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Low Sperm Count on TRT While Trying to Get Pregnant. Best Option?

Hey guys. I’ve already gotten some feedback which is great but trying to weigh my options on treatment approach to get count back up on fertility. So looking for people’s experiences in this department. I’m finally getting improvement on T injections without the hcg. I do not want to take hcg as days after taking it I’d have loss of libido, less sensation in genitals, and Ed. My estrogen would be considered above normal at 54 as of two weeks ago. My sperm count however has gone from 250 million last month to just 16 million. My wife wants me off everything but I’m finally feeling remotely normal. I’ve had clomid suggested instead of injections. Anyone have feedback on enclomephine, or adding fsh or hmg to normal t injection ?

FSH would almost certainly get your sperm count back up, if you can afford it (or even better… if you can get insurance to pay for it). It was something like $150/week last time I looked at it, thus the reason most use HCG instead

Have you stayed on HCG long enough to get through the usual 6-8 week adjustment period? I have had the same issues every time I try it but I’ve never stayed on it long enough to see what happens longer term. How much were you on?

I’m about to have to tough it out though

I was on it six weeks. I don’t know if it spikes my estrogen or does something negative to me in other aspects as I have pssd from antidepressant usage so it may aggravate those symptoms but it does something negative. Every time I take it within a day or so it happens and takes week if not taking it to get better. Is the fsh just called fsh? I can’t find a lot on it. Is it known to help with fertility and testicles size? I read the one article I found that said it had to be used with hcg for fertility?

I’m to the point I’d almost rather stop trt all together for 3-4 weeks and see if count rebounds rather than hcg

This is the one I am familiar with. I think it’s sold under other names, HMG maybe? I haven’t done a ton of research on it other than to see how expensive it is

It won’t rebound in that amount of time, more like two months if you are simply not taking anything.

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Ok thanks good to know. Then maybe I need to be off it all together for several months then if I cant find anything to raise my count back besides hcg and stay on trt

Hmg seems to be an alternative if I can find it and afford it?

If it is me, I would stay on, and do HCG 3 times a week. I would do this for 6 months and then get a sperm test. This stuff does not come back all that quickly every time, but does almost always come back eventually.

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I totally understand your perspective, man. I don’t like HCG at all either but very badly want to be fertile. I see a few routes for you:

  1. Do the HCG, just accept that you won’t feel as good for a time, and save money. HCG is waaaay cheaper.
  2. Shell out the coin for FSH, acknowledging that you don’t know how this will make you feel. I believe HMG is actually something different, so that could be another option, but not sure about that (and it’s not offered by Empower).

I think coming off of T altogether is your worst option and I would recommend avoiding this if at all possible.

Am I wrong in thinking that hcg is the same thing as fsh? It’s not just that the hcg makes me feel bad. It literally makes me impotent after taking it and does other weird things… kills my libido.It sounds crazy but when I eliminate it everything goes back to normal within a week or two. I’d spend the extra money for hmg if I can get it and it doesn’t have the side effects

My count is still 16 million so am I crazy to think I could increase that quickly. It’s not zero or anything like that so thought I could rebound it pretty quick with treatment since I’ve only been on trt seven weeks

Are you sure you can’t get your girl pregnant as is? At 16 million you might have a shot. No, HCG and FSH are not the same thing.

My wife is doing iui so I don’t really have six months to risk much dropping further staying on unless I know I can take something that helps

I know hcg and fsh aren’t but I thought hmg and fsh were? We have been trying for two years. We’re doing iui currently and fertility clinic said that’s not enough.

HCG is an LH analogue. Meaning it has the same receptor points as LH and a few others, it’s a bigger molucule. In men it functions pretty much the same as LH, but some guys just don’t like it. It could be the way it’s dosed or possibly the extra binding sites doing something, or something else. I’ve not tried it, personally.

Regardless the two substances are slightly different.

You could try low dose nolva or clomid to help keep sperm count from going to zero. Both readily available and cheap. Some don’t tolerate clomid very well though.

Can you take that with t injections?