T Nation

TRT + Fertility + Steroid Cycle

Hi all, I have some questions about our specific situation that I could not seem to find an answer for…

Background: partner is currently on TRT; 125mg Test-E p/w, 1mg Arimidex p/w & 500iu HCG p/w.

Last test that he had done, he had a sperm count of <1million per deciliter(?), anyway it was VERY low. At this stage, he had only just introduced the HCG. With this in mind, the doc is going to retest once he has been using the HCG for approx 5 months ie enough time to determine if the HCG will restore sperm production to a sufficient level to actually get me pregnant…hence why we’re having it tested.

Now, the tricky part comes in that he wants to do a cycle of 500mg/pw test prop for 4-6 weeks. So my questions are:

  1. Will doing this affect his sperm production, or is this independant of the current dose of HCG?
  2. If, when he is retested, his sperm count is still too low, we will be getting fertility treatment in the form of adding FSH (which apparently makes sperm grow??)- will doing this cycle counteract the FSH and keep sperm from growing if we did it at the same time?

If these questions don’t make sense please let me know!

Thanks fellas :slight_smile:

All good questions.

I think it would be most helpful to look at the big picture…

The testosterone he is taking is sensed by the HPTA and so it is reacting to those levels by no longer sending out LH which stimulates the Leydig cells to make testosterone and sperm.

This means the exogenous testosterone isn’t acting directly on the testes in any way. It is acting higher up the food chain, as it were.

By taking hCG (and FSH) you are replacing the “signals” that the HPTA is no longer sending out.

If the testes were a water fountain, the exogenous testosterone would be the guy shutting off the water flow to the fountain at the spigot. No more fountain. But once the spigot is closed, it can’t get “more closed.” Using hCG and FSH is like running a hose from the neighbor’s house to the fountain. The spigot is still off, but the fountain is now working because it is getting what it needs from somewhere else.

In other words, because testosterone doesn’t work directly on the testes, it can all be independent.

I see what you’re saying - irrespective of whether he is only having the TRT dose of 125mg/pw or 500mg/pw as per a cycle, the HCG & FSH are a separate issue from a fertility point of view right?

So in your opinion (educated I’m sure), extra testosterone should not affect the function of HCG & FSH as it pertains to his sperm and therefore ability to get me pregnant?

I guess I just worry that extra T may affect it in some way - negatively, and given how expensive those drugs are here in Australia, would want to give us the best possible chance…

The gear or TRT will shut down the HPTA. No LH and no FSH. hCG can replace LS and maintain the testes. But FSH is needed for a good sperm count.

250iu hCG EOD is what you should be using. That has been shown to restore baseline testicular function in normal guys who are HPTA shutdown. 500iu EOD was better, but definately deminishing returns.

If a SERM is used, the HPTA might produce LH and FSH and solve the problem. SERMs are not for life long use.

He is on 125mg T per week and is now fully HPTA shutdown. 500mg/wk can’t shut him down more. There will be a lot more T to T–>E convert, so he will need a lot more adex to keep E levels low. If E2 gets into the 30’s [0-54 pg/ml], he may not have any sex drive to deliver the sperm. If E is managed properly, his sex drive should be very high. Sex twice a day may reduce the sperm count.

[quote]KSman wrote:
The gear or TRT will shut down the HPTA. No LH and no FSH. hCG can replace LS and maintain the testes. But FSH is needed for a good sperm count.

250iu hCG EOD is what you should be using. That has been shown to restore baseline testicular function in normal guys who are HPTA shutdown. 500iu EOD was better, but definately deminishing returns.

If a SERM is used, the HPTA might produce LH and FSH and solve the problem. SERMs are not for life long use.

He is on 125mg T per week and is now fully HPTA shutdown. 500mg/wk can’t shut him down more. There will be a lot more T to T–>E convert, so he will need a lot more adex to keep E levels low. If E2 gets into the 30’s [0-54 pg/ml], he may not have any sex drive to deliver the sperm. If E is managed properly, his sex drive should be very high. Sex twice a day may reduce the sperm count.

[/quote]

It’s a sad fact that HCG is prohibitively expensive over her :frowning: hence why we are only using 250iu 2x pw…

I understand your response, however I guess my question now is: with the increased T to 500mg/pw, would an increase in the dosage of HCG and/or FSH be necessary (Adex aside) from a sperm count perspective or is it irrelevant to that??

[quote]Foxen wrote:
with the increased T to 500mg/pw, would an increase in the dosage of HCG and/or FSH be necessary (Adex aside) from a sperm count perspective or is it irrelevant to that??[/quote]

His HTPA is shutdown on 125mg/pw and that does not change. So sperm count should not be affected with more T. He has lost FSH with TRT, that does not change.

If E2 elevated because adex dose is not sufficient, sperm count should not change, but libido would suffer and that has an obvious effect on fertility.

[quote]Foxen wrote:
…with the increased T to 500mg/pw, would an increase in the dosage of HCG and/or FSH be necessary (Adex aside) from a sperm count perspective or is it irrelevant to that??[/quote]

Irrelevant to that. Testosterone isn’t competing with the hCG and FSH in any way. They’re not at all related in the sense you’re worried about.

I think KSman’s idea of add a SERM to the mix for a short term makes a lot of sense. I think Toremifene would be a good choice as I have read studies where it has been used specifically (and successfully) for help with sperm production.

So long story short doing a steroid cycle before or during any other drugs taken with the express purpose of increasing sperm production (HCG, FSH or SERM’S) should have no adverse effect to their effectiveness - thanks!