As shown in table 1, the typical probability of recovery to 20 million/mL was 67% within 6 months, 90% within 12 months, 96% within 16 months, and 100% within 24 months. Testosterone (also referred to as “T”) is a hormone produced in men by the testes (testicles). No prescription will be provided unless a clinical need exists based on Don't get fooled by marketing claims! For those hypogonadal men who desire to protect their future fertility in the near future, testosterone supplementation should be done in a low dose, or temporarily discouraged. 3. Fertil Steril, 2003. Trinick, T.R., et al., International web survey shows high prevalence of symptomatic testosterone deficiency in men. Main Outcome Measures But you can send me an email and I'll get back to you soon. Roth, M.Y. This stimulates the production of sperm. Clomid is also easier to administer as it is an oral, and not an injectable like HCG. No patient became azoospermic during concomitant testosterone replacement and human chorionic gonadotropin therapy. Int J Impot Res, 2003. For men who experience drop-offs in sperm production due to TRT, several … Testosterone Gel group – average age 57 years, receiving 5 g/day of either Androgel® 1% or Testim® 1%. Clomid (clomiphene citrate) is a good treatment option for men with hypogonadism, demonstrating biochemical and clinical efficacy with few side effects and much lower cost compared with testosterone gel. However, while testosterone replacement therapy (TRT) confers great benefits to men with sup-optimal testosterone levels, it also comes with some side-effects which are especially relevant for men who wish to have a family...Many testosterone users and even clinicians [12] are unaware that exogenous testosterone suppresses the hypothalamic-pituitary-gonadal (HPG) axis and may result in infertility...however, in most cases, TRT induced infertility is reversible. Clin Pharmacol Ther, 2011. Subjective follow up of patients receiving clomid was performed via telephone interview using the ADAM questionnaire. Effects of Testosterone Administration for 3 Years on Subclinical Atherosclerosis Progression in Older Men. I am just amazed that the Doctors that are accessible to us on the regular insurance plans and specialize in this area are so clueless. We know that TRT may reduce sperm production and impact fertility. [4], HCG not only helps resume spermatogenesis after a TRT cycle, but also can be used in conjunction with TRT to preserve sperm quality. 90(5): p. 2595-602. Millions of men in the United States use testosterone replacement therapy (TRT) to treat low testosterone (Low T). I'm not around right now. Hey Will, great job done in choosing someone of this calibre to present information in their field. 10. Average follow up was 23 months (Clomid group; range 8–40 months) vs. 46 months (Testosterone Gel group; range 6–149 months). Clomid mono-therapy is an effective way to increase T levels in the physiological range, and is cheaper that T gel. HCG is an LH analogue and thus stimulates testicular (Leydig cell) production of testosterone, and increases both intra-testicular testosterone (ITT) concentrations and serum T levels. She has completed one semester at the PhD-program “Exercise, Nutrition and Preventive Health” at Baylor University Texas, at the department of Health Human Performance and Recreation, and worked as an ISSA certified personal trainer. 1) old-school dogma mindset What are Bioidentical Hormones? All Rights Reserved. 110(4): p. 573-8. Int J Psychophysiol, 2011. J Androl, 1991. [19-21] Therefore it is critical to go to a doctor who is well versed in the area, and who regularly have patients do blood work. Fertil Steril, 1997. Thus, in healthy men HCG increases the bioactive fraction of testosterone (free and non-SHBG-bound) to a greater extent than the TT level. It is imperative to understand that this is not the natural test boosters that can cause it, but the prescription testosterone … Int J Psychophysiol, 2012. 2(5): p. 716-21. Liu, P.Y., et al., Rate, extent, and modifiers of spermatogenic recovery after hormonal male contraception: an integrated analysis. OK, if fertility appears earlier than full HPTA recovery, isn't it a bit problematic if there was an actual health reason to start TRT? 2. Test yourself with a questionnaire, TRT and Fertility – how to get the best of both worlds - Clomid and HCG - part 2. 2011. TRT was combined with intramuscular injections of human chorionic gonadotropin (500 IU) every other day. – Androgel® 1% (5 gm daily) = $265 63(6): p. 1200-3. 16. 23(2): p. 149-62. required lab work, physician consultation, physical examination, and 5. Bioidentical Hormone Replacement Therapy (BHRT), Bioidentical HRT - safe and effective treatment of menopausal symptoms, DHEA – why it is especially important for menopausal women, Menopausal HRT with non-bioidentical hormones - the WHI studies. You may be wondering about testosterone replacement therapy (TRT) and fertility issues. It has given me appropriate knowledge about fertility and pregnancy. 7. Clin Endocrinol (Oxf), 2013. 110(10): p. 1524-8. [13-15] Suppression of gonadotropins (LH and FSH) deprives the testes of the signals required for both testosterone production and spermatogenesis, leading to markedly suppressed sperm counts in many men. Your email address will not be published. A study induced experimental gonadotropin deficiency in 37 normal men with gonadotropin-releasing hormone (GnRH) antagonists and randomized the men to receive one of four doses of HCG: 0, 15, 60, or 125 IU subcutanesouly every other day for 10 days. Butzow, T.L., L.M. In this article, we will reveal more about the effect of TRT on fertility, … 79 Suppl 3: p. 1659-61. 1. Save my name, email, and website in this browser for the next time I comment. 99(3): p. 718-24. If fertility is affected because of TRT, couples may require the use of in vitrofertilization or intra-cyto- plasmic sperm injection for future conception. They should be trying to access this type of information and educating themselves more thoroughly in this area. Both intra-testicular testosterone and FSH are required for quantitatively normal spermatogenesis. If you missed part 1 on this topic, here it is http://www.brinkzone.com/mens-health/testosterone-replacement-therapy-trt-and-fertility-how-to-get-the-best-of-both-worlds-part-1, The same strategies apply to increasing endogenous testosterone production and speeding up its recovery after supplementation, as illustrated in the figure  below (click image to see it in full). It has to be remembered that there is not one single T level that it optimal for everybody due to differences in AR (androgen receptor) sensitivity.. Saad, F., Androgen therapy in men with testosterone deficiency: can testosterone reduce the risk of cardiovascular disease? 78(3): p. 330-7. Traumatic Brain Injuries (TBI ) and Post Traumatic Stress Disorders (PTSD), Related? Oral CC has been shown, in doses of 25 mg per day or 50 mg every other day for up to 19 months, to be safe and effective in the treatment of testosterone deficiency (aka hypogonadims) and infertility in men. blood lipids, lipoproteins, glucose, fat mass, libido, psychological symptoms etc etc. However, one side effect of TRT can cause infertility. These studies proved that by concomitant hCG administration with TRT spermatogenesis, and thus potentially fertility could be preserved. Int Braz J Urol, 2012. Thinking of hopping on TRT, my bloods show slightly below average test levels (~500) and I’m 26. In the T enanthate/placebo group, LH and FSH were profoundly suppressed to 5% and 3% of baseline, respectively, and ITT was suppressed by 94%. Couldn't get her pregnant easy this time. TRT and Fertility – how to get the best of both worlds – part 2, Monica Mollica has a Bachelor’s and Master’s degree in Nutrition from the University of Stockholm, Sweden, and is an ISSA Certified Personal Trainer. In part 2 I outline studies that have investigated HCG, HCG+T and clomid for the purpose of increasing endogenous testosterone production and/or speeding up recovery of endogenous testosterone and sperm production after a TRT cycle: Please fill out the form below with your contact information and we will contact you within 1-2 business days. and W.J. Most clinical research has studied HCG treatment on patients with hypogonadism induced by pituitary disorders, idiopathic or genetic abnormalities. Mulligan, T., et al., Prevalence of hypogonadism in males aged at least 45 years: the HIM study. Stress, 2010. 189(2): p. 647-50. In part 1 I covered issues related to the effect of TRT (Testosterone Replacement Therapy) on male fertility. Thanks for what you have shared with us, 11. 95(8): p. 3806-13. – Clomid (50 mg every other day) = $83. During her years at the University she was a regular contributor to the Swedish bodybuilding magazine BODY, and she has published the book (in Swedish) “Functional Foods for Health and Energy Balance”, and authored several book chapters in Swedish publications. These assistive reproductive technologies are … 14. Asian J Androl, 2013. Boosting Fertility When Testosterone Levels Are Low. With the rise in testosterone supplement use, fertility doctors are warning men who would … J Androl, 2002. The importance of blood work cannot be overstated. Menon, D.K., Successful treatment of anabolic steroid-induced azoospermia with human chorionic gonadotropin and human menopausal gonadotropin. It should also be noted that the efficacy of CC treatment in raising T levels and improving symptoms might be reduced in older men over 65 years of age  (due to impairment of testicular function) [10] and in men with diabetes, hypertension, coronary artery disease, and multiple medication use.[8]. No claim or opinion on this website is intended to be, nor should it be 38(4): p. 512-8. Methods: To maintain fertility in men with hypogonadism prescribed testosterone, Lipshultz said, clinicians should first insist on a semen analysis before beginning testosterone treatment. Low testosterone is very unlikely to cause fertility issues. Today, Monica is sharing her solid experience by doing dietary consultations and writing about topics related to bodybuilding, fitness, health and anti-aging. I have read your blog, it was very informative. 17. The prevalence of testosterone deficiency (aka hypogonadism or Late Onset Hypogonadism), defined as total testosterone (TT) at or below 300 ng/dl is close to 40% in men aged 45 years and older presenting to primary care offices in the US. The main outcome measures were change in serum testosterone with CC and TGRT therapy, and change in the androgen deficiency in aging male (ADAM) questionnaire scores with CC therapy. Schoofs, D. and O.T. McLachlan, R.I., et al., Hormonal regulation of spermatogenesis in primates and man: insights for development of the male hormonal contraceptive. construed as, medical advice or hormone diagnosis. 19. All men wishing to preserve fertility while on TRT should have a … J Androl, 2009. Saad, F. and L.J. Many factors need to be taken into consideration, eg. Concurrent testosterone replacement and human chorionic gonadotropin use may preserve fertility in hypogonadal males who desire fertility … Lennartsson, A.K., et al., Sex steroid levels temporarily increase in response to acute psychosocial stress in healthy men and women. To put the data on HCG in perspective it is interesting to look at some case study. Hi, I have been on TRT for nearly a year. Fertil Steril, 2013. 2) lack of interest 80(1): p. 36-43. Crabbe, P., et al., Part of the interindividual variation in serum testosterone levels in healthy men reflects differences in androgen sensitivity and feedback set point: contribution of the androgen receptor polyglutamine tract polymorphism. Guay, A.T., S. Bansal, and G.J. J Clin Endocrinol Metab, 2007. and M.A. 13(5): p. 413-24. If you have low testosterone, one way to improve sperm count is with gonadotropin injections. current medical history. 18. Doing so can lead to problems, according to Puneet Masson, MD, assistant professor of Urology and director of the Male Fertility Program at Penn Fertility Care. The Alpha Male Challenge by James Villepigue, CSCS and Rick Collins, JD, CSCS Review By Will Brink and Elissa... “Bio Identical” hormones are being marketed strongly as a safer alternative to other forms. As hormone... Hi Monica, I am 56 and live in the UK. 80(12): p. 3546-52. That article covers the issue of TRT in competitive athletes, which is not applicable to the main part of the population.
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