How fast do you become infertile through external testosterone?

[sims7]

Hi,
I am 30 and have sec.hypogonadism.
2 years ago I had a sperm test and my sperm was okay.
Now I have been on T injections since 6 months. My LH is zero now.
And my testicles have shrunken very much.
I now had a prostate check which was okay and a sperm test and my sperm count is zero now.
Is this normal?
Does sperm production shut down that fast?

I get 250mg e17d, this is the best I can get in Germany where I live. Doctors don't administer hcg for men.
I already asked my endocrinologist and my urologist they both acted like they never heard of such a thing.

I could try to get hcg on my own but I don't really know how to use it, like how much how often and so on.

I also don't know if adding hcg will also make me need an AI because of E2. Cause I will also not get an AI
from the doctor.

 

[Megatron28]

Exogenous testosterone shuts down your HPTA. This means your pituitary senses that your body already has enough testosterone so it stops sending out LH and FSH. Without LH and FSH your testicles will likely not produce a viable amount of sperm.

The way to circumvent this is by using hCG (and sometimes hMG). You doctors should put you on hCG if you want to have children.

A common dosage of hCG is 250-500iu twice a week.

Using hCG may cause your estradiol to increase, but not always. If you procure hCG you should also get Arimidex or Aromasin just in case you need it.

Sounds like you may need a new doctor.

 

[RIB]

Interesting, didnt know it could happen so quickly. I got a son and im 41 years old so i hope i get sterile also.

 

[snowpatrol123]

That's an unfortunate situation & protocol...I'd second megatron's suggestion regarding a new doctor

 

[IMT staff]

maybe never just depends

 

[PrinceDianabol]

maybe never just depends

IMT, in your opinion do you think including hCG in your TRT protocol would entirely remove the risk? Or would there always be a possibility of sterility?

 

[Fred87]

Getting a new doctor wont help. Here in Europe we cant get HcG and we cant get an AI, no doctor will ever prescribe those things, ever.

 

[IMT staff]

IMT, in your opinion do you think including hCG in your TRT protocol would entirely remove the risk? Or would there always be a possibility of sterility?

There is a small risk of infertility but i mean VERY VERY VERY small.

Eugen Lipshultz did a study on this, here it is:

Abstract
PURPOSE:
Testosterone replacement therapy results in decreased serum gonadotropins and intratesticular testosterone, and impairs spermatogenesis, leading to azoospermia in 40% of patients. However, intratesticular testosterone can be maintained during testosterone replacement therapy with co-administration of low dose human chorionic gonadotropin, which may support continued spermatogenesis in patients on testosterone replacement therapy.
MATERIALS AND METHODS:
We retrospectively reviewed the records of hypogonadal men treated with testosterone replacement therapy and concomitant low dose human chorionic gonadotropin. Testosterone replacement consisted of daily topical gel or weekly intramuscular injection with intramuscular human chorionic gonadotropin (500 IU) every other day. Serum and free testosterone, estradiol, semen parameters and pregnancy rates were evaluated before and during therapy.
RESULTS:
A total of 26 men with a mean age of 35.9 years were included in the study. Mean followup was 6.2 months. Of the men 19 were treated with injectable testosterone and 7 were treated with transdermal gel. Mean serum hormone levels before vs during treatment were testosterone 207.2 vs 1,055.5 ng/dl (p <0.0001), free testosterone 8.1 vs 20.4 pg/ml (p = 0.02) and estradiol 2.2 vs 3.7 pg/ml (p = 0.11). Pretreatment semen parameters were volume 2.9 ml, density 35.2 million per ml, motility 49.0% and forward progression 2.3. No differences in semen parameters were observed during greater than 1 year of followup. No impact on semen parameters was observed as a function of testosterone formulation. No patient became azoospermic during concomitant testosterone replacement and human chorionic gonadotropin therapy. Nine of 26 men contributed to pregnancy with the partner during followup.
CONCLUSIONS:
Low dose human chorionic gonadotropin appears to maintain semen parameters in hypogonadal men on testosterone replacement therapy. Concurrent testosterone replacement and human chorionic gonadotropin use may preserve fertility in hypogonadal males who desire fertility preservation while on testosterone replacement therapy.

Concomitant intramuscular human chorionic gonadotropin preserves spermatogenesis in men undergoing testosterone replacement therapy. - PubMed - NCBI