Hello All- a little background I have been married for 1 year and I am in my late 20’s. My husband is older by about two decades. He has been on TRT for about 6 or 7 years now. He said when he initially saw a Dr it was because he was depressed and had low energy and the Dr told him you have low T. So that is how the diagnosis was made. Im guessing it wasnt a real RE doctor or urologist. Probably just a primary care. He put him on 200mg cyponiate every 3 weeks. He has been on this dose ever since. I dont know if a person is supposed to stay on the same dose for years. Assuming we want to have kids now (we dont) but lets just pretend we do…What is the course of action to take. I know if you have been on TRT for years you probably have low sperm count or no sperm count. We have not yet tried to get pregnant. Meaning we did not systematically calculate ovulation and plan it and monitor everything. We have not pursued pregnancy yet. But I do have one clue that says something. We have been having unprotected sex for the past year. No pregnancy occured. This leads me to believe he 100% has a Fertility issue. I am just predicting here. Nothing has been proven yet, but come on! Its obvious LoL. Maybe we should actually try to monitor ovulation and do all the stuff needed but we havent yet. Maybe I am wrong but science says 9 times outta 10 if you are on TRT it is extremely difficult to achieve pregnancy. If you are a man on TRT and got your girl pregnant you are an anomaly. Anyway I have heard various options for TRT patients:
option 1: Some men say they went off TRT completley and took clomid, HCG, HMG etc etc…and that helped their sperm regain itself which helped the sperm numbers go up which helped them conceive via normal conception or IUI or invitro or whatever.
option 2: others say they continued TRT and also added HCG or HMG etc …
My question is if we do option 1 and my husband does go off TRT isnt he going to experience bad side effects like decreased libido, ED, low energy, etc…So then should he continue taking TRT while adding in another horomone (i.e: HCG etc…) Unfortunatley he never took HCG while remaining on TRT. I have heard you should take HCG while on TRT but too bad he was never informed of this.
Keep in mind my husband has not had his testosterone retested again since 6-7 years. Nor has he had a semen analysis. We dont know anything at this point about his testosterone/sperm health. He has been on a dose of 200mg cyponiate every 3 weeks for the past 6 to 7 years. Some say this dose is old school and should be more like 200mg every week. Ill never know the truth since he hasnt been tested in years. He did do a routine physical two years ago that captured testosterone as part of the test. His testosterone was 100 and his FSH/LH was <0.3 (1.4-18.1) and LH was <0.1 (1.5-9.3). I dont know what these numbers mean but I do know when he had his blood drawn he was on the last couple days of his cycle so it was expected to show low levels. The doctor was a primary care not an endo nor a urologist nor an andrologist just a freaking primary care since it was just a routine physical. The doctor did tell my husband his levels were low and my husband said yea I know they are low I am taking injections. So that was that. This was not the same doctor who he saw 6-7 years ago for the injections.
What is the first step now? Is it for him to do another testosterone evaluation by an RE and to know the real levels, the real sperm count, the real everything and then move forward?
When time comes and I decide I do want a kid should he just go off TRT completley or combine it with another hormone? I just dont want him to go through bad side effects if he goes off it. Thanks All!