T Nation

Maintaining Fertility While on TRT

First, thank you for all the great information on this forum. I have read through many posts and it seems like the accepted protocol of HCG while on TRT will maintain fertility but i have not seen anyone say they have been tested and it works. I have been diagnosed with Vericocele which I want to have surgically repaired. I have concurrent lower range test and have a doctor who is willing to prescribe TRT.

I have had fertility checked and I am at the low end of normal (doctor thinks it is from the Vericocele)for which i suggested HCG to maximize fertility until the wife is pregnant so that i can have the surgery and he agreed and wrote the script. Should I wait until she is pregnant to start TRT and continue the HCG until then or will the HCG take care of that if i start now? If so what is the commonly accepted dose. 250IU EOD is what seems common. Thoughts Suggestions are greatly appreciated.

My first priority is starting a family and I feel reasonably good right now, but if i can start getting results in the gym again that would be great.

Just do the TRT + hCG, stay with the hCG forever.

You need to test for E2 and use Adex as needed to have E2 in the lower 20’s.

What kind of TRT?
What dose?

Get and retain copies of all lab work. Get tested for E2.

Thanks KSman, that was what i was thinking. I was prescribed Adex at 1mg/day and 100mg of test/week. I have the means to adjust that to 100mg E3D and will drop the Adex to 1/2mg E3D and get tested for E2 in a few weeks.

I will PM you with a few more details if that is OK with you.

Thanks again for your reply

My count was at 880k after a few months of hcg I was at just over 9 million. I would think it would do the trick for you.

Thanks rfish, was that HCG alone or while on TRT? And what doses?

You cannot generalize how one will respond to hCG. If one had low T because LH was low, then hCG can increase T quite a bit IF the testes are healthy and responsive. That can be true for some younger guys. In general, those will age related decline have lower LH and their aged testes are not able to create a lot of T in response to hCG. A combo of type 1 and type 2 hypogonadism.

In my case, adding hCG to my TRT increased my T by ~15%. Obviously I would not have done very well on that alone.

Sperm production requires a high intratesticular testosterone levels. That can be around 80 times higher than serum levels. You can then see that the serum levels achieved with TRT are not going to make much difference inside the testes.

But TRT will increase DHT which does maintain the sex organs. Birth defects caused by drugs that lower DHT such as proscar produce males with underdeveloped or malformed sex organs. DHT may be important for those trying to correct low sperm counts.

Drugs like prosar disqualify one as a blood doner!

Thus TRT + hCG may work better than hCG alone for some. The increased T and DHT will also improve ones sex life… more bullets on target.

Transdermal T will make more DHT than injections, but also increases E2 levels. One may need to use more adex with transdermals then injections. If E is elevated, less bullets on target.

20% T cream applied to smaller skin areas also reduces E2 production compared to weaker creams applied to large areas or a-gel.

T cream applied to the scrotum also creates DHT. Does T applied to the penis create significant amounts of DHT? Research trials have not been done… try to get grant money for that.

When T cream is applied to the genitals, one needs to be very mindful of the potential transfer to one’s wife and/or GF[s]. I used the “and/or [GFs]” in consideration of push :wink:

I used it along with TRT.Yes you cannot generalize how one will respond to hCG, you won’t know until you try.

This is no big deal. You can go the usual TRT route with HCG and when it’s baby time have your Dr add in HMG. I was concerned about the same thing and after a lot of research I’m comfortable with what I’ve read. I know Dr Crisler helps his TRT guys in that area if needed.