HCG Mono...New bloodwork - Thoughts?

[Nuclearbark]

Hey Guys,

I chimed in back in the summer about coming off trt to restore fertility. Got tons of great advice and I'm happy to say as of my last sperm count (about 2 months ago) everything looks great. Sperm has returned and is highly motile. Unfortunately the bad news is that the wife still isn't pregnant and I continue to struggle with the typical low t symptoms even on a low dose HCG protocol.

I was in to see my new doc today and pick-up my blood work. He said that there's not much more I can do except get back on the T with hcg and hope the sperm stays. I want to maximize my chances of conception, so I begrudgingly said no to the T. He noticed that my DHEA was low and he suggested 25 mg a day along with a dose of Saw Palmetto. He admitted that there probably wouldn't be much change with addition of the two.

My current protocol is 250 iu twice a week and my bloodwork shows:

Testosterone Total: 17.2 nmol/L (8.4-28.8)
Testosterone Free: 29.5 pmol/L (31.0 - 94.0)
Estradiol: 70 pmol/L (<150)
LH: 3 IU/L (2-8)
FSH: 2 IU/L (2-6)
DHEA-S: 6.0 umol/L (<15.0)
Cortisol: 404 nmol/L (170-720)
TSH: 4.21 mIU/L (0.30-4.00) HI
T3: 5.3 pmol/L (3.5-6.5)
T4: 15 pmol/L (9-23)

Anyone out there have success with conception while on T and hcg? Do you think an increase of HCG per injection would make a difference (doc doesn't think so)?

I'm really tired - literally and metaphorically - of being brain-fogged, lethargic and impotent!

Other stats:
35 yrs old
5'7 - 165 lbs
I'm in Canada hence the odd measurement ranges.

Bloodwork while on 50mg clomid a day back in June:

Test, serum: 420 ng/dl (348 - 1197)
Estradiol: 26.3 pg/ml (7.6 - 42.6)
FSH: 10.1 mIU/ml (1.5 - 12.4)
LH: 15.1 mIU/ml (1.7 - 8.6)

 

[Megatron28]

Have you discussed HMG with your doc? Although if you have a good sperm count, etc already, I don't see why you are trying to improve it further. Sounds like the problem may be with your wife. Has she been looked at?

You could also discuss Arimidex monotherapy instead of hCG. That will raise your testosterone. Not a longterm solutions for TRT in my mind, but while you are trying to conceive it is fine.

Most importantly, are you addressing your apparent hypothyroidism? I imagine that is dragging you down.

 

[Alpin]

Thank you for writing. What time did you do this blood work on ?
In both cases (HCG mono protocol and Clomid ED protocol)
The bloods were done at the very end of the clomid trial...what time frame can you give us exactly ?
I was on HCG mono protocols for a while in my mid twenties to 30 years old. Recently went back on them.
My dose was 350 i.u. 3 times a week with 1/4 TAB ADEX E3D....
Currently using 500 i.u. EOD with same ADEX dose but E4D.
Waiting on labs to see where I'm at with this current protocol. Will post results ASAP.
I was shut down for 2.5 yrs with no HCG while on.

 

[Alpin]

Have you discussed HMG with your doc? Although if you have a good sperm count, etc already, I don't see why you are trying to improve it further. Sounds like the problem may be with your wife. Has she been looked at?

You could also discuss Arimidex monotherapy instead of hCG. That will raise your testosterone. Not a longterm solutions for TRT in my mind, but while you are trying to conceive it is fine.

Most importantly, are you addressing your apparent hypothyroidism? I imagine that is dragging you down.

A lot of Docs out there wont use ADEX in men....

 

[Megatron28]

A lot of Docs out there wont use ADEX in men....

And a lot will.

 

[Alpin]

It's off label in men. Conventional Endo's wont touch it. GP's as well.

 

[Megatron28]

It's off label in men. Conventional Endo's wont touch it. GP's as well.

Maybe in Canada. In the US, doctors prescribe medications off label every day. How do you think most of us here in the TRT forum are getting our AI's?

 

[Alpin]

Maybe in Canada. In the US, doctors prescribe medications off label every day. How do you think most of us here in the TRT forum are getting our AI's?

Not arguing with you but 2 endos I seen so far were less than thrilled I was using the slight dose of ADEX...even on HCG.
They demanded I stop it cause "safety risks are unknown" at this time.

 

[Nuclearbark]

I actually asked about Adex (you guys have trained me well) and he said that due to my already low estradiol that it wouldn't raise it greatly. He is familiar with Arimidex and will prescribe it. Hopefully by then my wife will be preggo and the conversation will be a little different...

As for the hypothyroidism, doc said that since my T3, T4 values were in range, I shouldn't worry. Yet. He thinks I'll need some treatment in the next 10 years or so. Apparently the acceptable ranges recently changed?

My wife is likely the issue with pregnancy. We had to see a fertility specialist when we concieved our daughter a couple years ago. We ended up doing it naturally, but had help pinning down her ovulation day. We're in the process of doing that again, but things move a little slower in Canada with long wait lists. However, we don't have to pay a cent, so I'll compromise

APOLLON: Test was done at 7:30 am. How did you feel while on HCG mono? I definitely have days where I feel great, but mostly it's the dumps.

 

[Alpin]

I actually asked about Adex (you guys have trained me well) and he said that due to my already low estradiol that it wouldn't raise it greatly. He is familiar with Arimidex and will prescribe it. Hopefully by then my wife will be preggo and the conversation will be a little different...

As for the hypothyroidism, doc said that since my T3, T4 values were in range, I shouldn't worry. Yet. He thinks I'll need some treatment in the next 10 years or so. Apparently the acceptable ranges recently changed?

My wife is likely the issue with pregnancy. We had to see a fertility specialist when we concieved our daughter a couple years ago. We ended up doing it naturally, but had help pinning down her ovulation day. We're in the process of doing that again, but things move a little slower in Canada with long wait lists. However, we don't have to pay a cent, so I'll compromise

APOLLON: Test was done at 7:30 am. How did you feel while on HCG mono? I definitely have days where I feel great, but mostly it's the dumps.

felt a bit better than without it....posted new labs that came in Today in new thread.

 

[Black Beard]

Thyroid can affect the HPTA, energy levels and libido.

 

[Alpin]

NuclearBark, I overlooked something important here....
how is it you have low but still normal LH/FSH levels while on HCG monotherapy ?

 

[Alpin]

NuclearBark, can you tell me what lab you use ?
You are in Canada correct ?

 

[Nuclearbark]

Yes, I'm in Canada and use a lab here - Lifelabs. Not sure why my LH/FSH are normal, however, I used clomid directly after coming off TRT and then moved to HCG. I know others sometimes do the opposite. Maybe that has something to do with it?