TRT and future fertility?


New member
Hey guys, how's it going?

I've been thinking about this a bit lately and could do with some advice.

I've already read a few of the many threads to be found online but decided to create my own as my options here in the UK are perhaps different from in the US (and also because I want a two way discussion).

Been on TRT for just over a year (Tostran/Fortesta with no AI) and it's working well at my current dose - all labs within range and T levels between approx 700-1000 ng/dl (seems to vary a bit depending on several things, including whether I apply lotion afterwards).

Looking back, I was pretty miserable before starting TRT. Hated my career but didn't know what to do, was lethargic/depressed, carrying too much weight, and had a crap sex drive compounded by the frustration that I was fairly good at getting dates but struggled with the sexual side.

Fast forward a year and I'm a different person. Changed career for the better and have good prospects/satisfaction now. Am in fairly good shape again and was dating a hot girl from work before I moved city. Confidence/ambition/libido through the roof too. It's like I now have the drive to fulfil the ambitions I always had (sorry if this is all a bit cheesy!).

However, the family side is the only element that has me confused.

I had never ruled it out previously, but with so many immediate concerns it just seemed a lifetime away. By my early 30s (I'm 36 now) I reflected that I'd probably missed the boat but didn't really care.

However, with my newfound security and focus, I can for the first time imagine being a parent, even if it's not a pressing concern. This is likely due to having spent a lot of time with my two nieces (4 and 6), my nephew (6 months) and my godson (8) who I babysit a lot. It's almost like I realised it's not some sort of arcane magic and that I could do this too in the right situation.

I'm now back on the dating scene and reflecting that a lot of women in their early 30s are likely to want kids in the future (or at least the option). HCG isn't prescribed over here and the typical recommendation seems to be just stopping TRT for a few months whilst trying. However, not currently being in a relationship I don't see how this would help me.

What are my options to preserve any remaining fertility? I almost wish I'd frozen some sperm, especially as my boys weren't particularly big to start with according the my private doc.

I'm finally now on the NHS, but thankfully still under the care of my private doctor (who also consults for the NHS). It's a good deal which I'm keen to maintain as I get my treatment paid for but don't have to deal with a shitty NHS endo and their stupid guidelines like 'aiming for 15 nmols' (433 ng/dl) and I also have access to an AI if
needed through this consultant. He also uses Clomid to do restarts (very forward thinking for the UK) and originally wanted me to do this. However, at my age I was sceptical of how far my natural production would take me and chose testosterone instead (partly through fear of finding myself in the low normal range in future years and being denied further treatment).

Sorry for the long post but I really want to try and resolve this in my head. My best mate's girlfriend is trying to set me up with her 31yo mate - right now I'm thinking of just sacking that option off and sticking to online dating where I can select 'do not want kids', which would be a real missed opportunity. I don't want to have to drop all this on a new love interest but it's a pretty big consideration not to be honest about I feel.

What are my options aside from accepting a childless future (which doesn't bother me right now but is something I might come to regret). I can't really afford to go cold turkey with my new job anytime soon - last time I went without TRT for a week I could barely get out of bed.


Well-known member
Some very knowledgeable guys will certainly chime in here and give you some great advice and I'll go ahead and throw my 2 cents in.
Depending on of you are primary or secondary, clomid may end up being a great option. It is proven to help some people improve their sperm count restore fertility.......while also possibly raising testosterone levels. My point is, if you chose clomid you may have enough of your "natural" testosterone being produced to keep you from experiencing the lows you have experienced in the past and then resume your current treatment once you have been successful. Also, many many men are perfectly capable of having children on trt with no issues at all. I even know a few who have conceived while on rather high doses of exogenous test. Maybe get tested to see what your sperm count is before you change anything at all.
And as always......most definitely seek the advice of your doctor and see what they think the best course of action for you would be. From what you've said above, I can think of no reason to assume you won't be able to have children. Again.....see your doc and get tested. Good luck my friend. I'm sure it will all work out just fine


If I were in your shoes I would just order hCG myself and take it without my doctor knowing. It's very easy to get in the UK.

What does your estradiol come in at without an AI and your TT levels?


New member
Thanks for the replies.

I think estradiol was either 27 or 30 last time I checked. Don't have the printouts to hand but remember thinking it was where it should be. It only ever went out of range when my TT was around 2300 ng/dl.


New member
Clomid and hcg together make a great combo to increase spermogenisis. Have had a few patients this year conceive from this combo

Dr. B


New member
I don't find clomid soo nice. An small dosed AI is doing the same job but without the risks of this chemical changed estrogens like clomid, tamox, ralox. ;)
You only need to lower the estrogen in your system and your system will producing more LH and so on.