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Thread: HCG for TRT

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    HCG for TRT

    Interesting look at the effect of 3 different HCG doses (250,500,1000iu) on adult men currently receiving TRT. Looks like 500 units QOD is the way to go to keep sperm count at baseline. From
    Healio- Endocrine Today

    I’d post the link but count not high enough yet. Article title is: Low-dose hCG can prevent sterility in men prescribed testosterone


    Low-dose human chorionic gonadotropin or HCG may preserve spermatogenesis in men with hypogonadism treated with intramuscular or transdermal testosterone replacement therapy, according to a speaker at the Androgen Society annual meeting.

    The estimated male population in their reproductive years is about 52 million in the United States, with the age of first-time fathers rising, and about 2.5 million of those men are estimated to have low testosterone, Larry I. Lipshultz, MD, a professor of urology and chief of the division of male reproductive medicine and surgery at Baylor College of Medicine in Houston, said during a presentation. Intratesticular testosterone — typically 50 to 100 times higher than serum testosterone levels — is a prerequisite for normal sperm production in men; however, exogenous testosterone prescribed to men with hypogonadism suppresses the intratesticular testosterone level, impairing fertility.

    “When one introduces exogenous testosterone, whether it is topical or injectable, what we see is [gonadotropin-releasing hormone] is turned off, gonadotropins decrease, and we see a corresponding decrease in testosterone within the testes and an associated turnoff of sperm production,” Lipshultz said. “A lot of what we know about this phenomenon comes from previous studies in male contraception using testosterone.”
    hCG studies

    Small studies suggest that men treated with testosterone who subsequently developed azoospermia experienced a recovery of spermatogenesis in about 4 months after discontinuing exogenous testosterone, regardless of the testosterone preparation, and initiating intramuscular hCG every other day, Lipshultz said. However, the studies were single-arm, observational and retrospective in nature, he added.
    “We concluded that impairment of fertility following testosterone replacement therapy suppression is reversable, and the rate of sperm return appears unrelated to the [testosterone] delivery system,” Lipshultz said. “But, giving some type of stimulatory agent avoids the unwanted, severe hypogonadal symptoms these men would have experienced had they just suddenly stopped the testosterone.”
    The findings, Lipshultz said, led researchers to question whether it was possible to prevent sterility in a man with hypogonadism who must use testosterone.
    In a study published in 2005 in The Journal of Clinical Endocrinology & Metabolism, Andrea D. Coviello, MD, a reproductive endocrinologist and practicing clinician and researcher at Boston University School of Medicine, and colleagues analyzed data from 29 men with normal reproductive physiology randomly assigned to 200 mg testosterone enanthate weekly in combination with saline placebo or 125 IU, 250 IU or 500 IU hCG every other day for 3 weeks. The researchers found that intratesticular testosterone increased linearly with increasing hCG dose, demonstrating that a relatively low dose of hCG maintains intratesticular testosterone within the normal range in healthy men with gonadotropin suppression, Lipshultz said.

    “Without any hCG replacement ... there was literally no intratesticular testosterone, and then as hCG was given in a stepwise fashion, once it reached about 500 U, you were back to baseline [level],” Lipshultz said. “Using this data, and realizing that despite very high doses of testosterone, there were high levels of intratesticular testosterone maintained with low-dose hCG, we then asked whether this low-dose maintenance could also protect spermatogenesis during testosterone treatment.”


    A small, prospective study indicated that may be true, Lipshultz said. In data from an abstract presented at the American Urological Association annual meeting in 2010, Lipshultz and colleagues analyzed data from 10 men prescribed intramuscular testosterone (n = 8) or transdermal testosterone (n = 2) along with 500 U intramuscular hCG every other day. Men underwent routine semen analyses throughout the study (mean follow-up, 4.5 months).
    “Interestingly enough, no one became azoospermic,” Lipshultz said. “More importantly, using the patients as their own controls, we saw only a minimal decline in density at the end of the study period.”


    In an expanded study assessing a larger population of 26 patients, results were similar, Lipshultz said. Low-dose hCG appeared to maintain sperm quality in men with hypogonadism using testosterone replacement therapy.




    “Low-dose hCG may be beneficial for men in their reproductive years requiring testosterone replacement therapy,” Lipshultz said. “Longer follow-up is needed to determine whether this benefit is sustained both qualitatively and quantitatively.”
    Strategy for clinicians
    To maintain fertility in men with hypogonadism prescribed testosterone, Lipshultz said, clinicians should first insist on a semen analysis before beginning testosterone treatment.
    “Patients need to realize that 2% of all men are sterile,” Lipshultz said. “We need to know where the individual is before we introduce testosterone because our endpoint may not be able to be any better than pre-treatment level.”
    If the man desires a future pregnancy, the clinician should prescribe hCG concurrent with testosterone therapy, typically at 500 U subcutaneous three times per week or 1,500 U once weekly if the patient wishes only to prevent testicular atrophy. The patient should cycle off of testosterone twice yearly, at a rate of 3,000 U three times per week for 4 weeks, adding 25 mg daily clomiphene therapy during that period, Lipshultz said. However, for men desiring a pregnancy, 3,000 U hCG three times per week should be prescribed in addition to clomiphene therapy. Clinicians should check the patient’s follicle-stimulating hormone (FSH) level and conduct a semen analysis after 4 months for men desiring pregnancy; if the FSH level is not sufficiently elevated, the clinician should discontinue clomiphene and instead introduce FSH concurrent with the hCG, he said.

    “To date, we have not had any patients who did not return to baseline,” Lipshultz said, referring to the regimen.

    Last edited by lastcaress83; 12-12-2019 at 07:43 PM.

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    A good read, thanks.

    I’m 3 years and 17 days away from my youngest turning 18. I’m glad to know I’m basically shooting blanks, and if I happened to pull out a little late and only cover my ol lady with half a load that it’s likely not gonna matter

    **** HCG

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    decent read bud

    thanks

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    Member I'mThatFitGuy's Avatar
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    Thanks for the read. But, unless I'm trying to get someone pregnant, is there any other reason why would I want to take HCG and raise my sperm count if I'm on TRT? To make my own Test as well? Seems like an extra 1/4 cc in the syringe would be the same thing. Am I missing something? I always thought that was one of the more desirable side effects of TRT

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    I guess it depends on your priorities. I was interested because this also applies to shutdown during cycles. According to Anabolics (10th Ed), LH begins to correct much earlier than testosterone (about 3 weeks vs 10 weeks for the latter). Apparently, fully shutdown balls take a lot longer to get back going than the HPTA. This research gives us an exact dose (500iu eod) to keep our testicles at their normal rate of production during cycle so we don’t have the recovery rate-limiting-step of trying to get our boys pumping again. Too bad we won’t get any research comparing recovery time in continuous HCG vs no HCG vs high dose HCG beginning post-cycle ala Dr. Scally... along with SERM therapy. I think it makes sense to assume keeping your testicles at normal function during cycle is the safest bet for a quick recovery (along with added benefit of maintaining natural test)

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    E-Fighter Extraordinaire Joliver's Avatar
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    Originally Posted by I'mThatFitGuy View Post
    Thanks for the read. But, unless I'm trying to get someone pregnant, is there any other reason why would I want to take HCG and raise my sperm count if I'm on TRT? To make my own Test as well? Seems like an extra 1/4 cc in the syringe would be the same thing. Am I missing something? I always thought that was one of the more desirable side effects of TRT
    Trt doses, according to the study, lead to zero inter-testicular testosterone. Deductive logic tells me that this is why certain guys on blast and cruise still have a low sex drive. A bit of HCG gives a lot of guys that sex drive back because it raises that inter-testicular testosterone...even at 500ius a day a few times a week.
    Stroking out on the toilet = gay. Stroking out on the platform = legend. --DYS

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    Originally Posted by Joliver View Post
    Trt doses, according to the study, lead to zero inter-testicular testosterone. Deductive logic tells me that this is why certain guys on blast and cruise still have a low sex drive. A bit of HCG gives a lot of guys that sex drive back because it raises that inter-testicular testosterone...even at 500ius a day a few times a week.

    TRUTH^^^

    trt and hcg combined was like a dose of mast....shooten streams and horny all the time, also felt a ton better, mood wise...some get good mood feeling from taking hcg and some dont, also throw in some clomid from time to time to feel even better and water falls from my wee wee of white gold or so she says

    this is what my best trt looked like and i felt amazing

    monday: trt of 200 mlg

    wed .5 anastrozole

    friday 250 iu hcg

    sunday 250 iu hcg

    gonna go back to that asap once my blood work is done and i see both endo and urologist
    "I think I'm gonna try to do a barrel role, and if that goes good, I'm just gonna nose down and call it a night"

    "Nahh....I'm a white Guy"

    Muther Fawken RICH -RIP BIG BALLS

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    Senior Member notsoswoleCPA's Avatar
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    I was prescribed 500 iU of HcG every 3.5 days for "mood enhancement" since I had a vasectomy and could care less about fertility. My only problem is it would cause random testosterone spikes of about 400 total in addition to my 900 to 1100 testosterone levels that TRT was already providing, which would also spike my estradiol. There was no rhyme or reason as to when or why it would happen, but even with anastrozole, those estradiol spikes took a while to come down.

    Source: While on HcG with TRT, I usually ran 900 to 1100 total testosterone except on two sets of labs where I pulled 1496 and >1500. Then when reviewing my notes over the 6 months leading up those labs, it was speculated that I had more spikes than just those two which happened two years apart. I still have a standing prescription for it, but since discontinued its use. I notice no difference in mood on or off it, except for when my estradiol spiked...

    Even with discontinued HcG, my last total testosterone lab was 1,001.

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    Senior Member Redemption79's Avatar
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    Originally Posted by notsoswoleCPA View Post
    I was prescribed 500 iU of HcG every 3.5 days for "mood enhancement" since I had a vasectomy and could care less about fertility. My only problem is it would cause random testosterone spikes of about 400 total in addition to my 900 to 1100 testosterone levels that TRT was already providing, which would also spike my estradiol. There was no rhyme or reason as to when or why it would happen, but even with anastrozole, those estradiol spikes took a while to come down.

    Source: While on HcG with TRT, I usually ran 900 to 1100 total testosterone except on two sets of labs where I pulled 1496 and >1500. Then when reviewing my notes over the 6 months leading up those labs, it was speculated that I had more spikes than just those two which happened two years apart. I still have a standing prescription for it, but since discontinued its use. I notice no difference in mood on or off it, except for when my estradiol spiked...

    Even with discontinued HcG, my last total testosterone lab was 1,001.
    What is your TRT dose (test)?

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