I have a consultation with an informed physician on Monday and fully expect to be prescribed T + anastrazole + HCG (standard protocol).
My only real question / concern: my wife and I have a 1yo child and hope to conceive again very shortly. I know, even with HCG, that this will reduce my fertility (right?). But, if we manage to get pregnant, are there any risks to the baby? Is there a higher incidence of miscarriage with TRT? Plenty of new epigenetic research is coming out and changes to genes have been shown to be passed down to offspring. I imagine TRT would certainly affect gene expression…it just seems like a bad idea. I doubt any of it has actually been studied so I am more worried about the unknown unknowns in the light of above mentioned epigenetic studies. Does anyone have any thoughts / experience with this?
Many guys on T+hCG+AI have made babies. When seriously trying, swapping 250iu hCG EOD for 20mg Nolvadex EOD or 25mg Clomid EOD will improve things with LH+FSH. Some feel horrible on Clomid, others just fine. Nolvadex does not to that. Clomid is a doctor favored drug, but nolvadex work the same way, docs can be brain dead.
Labs should have been LH and FSH because LH is pulsatile with a short half-life and lab values have a poor signal to noise ratio. In many cases, FSH provides a better LH status than LH itself. If FSH is oddly high, that can be from a FSH secreting testicular cancer. On TRT, LH and FSH should -->zero. If FSH does not, a one time on-TRT FSH lab can detect or rule out such a cancer. Testicular cancers are not rare.
You need to test prolactin to see if elevated which can be from a prolactin secreting pituitary adinoma that leads to low-T. This is not rare.
In a case like this, a diagnostic effort is required to look for causes. Low-T is the symptom, not the disease.
You can be carrying a lot of fat from low-T and/or low thyroid function. Please eval that via last paragraph in this post.
Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.
“Have you heard anything or read anything about epigenetics and the potential for TRT to negatively affect offspring?”
I understand epigenetics. Injected T yields bio-identical T when the ester groups are removed. The concern is all about the sperm. In normal testes, intratesticular T can be up to 80 times higher than serum T levels. So T itself is part of the landscape. In terms of fertility, you need hCG to preserve testes and fertility and a number of guys here have made babies with T+hCG. That does create very low FSH levels and sperm counts can be lower but functional. T+SERM can lead to good levels of LH and FSH which is optima for sperm production.
Frequent sex helps turn over sperm to have fresher swimmers. If E2 is optimal, libido and performance will be near your optimal. If E2 is high or really low, you may not be interested in sex.
T is a natural human hormone, same from a factory.