it too was about 25hr after my injection. LH was not detectable, but my understanding is HCG is not picked up as LH on blood work nor does it stimulate LH (if you've seen something contradictory to that please let me know or post it, I thought it was just an LH mimetic) whereas I'm taking FSH directly and that was on the low end of normal at the 25hr mark.

I was considering taking the HCG/FSH 1-2hr before my blood work this time, just to see what FSH levels get to at their peak.
 

Needmassquick

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Was in my mid 30's and had been more or less on a perpetual cycle since I was 18 when my wife and I started trying to conceive.
Same issue your going through, azoospermia. I tried just about everything for 2+ years but could never get my #'s high enough to get pregnant.
Finally went and talked with a fertility clinic. About a year later my wife and I became parents to a healthy baby girl through invetro plus ICSI. ICSI was the ONLY way we were going to get pregnant
The clinic froze/stored the other viable embryos from the procedure. 4 years later we inserted the two remaining embryos and had another girl.
Just know that there are options. Hopefully you won't have to resort to this level of assistance but the technology is available.

Oh man :( I wasn't on that long but I was shut down from about 22-29. I know you said everything but could you write out here what specifically you tried? I'm hoping the fact that my testosterone is now normal on HCG/FSH means I am responding and can respond soon with sperm production as well. Did your testosterone come back to normal and no sperm, or neither came back?

How much did all of that cost?

Glad you eventually got your two baby girls though, congrats
 

NEMSZ

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My understanding is that estrogen is pretty suppressive of pituitary output so if that's the case it makes sense that an AI would help in that case. I'm sure you're correct that since you're on TRT it won't have that benefit. I would guess that since I'm on exogenous HCG and FSH it similarly would not help pituitary output but maybe it would help slightly. I can't see how it would hurt and it would be nice to be a little less bloated.



Great post, thank you. Last time I got blood work it too was about 25hr after my injection. LH was not detectable, but my understanding is HCG is not picked up as LH on blood work nor does it stimulate LH (if you've seen something contradictory to that please let me know or post it, I thought it was just an LH mimetic) whereas I'm taking FSH directly and that was on the low end of normal at the 25hr mark.

I was considering taking the HCG/FSH 1-2hr before my blood work this time, just to see what FSH levels get to at their peak.

Just Google “HCG stimulating LH in men” and things like that and you’ll see various studies and articles...

From what I gather though, it’s that LH is only in the body for very short periods of time.. Some show the half life of LH to be only a few minutes..

But a lot of the articles state that HCG mimics LH as far as productions of sperm goes, so I’m not sure that because it mimics LH it doesn’t come up as LH in blood test but is in fact doing the job of LH in the body...
 

Reload

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Oh man :( I wasn't on that long but I was shut down from about 22-29. I know you said everything but could you write out here what specifically you tried? I'm hoping the fact that my testosterone is now normal on HCG/FSH means I am responding and can respond soon with sperm production as well. Did your testosterone come back to normal and no sperm, or neither came back?

How much did all of that cost?

Glad you eventually got your two baby girls though, congrats
HCG/FSH/Clomid...all straight from an Endo Doc that specialized in male fertility. Tried acupuncture, stopped drinking alcohol, NoFap. Increased cardio, etc. Essentially was the healthiest version of me I could be. That was 17-18 years ago and unfortunately don't have any of the Dr. prescribed protocols that they had me try. They didn't work in that 2 years anyway. No idea how permanent all those years of AAS use shut down my HPTA? I've been on various cycles over the past 3-4 years settling on the KISS principle of 10-20mg/day of testosterone (no specific ester) which keeps my total in the 780-1000 range which I'm very happy with. No prostate issues. BP is a healthy range with Telmisartan. Best of all this small dose allows me to retain a fair % of the mass & strength I'd built up over the years.
Something I've always questioned was what my natural sperm count was prior to using AAS? I'd had many girlfriends, didn't practice safe sex (at all) and never had a close call with any of them so?
I eventually did have a few swimmers for the fertility clinic to micro pipet out from of my sample to individually fertilize around 5 of my wife's eggs to create embryos. My first daughter was a blessing, the second a miracle in that she was literally frozen for 4 years. We often joke with people telling them that my daughters were conceived at the same time yet are 4 years apart in age. How is that possible?
 

Needmassquick

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Just Google “HCG stimulating LH in men” and things like that and you’ll see various studies and articles...

From what I gather though, it’s that LH is only in the body for very short periods of time.. Some show the half life of LH to be only a few minutes..

But a lot of the articles state that HCG mimics LH as far as productions of sperm goes, so I’m not sure that because it mimics LH it doesn’t come up as LH in blood test but is in fact doing the job of LH in the body...

Right, I wasn't too concerned about the LH being non-detectable since HCG should be doing it's job. I think I'll still try injecting 1-2 hours prior to the blood work next time though and will report back here.

I spoke with my urologist who has me on these meds and he said there's no issue with 0.5mg anastrazole 2x per week so I might go back on that depending on how high my estradiol comes back next test.
 

Needmassquick

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HCG/FSH/Clomid...all straight from an Endo Doc that specialized in male fertility. Tried acupuncture, stopped drinking alcohol, NoFap. Increased cardio, etc. Essentially was the healthiest version of me I could be. That was 17-18 years ago and unfortunately don't have any of the Dr. prescribed protocols that they had me try. They didn't work in that 2 years anyway. No idea how permanent all those years of AAS use shut down my HPTA? I've been on various cycles over the past 3-4 years settling on the KISS principle of 10-20mg/day of testosterone (no specific ester) which keeps my total in the 780-1000 range which I'm very happy with. No prostate issues. BP is a healthy range with Telmisartan. Best of all this small dose allows me to retain a fair % of the mass & strength I'd built up over the years.
Something I've always questioned was what my natural sperm count was prior to using AAS? I'd had many girlfriends, didn't practice safe sex (at all) and never had a close call with any of them so?
I eventually did have a few swimmers for the fertility clinic to micro pipet out from of my sample to individually fertilize around 5 of my wife's eggs to create embryos. My first daughter was a blessing, the second a miracle in that she was literally frozen for 4 years. We often joke with people telling them that my daughters were conceived at the same time yet are 4 years apart in age. How is that possible?

Hah that's a great story about your daughters. I didn't realize these exact same protocols have been around for 2 decades, I guess it's hard to improve on what should be replacing exactly what we need.

I definitely didn't always practice safe sex when I was on suppressed and never had any issues either, but I knew I was azoospermic at the time. Prior to that I was always having safe sex. I'm guessing you've never asked your father or brothers (if you have them) if they've had issues? My brother was told he had a very high sperm count and my dad and his brothers had no issue so I don't think there's any inherent issue other than my self induced shutdown.
 

Reload

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No brothers, just a sister with ZERO fertility issues.
My mom loves to mention that I was the result of her very first time having intercourse so it would seem
it's not a genetic thing. Always felt kinda bad for my dad though. lol
 

beast405

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Was in my mid 30's and had been more or less on a perpetual cycle since I was 18 when my wife and I started trying to conceive.
Same issue your going through, azoospermia. I tried just about everything for 2+ years but could never get my #'s high enough to get pregnant.
Finally went and talked with a fertility clinic. About a year later my wife and I became parents to a healthy baby girl through invetro plus ICSI. ICSI was the ONLY way we were going to get pregnant
The clinic froze/stored the other viable embryos from the procedure. 4 years later we inserted the two remaining embryos and had another girl.
Just know that there are options. Hopefully you won't have to resort to this level of assistance but the technology is available.
I had to go the ivf with Icsi route also brother. My lady is pregnant with our baby girl as we speak
 

beast405

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Was in my mid 30's and had been more or less on a perpetual cycle since I was 18 when my wife and I started trying to conceive.
Same issue your going through, azoospermia. I tried just about everything for 2+ years but could never get my #'s high enough to get pregnant.
Finally went and talked with a fertility clinic. About a year later my wife and I became parents to a healthy baby girl through invetro plus ICSI. ICSI was the ONLY way we were going to get pregnant
The clinic froze/stored the other viable embryos from the procedure. 4 years later we inserted the two remaining embryos and had another girl.
Just know that there are options. Hopefully you won't have to resort to this level of assistance but the technology is available.
After 10 years of gear on and off. I got my sperm count up from 2million to about 30million on Hcg and hmg but my main problem was my sperm morphology was very rough. And would have made it almost impossible to get pregnant naturally.
 

Needmassquick

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After 10 years of gear on and off. I got my sperm count up from 2million to about 30million on Hcg and hmg but my main problem was my sperm morphology was very rough. And would have made it almost impossible to get pregnant naturally.

How long did it take you to get from 2 million to 30 million? Could you elaborate on what you mean by saying your morphology was "rough"?
 

beast405

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How long did it take you to get from 2 million to 30 million? Could you elaborate on what you mean by saying your morphology was "rough"?
It took me about 4 months if I remember correctly. And by my sperm morphology being rough I meant that my morphology was like 1% and they like it to be between 4%-14%
 

Needmassquick

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My wife told me yesterday her period seemed to be coming 5 days early and I got excited as I've read light bleeding 5-7 days before a period could be a sign of implantation, but alas she said it's happened to her more recently and is in fact just her period :( lol

I'm getting another analysis and blood work next Friday. My balls still do not seem any bigger which really surprises me. When I started I thought they'd double in size within weeks. I have a worrisome feeling I'm going to get the same result with this analysis.

Also, oddly my strength, size, and libido have all been completely fine. Wanting sex just about every day, wake up with hard erections, all of that. But I'm tired as hell. I sleep 8 hours then wanted to nap in the middle of my work day every day this week. Just slept 8.5 hours and want to go back to sleep.
 

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