question from a user
I'm in a bind right now with my situation. I've been on trt for 11 months, 150mg a week split into 3 shots. I also take hcg with every injection, 500units every injection. The wife and I are trying for a baby. My urologist gave me shit for being on trt. I did a semen analysis and all my numbers are below normal. My total semen count was 3 million when normal range is 20-40mill. Urologist says to stop cold turkey and just stay on hcg for 6 months to see if my semen count improves or if we get pregnant during this time. I've been off test for 8 days and I feel like shit. It's how I was feeling before I started test. Any recommendations on how to feel better or how to improve fertility?
AlphaMD's Answer
While not knowing everything exactly and not wanting to step on anyone's toes, we'd suggest consulting with a fertility specialist rather than just a urologist for a second opinion. Try to find one who sounds like they know about TRT as well, as they'll be the ones with experience.
75% of men on that dose of HCG are able to have a child with their partner. Unless you've been unsuccessful for a long time now, it sounds like coming off T might be jumping the gun. Remember, urologists are just people who have bias as well, it's okay to get a second opinion. It's not okay for them to be judgmental in this day & age, though.
Sometimes that 25% of men need to come off TRT simply because their wives have low fertility. You may still be in a happy enough range to do the deed, but if her fertility is low then you might need to make up for that. TL:DR; Look for a fertility specialist.
People often forget that hCG is a LH analog. LH attaches to the Leydig cells of the testicles. Leydig cells sole function is testosterone production. While the increased intratesticular testosterone level will raise sperm counts slightly, it is FSH that is needed to produce sperm.
FSH attaches to the Sertoli cells in the testicles. Sertoli cells produce sperm.
Clomiphene or enclomiphene would be better and faster options to improve your fertility while also raising your testosterone.
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