T Nation

Please Critique this TRT Protocol


My other thread was getting a little off-topic. A lot of discussion about private vs public health care in the UK and so forth. It is not so relevant anymore.

Anyway, if you want more background, this is the thread you can refer to:

After seeing several doctors and taking all the necessary tests, I am now to begin a certain treatment. The protocol is work in progress it seems.

My last test results showed the following:

Follicle stim. Hormone = 3.1 IU/L (0.27-4.20)

Luteinising hormone = 4.0 IU/L (1.7-8.6)

IGF-1 = 17.3 nmol/L (15.0-39.9)

Testosterone = 10.2 nmol/L (9.90-27.80)

Free testosterone/SHBG Ration = 28.3 (41-159)

Testosterone levels are too low as you can see.

Still, the doctors seem reluctant to put me on a full-blown TRT with hCG, AI & Testosterone. Initially they want to bring me up to ‘normal’ levels first.

So, the treatment I started with this week consists of 1500 IU’s of hCG twice a week. The docs want me to follow this protocol for at least 6 weeks. Then we’ll do additional blood tests to see the effects.

Personally I want to go for a proper TRT plan on a permanent basis, but they say that fertility is an issue. That is why they are reluctant to put me on a full TRT protocol.

Any comments?

Why have they not done a sperm count?

TRT+AI does not cause significant fertility issues. TRT-AI does.

Your LH and FSH VS T levels seem to lean towards primary hypogonadism. High amounts of hCG will reduce your LH sensitivity, not improve it; certainly not a long term solution.

Hi again,

Actually a semen analysis was conducted. This is from the report:

‘Semen analysis was not normal. His seminal fluid was very viscous and liquefaction was incomplete. His sperm concentration and total sperm count were low. His sperm motility was reduced. His MAR test was positive for 1gA antibodies. He has teratozoospermia (a high % of abnormal forms)’.

So these semen abnormalities are giving the doctors some concern. At the same time, though, they say that nowadays there are so many semen samples with abnormalities, that it does not necessarily mean much. It does not mean that I am necessarily infertile or anything like that.

Personally, I’m very much prepared to go for a full blown TRT plan - with Test, AI and hCG. I will continue to argue for this approach.

I have given the doctor a copy of Dr. Chrisler’s “best practise” report also (the one from his web site).

If you have further arguments I can present to the docs in favor of a TRT plan (with Test, AI & HCG), do let me hear about it.