T Nation

24 Y/O on TRT - Concerned with Future Fertility

HI All!

I am 24 years old and have been on 180mg of testosterone cyp for a little over a year now. I got prescribed because I had extremely low testosterone levels and high cortisol levels:

Testosterone: 249 (300-800)
Free Test: 9 (9.8-26.5)
Cortisol 32 (2-16)

My protocol goes as followed:

180mg of testosterone cyp 1 time a week
.25mg arimidex 2 times a week
I cycle 6 weeks on 6 weeks off of HCG (was previously doing 250 iu 2x a week) now I am doing 250IU 4x a week

I am concerned about being fertile in the future and want to maximize my chances of having kids. So ultimately my question is: Should I come off a few times a year? Is 1 month enough to help restart my sperm production (I am not concerned about restarting testosterone production as I will be on for life).

I was thinking I would take 2 weeks of high dosed HCG (2000 IU per week) then 3 weeks of Clomid. Do you think this is a reasonable protocol. I have read the stickies and wanted everyones opinion.

I really appreciate the support and cant wait to hear your answers

Additionally, I wanted to ask if not incorporating a SERM and just taking HCG with some arimidex to control estrogen would be sufficient in regards to helping maintain fertility.

The standard protocol here is:

  • 100mg T cypionate or ethanate per week in divided doses of twice a week or more
  • 1mg/week anastrozole in divided doses
  • 250iu hCG SC EOD

Do not use high doses of hCG. That can desensitize the LH receptors
You do not cycle on-off hCG, no need.
Cycling on-off TRT will be very difficult to live with, we never see this done.

Fertility: hCG can lead to lower sperm counts, because of the absence of FSH. Injectable forms of FSH are hard to come by and $$$.
SERM’s will allow you to produce your own LH and FSH. You can use hCG and now and then switch to SERM for a while then back.
Do not ever do hCG+SERM as you can desensitize the LH receptors and can also create high E2 levels.
Too much SERM can desensitize the LH receptors and can also create high E2 levels, LH levels too high.

I think that you now have 5 threads and your case is scattered. So I will not go into more depth as info is not at hand here.

More to consider:

This is standard advice maintained here:

There is a huge amount of knowledge in the stickies. Please study these. Start with the advice for new guys sticky.

There is a lot to read there, so read carefully. There are suggestions for things that are root causes of low testosterone [T]. Low T is a symptom, not a root cause itself. But low T itself is a root cause of many of the symptoms one experiences. Note that other things cause the same spectrum of symptoms, so do not have T tunnel vision. Many docs are guilty of that and they only treat the symptom [low T] and do not attempt to find the real problem. If you go to a clinic that specializes in low T, you will get T tunnel vision for sure.

Post info about yourself as suggested in the above sticky. We need labs, almost all of your labs, not just hormones. We also need the lab ranges.

We see a very high number of thyroid issues in the population of guys that show up here. So there is a strong focus on that. Most people are iodine deficient to some degree. Your history of iodine intake from iodized salt and vitamins that list iodine is important. If you become iodine deficient, the RDA [recommended daily allowance] is inadequate for recovery of iodine stores. Please see the thyroid basics sticky for more information.

You do not want to suffer from subclinical hypothyroidism or get Rx thyroid meds to treat iodine deficiency.

If you are injecting T or contemplating that, read the protocol for injections sticky.

There are stickies for finding a TRT doc, estradiol [E2] and lab work.

Do not place your history or treatment details in the stickies! That belongs in your thread. Keep all of your posts in your thread so we can have a clear picture of your situation and needs.