Good evening ladies and gents.
I’m gonna jump right in. I’m here for advice on lab-work combined with symptoms, in an effort to figure out the best fertility regimen so that eventually I can go on Dr. prescribed TRT without adding extra obstacles to pregnancy. But first, some background…
I’m 29 years old, living in the northeast US. I’m fairly active, with workouts ranging from 1.0-1.5 hours per day 5-6 days per week. I’m 6’1, 200lbs, with decent body composition (by no means fat, nor jacked for that matter). I watch my diet and consume as little sugar as possible, eat organic when I can, supplement my diet with a multi-vitamin, B-Complex, Vitamin D, Zinc, and powdered vitamin C (1g) and drink enough water for two humans. I do have a history of epidydimitis of the left testicle (the larger one, strangely), and a ‘‘level 1 vericocele’’ which I have deemed insignificant.
I work full time as a police officer in a busy city… I like to think I’m stress free, but when considering chemical stress (cortisol, etc), I’m going through adrenaline dumps multiple times every day. Otherwise, I’m financially stable, happily married, and generally quite pleased with life as it is.
When my problems became recognized:
My wife and I attempted conception for approximately one year without success. At this point, she went through all sorts of fertility testing though a recognized IVF clinic, at the end of which, the doctors told her she’s so fertile she should be the next Virgin Mary (okay, a bit of an exaggeration, but she ain’t the issue). That’s when I realized the math wasn’t adding up, and I was the issue.
A semen analysis of 4.4 million total, in addition to 1.1 million motile, and 0% morphology lead to blood labs. They are as follows;
Total Testosterone: 264 (348-1000)
Free Testosterone: 6.6 (9.3-26.5)
LH: 3.22 mIU/mL (1.8-12.0)
FSH: 7.04 mIU/mL (1.5-12.4)
TSH: 1.210 uIU/mL (0.450-4.500)
E2/Estradiol (sensitive): 38 pg/mL (10-40)
Prolactin: 11.4 ng/mL (4.0-15.2)
Okay so plot twist, these labs were taken at approximately noon, so not optimal for T, but probably not far off, either. I did a follow up with my primary, who conducted a second set of labs approximately two weeks later at the proper time (right at 0800)… Only LabCorp dropped the ball and lost most of my blood, somehow. But I got results for Total Testosterone (350) and PSA (0.36 ng/mL (0.00-4.00)). I also did a follow-up semen analysis two months later, which came back at 26 million total, 13 million motile, still 0% morphology. What I changed: No long johns at work, no heated seats cooking my testes, 3000mg vitamin C per day, 100mg zinc per day. A pretty good boost, still low.
Doc wanted me on Clomid, which isn’t going to happen. Can’t have visual disturbances in my line of work, as rare as they may be. So I did about 50 hours of google research… This forum, a dozen others, medical journals and documents, fertility forums, etc etc…
What I came up with:
Rather than stimulate my pituitary with Clomid to produce LH/FSH naturally, I’ll supplement with HCG and HMG, if necessary.
I riled up a prescription for HCG/Pregnyl, dosed at 1500iu/2 days per week. I’ve taken the liberty of using 500iu/EOD to prevent spikes and lows, over stim of the leydigs, and over aromitization of E2. HMG/rFSH are not covered by insurance, but I have a script…
I have read a ton of articles which contradict each other on whether or not that dose of HCG will shut down the pituitary and thus stop FSH, meaning less sperm. On that note, I have also read FSH is only necessary for initial spermatogenisis, and once started (which mine is, if I have sperm…) is no longer necessary to be maintained by further FSH stimulation. So is FSH really necessary? I don’t know… But it can’t hurt.
I will get labs in one month post HCG treatment (I started yesterday), and if FSH is low or low-normal, I will probably start HMG 75iu EOD, off days of HCG just to be sure FSH is there.
Also considered super low dose Clomid (12.5mg/day) in addition to HCG 500iu/EOD, keeping the pituitary somewhat alive and producing FSH, while getting plenty of LH/LH analog, however the general consensus seems to be that Clomid with HCG is useless.
Some guys have great luck with just HCG alone (TRT), some don’t, so I know it varies from person to person… But does this plan make sense?
Thank you guys in advance and sorry to make your eyes sore with the above essay lol