Change in TRT When Trying to Have Kids?

No I did not request a new semen analysis, because it costs north of $200 and insurance won’t cover it. So, I’m using my FSH result as a “proxy” for my fertility. Clomid made it go up - which tells me that I am definitely secondary.

Your old clomid dose was too much for your testes and you got a lot of T–>E2 inside the testes.
Now you are good.

Transdermal T creates T spikes and fT has a short half life. Part of your fT is from the clomid induced LH. As fT changes so much, you really have no idea what an average fT level might be.

Transdermals create a lot of DHT for you, good for libido.

You can increase T cream using TT as your guide. But DHT might then get too high. And you can try to find a sweet spot with clomid. Or you could do injections or injections with some T cream.

Thank you KSman. Until I am able to convince my doc that I should use injections, I’ll stick with 12.5 mg clomid + T creams (or switch to Nolvadex).

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I’m also going to try L-Citrulline, touted by many as a good ED supplement. Just ordered it and I’ll give it a try and report back.

I wanted to add that since my T levels went up and my E2 is close to mid-range, I’m feeling better. More energetic, my knees and ankles don’t hurt randomly anymore, better concentration and focus, and a more positive attitude. My muscles are even a little more defined and I’ve lost 9 pounds in the past 4 months.

The libido is there. But ED and morning wood is kind of lagging behind, and that’s why I want to give L-Citrulline a shot.

NOW Foods L-Citrulline 750mg, 180 Capsules, 22.20 amazon

KSman.

I have been using 300iu of hcg twice a week with 150mg of test weekly. I don’t think my dosing is right with the hcg me and my wife don’t use protection and she isn’t getting pregnant. Should I change the dose or the schedule? Or use something else?

Get a semen analysis done. That’s the only way to tell if you are making sperm. The issue could be with either of you.

I’ve been on TRT for years. I was on 250iu twice a week with 100mg test/wk, and had great results from two different semen tests. Count, motility, volume were all excellent. However, we only had one pregnancy in three years, and it ended in miscarriage (prior to starting TRT I fathered a healthy son, several years ago with my ex-wife).

There is some (very limited) research that showed that sperm maturation required both FSH and LH.

I’ve since tapered off T, finished out my bottle of hcg, and am in the process of doing a restart with nolva at 20mg/day. I’ll do this for two weeks, then two weeks at 10mg/day. After that I’ll keep my AI going and see how things work.

I would be interesting to here how this restart goes for you and the levels you maintain after it. Mainly- How are you feeling through the whole process from tapering off of the T(how did you taper) How much HCG x and iu per week and then the addition of the Nolvadex. How are you feeling?

Right now, I feel “ok”. My strength has been fine in the gym, no noticeable loss there to speak of. The only thing I’ve really noticed are more mental issues - word searching, forgetting what I was going to say, etc. Nowhere near as bad as it was before I started TRT, but definitely worse than when I was on. My T taper wasn’t much of a taper, I just stopped my twice-weekly injections, and continued on hcg (250iu) until it ran out. I did add a third dose of hcg in each week, I was previously only doing twice a week injections. That lasted about two weeks I think? I then started the nolva, Saturday will be 14 days. I’ll switch to 10mg/day on Sunday. Libido isn’t what it was. I need to get my labs done soon, but I’m going to wait until after this restart.

Can you keep me posted? I’d be interested to see how it turns out. I know I’m secondary cause solo hcg will work and I came off trt for a while and took 1mg a day of Arimidex and that had my t in the 700 and lh and fsh where high. But my mood was crap libido was come and go and I had achy joints all the time. But I got Wifey pregnant. Then went back to the shots and felt hella better. I am still thinking restart but I will have to time it. I’m building a company and I alway speak infront of people

Yeah I’ll keep this updated. So you got her pregnant on hcg monotherapy? What was your protocol? How long did it take for you to get her pregnant?

My thoughts are once I get her pregnant again I’m going back on TRT.

I got my wife pregnant on Arimidex monotherapy. The blocking of the estrogen kick starts the LH AND FSH. It worked but I didn’t feel as good as with t

I see. How long did you do the arimidex mono? I’m an over-responder, so I have to be real careful with my arimidex dosing.

In that case, you may do OK on 1/4th the doses that would otherwise be suggested. If that fails, Aromasin may be a better choice. Always good to have lab work to get dialed in.

Some of the content of the HPTA restart sticky might provide some useful insight.

When transdermal T does not work, we have to consider that there could be some issues with low thyroid function and there is an association of that with low T. Poor transdermal T absorption is a symptom of low thyroid function. By taking transdermal T and clomid together, we can’t sort out some of the implications.

Do not do high doses of hCG or SERMs. Do not combine hCG+SERM or stack SERM’s. You need to avoid over stimulation of the LH receptors in the testes.

Thanks KSMan, I always appreciate your input. You helped me get sorted back when I started TRT several years ago.

I’ve not done anything high dose. I’d be curious to hear from the OP and see how he fared.

Small update:

Finished up the nolva a week or two ago. Libido/desire is in the crapper, as is strength. No ED, just no desire for it. I’m having some fog still, but more-so the word searching is an issue. It drives me crazy. I’m going to try to stick it out for another month or two, and hope that I can “come back” a little bit more. If nothing improves, I’ll start my TRT back and likely alternate hcg with nolva plus my T. Protocol would be twice weekly SQ T injections of 50mg, plus hcg 3x/week at 250iu (or nolva 10MG 3x/week). Liqui-dex as needed.

Recovery cannot overcome causes that persist. Is your thyroid function good. We see so many young guys here with low T and low thyroid function that it is tempting to find an association.

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.

Thanks KS. Thyroid function was good during my last set of labs. I also supplement iodoral (1/2 tab weekly maintenance). I figured that at best I would come back to where I was before starting, which would still be low and at worst I would be worse off. I’m probably worse to be honest. I’m going to give it another month or two (just to ease our minds honestly) and then get back on my normal protocol (detailed above). Honestly, I don’t think my TRT was the reason we haven’t been successful, but I want to eliminate that as a potential cause.