Desensitized Leydig Cells

The quick story is that 2 years ago I started treating my low-normal T levels (upper 300s) with HCG monotherapy.

The doc wanted me to put me on 1500iu 3x/wk. Having read this forum, I instead only injected 250iu 3x/wk. Unfortunately this only brought my levels to the mid 400s. I slowly worked my way up to the full 1500iu which brought my levels into the 800s.

After ~12 months my levels slowly crept down until they were in the 400s again. At this point, I moved which means I had to find a new doctor. The new doc told me to stop everything and this is how my levels came back:

TESTOSTERONE, ULTRASENSITIVE, LC MS/MS 250 - 1100 ng/dL 72
Testosterone free 35.0 - 155.0 pg/mL 13.0
LH 1.0 - 12.0 mIU/mL 2.1

My LH before starting treatment was about this level as well and I was producing considerably more T, so it seems my leydig cells are desensitized.

I was thinking doing T without HCG would allow some time for my leydig cells to become sensitized again. The doc seemed vehemently against going on T though, so clomid may be my only option with him.

Thoughts on the next steps I should take?

no, you just need to see how this plays out, but right now, you have secondary hypogonadism, LH=1.0, and the LH receptor issue. So you need to win both battles to win this war

does see how it plays out mean don’t do anything or start the clomid and see how LH/T respond?

start the clomid and see how LH/T respond