T Nation

Fertility - HCG vs SERMs, KSMan?


Thoughts on HCG vs SERMs for fertility reasons? I've been on TRT (T, HCG, AI) for probably close to 4 years now. I recently had a semen analysis done as we are trying to conceive, and it came back normal. Actually the lady said "above normal", I'm assuming this is in reference to my sperm count.

So, can I assume that my sperm is good, or do I have a bunch of no-good sperm? I seem to remember reading about chlomid/nolva having something that is required for "good" sperm that HCG may not have. Any ideas? Thoughts?

Should I pick up some nolva or chlomid and drop the hcg for a while? My current protocol is 100mg test cyp in divided doses, with 250iu hcg twice a week. I use RC arimidex, 0.2ml/wk (over responder).


LH keeps the testes basically functional. But there is a dependence on FSH receptor activation. There is some small cross activation with hCG. Results will vary and you are doing well with what you have been doing. Your sperm was examined under a microscope where form and function can be judged and things look good. There are aways some malformed or low activity sperm but that does not matter.

The process of the sperm swimming to the egg is an effective [Darwinian] filter. The healthiest, youngest and strongest sperm get there first. Switching to a SERM would do no harm. It might take time for the effect of the increased FSH to lead to better swimmers. I think that you two can get pregnant without the SERM. Go forth and multiply!

Fertilization early in her fertility window can increase odds of having a girl. Later in the window increases odds of having a boy. It is the tortoise and the hare. Y sperm [male] are faster but run out of breath. X [female] are slower but that way they do not run out of energy. Early in the fertility window, the egg is far away in the fallopian tubes. The Y sperm run out of gas sprinting to get there, so there is less getting there.

The X sperm are better at distance swimming and more get to the target. When the egg is closer to the womb, the sprinters get there in better numbers. That is my explanation and many abound on the WWW. Here is one of those: http://www.fertilityfriend.com/Faqs/Gender-Selection-The-Shettles-Method.html


catfish74, have you noticed any changes in your load volume after the HRT and prior to it? Sorry for kind of a personal question but I am on a similar T+AI+hCG protocol and I am just curious as to what I can expect.


What is your findings ?


Been on the protocol for 6 weeks or so. Hcg at 250IU EOD. No change in volume or velocity compared to prior to HRT. Years ago, with good natural levels I had more of both.


Thanks KS, I value your input.

As far as my ejaculate, the volume is about the same, but it is much thicker if that makes sense. The first "shot" or two is about the same, but the following ones don't have as much velocity. Sorry, not really sure how to explain it much better lol. I have used chlomid in the past, and that increased my volume quite a bit.


Haha, it's all good. Thanks for the response, man.


Bringing this back up to the top. We still aren’t pregnant. I did get the results of the test I had done and looked over them myself (she wants to take them with her to her dr appt next month). Volume, count, and motility were all flagged high. I think I’m going to pick up some nolva and add a little in to the mix - say 12mg EOD, just for science. I’ll likely drop my hcg down to 50 or 100iu.


If your sperm Volume, count, and motility were all flagged high, then “you” don’t need to do anything more to hatch that egg. Its been a long time. Is the nolvadex for you or her? Note that you might have a multiple birth if you/she play with some of these things.


Good info in the other thread KSMan, thanks. I was thinking of adding in the nolva for me, but it sounds like I don’t need it. She is due to go back to her doctor in Feb, the first appointment was just “wait and see and try some more”. That was at the one year mark, so we are approaching 1.5 years at this point. We aren’t aware of any issues with her at this point, but that is why she is going back to the doctor.


[quote]catfish74 wrote:
Good info in the other thread KSMan, thanks. I was thinking of adding in the nolva for me, but it sounds like I don’t need it. She is due to go back to her doctor in Feb, the first appointment was just “wait and see and try some more”. That was at the one year mark, so we are approaching 1.5 years at this point. We aren’t aware of any issues with her at this point, but that is why she is going back to the doctor.[/quote]

Good to hear Fish! It certainly doesn’t sound like you need to add any other drugs to the mix. Just more practice.

I went from TRT to HCG mono about a month ago.

Im on HCG mono at this time, for fertility issues as well. I’m on 500IU EOD at this point.

After 2 weeks on HCg mono my t levels were at 447. Which I didn’t think were bad at all considering it had only been 2 weeks. I have bloods again next week and then a semen analysis again in march. Fingers are crossed.


Ned - what were the results of your previous semen analysis?


[quote]catfish74 wrote:
Ned - what were the results of your previous semen analysis? [/quote]


My Entire Clomid experience can be found here.

Long story short Clomid got my sperm count up to 85 mil from ZERO. Morphology and motility were both at the bottom of normal ranges though.


So here’s the latest on this: Since the last post, we have had one successful pregnancy (spring 2016) after our first IUI. Her doc has had her on chlomid each month. She later miscarried around the two-month mark. Three other IUI procedures were unsuccessful. At this point, I’m thinking my boys are of low quality, and we are pretty much out of options without resorting to IVF (cost prohibitive at this point). I’ve had a couple of semen analysis done, and count has always been flagged “high”, volume high, and I think motility/morph were normal. Nothing flagged as “bad” in any case.

At this point, I’m thinking there is something missing from my end with regards to there not being any FSH in the mix. So, I’m dropping my T completely, staying on HCG for a couple of months as sort of a restart procedure and see what happens. After a couple of months if nothing is happening, I’m going to add in some nolva.


Is there a reason to believe that your apparently healthy sperm can not penetrate an egg?

If that is a real concern the method used to find that out is called a “sperm penetration assay”. I believe it involves the death of a female hamster. But do not worry, you do not do the killing. The tests say your sperm is not just good, but above average. I dont see why you would be messing with your meds unless you fail a hamster test.

The male reproductive system is simple and close to fool proof. There are only three things they test for and it amounts to good sperm of not. A woman’s on the other hand is complicated. And can change without the doctors having anything to do with it. Or even being able to explain what changed. I understand what you two are going through with this. It took my wife and I 9 years to have our first kid. The second just happened on his own.


We’re going to go to a fertility specialist in April if nothing has happened by then, we’ve currently just been going to her OBGYN. He didn’t think my TRT would effect anything, considering my semen analysis results. Honestly, I’m just trying this to see if it makes any difference. We’re running out of ideas.


Update for those following along…
Since the last post here, I stopped my TRT protocol and tried a restart using nolva. I had a couple of weeks worth of HCG left, finished that, then did the nolva restart as mentioned here on the board for 4 weeks. It sucked as bad as you can imagine, to be honest. So I’ve essentially been off TRT since January.

Just got labs done, total T was 100 (348-1197). Free T was low (2.3 with a range of 6.8 - 21.5). E2 was pretty low at 9.4, well below ideal. I didn’t bother with FSH/LH for whatever reason.
So, this would explain the loss of strength, shitty libido, and aching joints. I’ve basically been unable to lose much weight either, even with a caloric deficit of 300+ calories/day.
The plan is to start TRT back as soon as possible, as this attempt hasn’t yielded any results in the baby department unless she’s pregnant now and we don’t know it (fingers crossed!). Honestly I think I was fine (if not better) in the sperm department before I tried the restart. All my semen analysis tests were good.


Looking at this: I don’t know how you can sexually function like that and getting pregnant has those demands. I hope that you can get on TRT soon. And I have to point out that both T+hCG and T+SERM are options.

Speaking of weight loss and my focus on thyroid: See what your waking and mid-afternoon oral body temperatures are to see if that might be a component of inability to loose weight. T is a big player of course. Note that you are loosing muscle mass and gaining fat, even if weight is not increasing.


Yeah it’s been rough! I’m ready to get back on my regular protocol for sure. I’ll be back to T+hcg soon - I have everything at home. Luckily, I kept my Rx active during the off time so I am stocked. We are going to discuss further options tonight, but she is fully supportive of me being back on. She has seen me struggle and wants me to be healthy and feel “like myself” again.