That's a god awful dose. T cyp is generally prescribed for 100 mg per week, which is what I've been using for bout four years. Before that, I was on gels for 10 grams per week. Clearly that doc doesn't know what he's doing.
Yes, one can stay on same dose for years if all is well.
I don't want to sound like a wiseass but did you two ever think of the genius idea of getting a semen analysis done, rather than hoping and hoping that unprotected sex will yield the desired result: a kid?
But yes, he is likely shut down, as are nearly all TRT patients.
Regarding option one, of course you can use only climbed or HCG at high doses, with no T. I took high dose of HCG for a few months but felt like crap on it and it did not sustain normal T vaues for me, even with a whopping dose of 9,000 IU per week. Some men even need 10,000 IU for normal T values and fertility when taking HCG alone. And again, some men can stay on that dose for years with no ill effects.
As stated before, I am on option two. At first my urologist prescribed 100 mg T with added 500 IU HCG twice per week. That didn't do the trick for fertility. When he increased the regiment to 100 mg T with 1000 IU HCG three times per week (3000 IU total per week), my sperm count increased sevenfold! And it's likely higher now. After two miscarriages we are now expecting our first kid this summer!
Question 1's answer: Yes, that can happen, if he does not respond to the mono therapy as desired.
Again, T and HCG work together, as it does for me and many others.
200 mg T every week is way too much for most men. Most men can archive a mid to high normal range of T with 100 mg per week of T cyp or 10 grams of gel a day.
It does not matter when those FSH or LH numbers were taken. It's not like they recover by the end of his three week gap between injections. He is shut down with those numbers. And you will continue to go on speculation until you actually get him to start taking semen analyses.
First step: Stop going to a PCP and get him to a urologist with a fellowship in andrology. Yes, get sperm count and go to a doc who knows what the heck he is doing with TRT and fertility. Where are you located?
When time comes: I'd say try mono therapy with HCG. If that does not sustain normal T values, go ahead and do T and HCG.
BUT.... this is just talk over the net, and we are not doctors. A qualified doc will know all the best steps to take, not us!