T Nation

Urologist and/or Fertility Dr Question - Getting Off TRT etc


#1

Hello. New here. This post I’m hoping will reach a doctor who’s well versed in TRT replacement and/or keeping fertility for men etc

I’ve been on TRT for 12 months or so. Started receiving 60ml cyponate shots every 2 weeks. Each two week interval, we would bump the dosage 60, to where I finally ended up at 200ml every two weeks.

I met someone, so I started caring about possibly having a child again. I had my PA at the men’s clinic I got my shots at, prescribe clomid. He seemed to think it would help but I had read it wasn’t her effective in men.

Either way, I’m still taking the clomid.

Now, in this last year of meeting my wife, I’ve since tapered the shots off to 80ml, every Friday. Vs every 2 weeks. Somewhere around month 6 the 2 week die off was getting to me too much so we switched to weekly.

My PA tells me once we get to 60ml there’s no need coming in because 60ml won’t do anything. Is this true?

Last piece to know: I got basically a second opinion from a fertility specialist (mainly in womens health but he saw us as a couple)…he wanted me off testosterone IMMEDIATELY.

I did 1, 10 week HCG cycle, 10,000mu’s total (5 boxes of pregynl). The shots are done every Monday/Wednesday/Friday at home by me.

When I would have my labs drawn, it was very apparent, the HCG was doing something. My free testosterone numbers kept going up and up. Highest reading was 1194. 1200 being high normal range. Free T was 40.00!!! Normal being like 12-20. Estrogen highest reading once was 91. Rough couple weeks lol

Ok. So, HCG seems to be working, I’m lowering my TRT shots every week. Taking clomid with HCG. Etc etc.

I have a semen analysis done. Now I know I wasn’t suppose to ejactulate 24-48 hours beforehand, but I did. and my E this week has been jacking with me pretty hardcore.

I got the results and it said 7million. Low end but doing high TRT doses for a year probably had me at zero before the HCG.

That’s my baseline, so I asked to go another 10 week cycle. Same 10,000imu’s etc etc. theory being, it’s absolutely working because my lab results show so.

For the doctors on this forum…do you think my second round will have my sperm #’s much higher? Does the brain see HCG and start to ignore it? I’m almost completely off outside testosterone…that’s good right?

Etc etc etc

I just want some input please. I have a child now so I don’t believe I have a varrecole (or however it’s soelled) no testicular damage etc. plus taking clomid.

My thought is I’ll see a huge improvement after this 10 weeks is done.

Thank you SO MUCH for your input. My PA is a place they give you a shot and send you on. He forgets half the time why I’m doing clomid and HCG!!!


#2

You need SHBG tested as this will determine how often you require shots. You’ve got your dosing mixed up, an example I’m taking .25ml from a 100mg vial every other day which ends up being 25mg EOD. You probably mean .60ml which is the volume which could be from 100-200mg vial. A good starting dose would be 100mg split twice weekly allows for a smooth consistent T levels minimizing the peaks and valleys from larger infrequent shots. It sounds like your current doctor is struggling in regards TRT, most doctors are clueless when it comes to male hormones! Why isn’t you doctor allowing you to inject at home? You can use 27-30 gauge 1/2" insulin syringes in the shoulder and quads. My endo originally prescribed 21 gauge syringes which is completely necessary, my doctor also struggles with TRT.


#3

SHBG is always in range when I have blood work taken.

Yeah I’m not the best at explaining medical dosages. I draw .75 on my syringe each Monday/Wednesday/Friday. Each box is 2,000 I/u or after the 10 weeks, I’ve taken 10,000.

I self inject the HCG. I don’t want to self inject the cypoinate because unfortunately, I need to go to them to have blood work drawn.


#4

There are a lot of guys that have within range SHBG, that doesn’t mean it’s all fine and dandy. Some guys are more sensitive to SHBG just below the high normal range, the word within range gets thrown around quite a bit, just because it’s within the range doesn’t mean you’re going to feel good. Labs can be very telling about what’s going on inside your body, you’re shortchanging yourself by not including them. We have a forum member here who can look at your labs and tell you which foods you need to ditch and which foods you require more of to function well. I thought for some reason you were on TRT, it sounds like you only on HCG.