Coviello, A.D., et al., Low-dose human chorionic gonadotropin maintains intratesticular testosterone in normal men with testosterone-induced gonadotropin suppression. 3. 9. 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. 2) lack of interest led by Dr. John Pierce a Board Certified Physician. and M.A. Mean serum hormone levels before vs during treatment were testosterone 207.2 vs 1,055.5 ng/dl, free testosterone 8.1 vs 20.4 pg/ml and estradiol 2.2 vs 3.7 pg/ml. Int J Psychophysiol, 2011. Main Outcome Measures Concurrent testosterone replacement and human chorionic gonadotropin use may preserve fertility in hypogonadal males who desire fertility … Kettel, and S.S. To maintain fertility in men with hypogonadism prescribed testosterone, Lipshultz said, clinicians should first insist on a semen analysis before beginning testosterone treatment. Regards, Gary. [1] Testicular fluid was obtained by percutaneous aspiration for steroid measurements at baseline and after 10 days of treatment. Concurrent testosterone replacement and human chorionic gonadotropin use may preserve fertility in hypogonadal males who desire fertility … Now it will be easy for me to determine my fertility days, as I am planning to get pregnant. 20. 30(2): p. 95-112. All men wishing to preserve fertility while on TRT should have a … Saad, F., Androgen therapy in men with testosterone deficiency: can testosterone reduce the risk of cardiovascular disease? We know that TRT may reduce sperm production and impact fertility. Menon, D.K., Successful treatment of anabolic steroid-induced azoospermia with human chorionic gonadotropin and human menopausal gonadotropin. http://www.cagepotato.com/heres-what-happens-to-your-body-when-you-stop-using-trt/, The Science Of Bomb Proof Coffee/AlphaJoe Coffee. Yen, Clomiphene citrate reduces serum insulin-like growth factor I and increases sex hormone-binding globulin levels in women with polycystic ovary syndrome. Most clinical research has studied HCG treatment on patients with hypogonadism induced by pituitary disorders, idiopathic or genetic abnormalities. 7(1 Pt 1): p. 269-76. Due my husband’s job, he is mostly out of station and it becomes difficult for us to coordinate during my fertility day. The concentrations of SHBG and albumin were constant. Fertil Steril, 2003. [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. Averbeck, Twenty-five milligrams of clomiphene citrate presents positive effect on treatment of male testosterone deficiency – a prospective study. As demonstrated in the contraceptive trials, while cessation of testosterone therapy often restores baseline testosterone levels, it might take up to 2 years (if non-assisted). However, one side effect of TRT can cause infertility. required lab work, physician consultation, physical examination, and Stress, 2010. In my professional opinion, HCG should always form part of your Testosterone Replacement Therapy (TRT) protocol. Retrospective data collection was performed via chart review. 16. In part 1 I covered issues related to the effect of TRT (Testosterone Replacement Therapy) on male fertility. current medical history. 14. 23(2): p. 149-62. and J.K. Amory, Pharmacologic development of male hormonal contraceptive agents. Da Ros, C.T. Due to the “negative feedback loop” described earlier, there is a risk of reduced fertility as a result of TRT. 10. Boosting Fertility When Testosterone Levels Are Low. 2. If fertility is affected because of TRT, couples may require the use of in vitrofertilization or intra-cyto- plasmic sperm injection for future conception. Methods: Traumatic Brain Injuries (TBI ) and Post Traumatic Stress Disorders (PTSD), Related? Symptom scores improved significantly among clomid treated patients; the average pre-treatment ADAM score was 4.9 vs. 2.1 at follow up. Clin Pharmacol Ther, 2011. Andrology, 2013. Not all men who start TRT are … Carruthers, M., The paradox dividing testosterone deficiency symptoms and androgen assays: a closer look at the cellular and molecular mechanisms of androgen action. look forward to reading more of your articles. 4. 5. 17. 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). In this article, we will reveal more about the effect of TRT on fertility, … 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. 13. CC works by blocking estrogen (E) action in the pituitary. 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. 32(2): p. 165-75. Int J Psychophysiol, 2012. 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. You may be wondering about testosterone replacement therapy (TRT) and fertility issues. Another Study also shows that IM injections of HCG 2-3 times per week at doses of 2,000–3,000 IU for 4 months can initiate spermatogenesis after anabolic steroid-induced azoospermia. J Obes, 2011. In the T enanthate/HCG groups, ITT increased linearly with increasing hCG dose. 19. Aging Male, 2011. J Clin Endocrinol Metab, 1995. 6. Fertil Steril, 1997. This rise was less than that in free testosterone (221% +/- 18%), which was in turn less than the rise in the non-SHBG-bound fraction (255% +/- 19%). Here I will outline options for men to increase endogenous testosterone production by non-TRT means, and ways to speed up spermatogenesis for those who chose to go the TRT route… [18] However, this finding does not exclude the possibility that disorders of sperm function might occur when spermatogenesis is suppressed further to very severe oligozoospermia (below 1 million/mL), commonly observed in hormonal male contraceptive clinical trials.[18]. 95(8): p. 3806-13. On a Chinese study, 1 out of 100 men were able to conceive … Thus, when on an HCG cycle it is important to do blood work and measure all T fractions in order to monitor treatment efficacy. J Sex Med, 2008. 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 … 17. 4. Thanks, Gary. If you have symptoms of low testosterone, TRT might be your best treatment option. 110(10): p. 1524-8. 187(3): p. 973-8. If You Don’t Have Enough; Health Will Suffer And You are Wasting Your Time In the Gym! It was concluded that HCG appears to maintain semen parameters in hypogonadal men on testosterone replacement therapy. Don't get fooled by marketing claims! and D. Vasudevan, Use of clomiphene citrate to reverse premature andropause secondary to steroid abuse. [5]. Guay, A.T., et al., Clomiphene increases free testosterone levels in men with both secondary hypogonadism and erectile dysfunction: who does and does not benefit? 2. It helps to maintain fertility, testicular and penis size, cognitive … Kim, E.D., et al., The treatment of hypogonadism in men of reproductive age. Average follow up was 23 months (Clomid group; range 8–40 months) vs. 46 months (Testosterone Gel group; range 6–149 months). 19. Low testosterone is very unlikely to cause fertility issues. Monica has admired and been fascinated by muscular and sculptured strong athletic bodies since childhood, and discovered bodybuilding as an early teenager. To put the data on HCG in perspective it is interesting to look at some case study. 80(12): p. 3546-52. HCG (Human Chorionic Gonadotropin). This large and rising prevalence of testosterone deficiency is gaining recognition among doctors and patients alike. [8-14] At a dose of 100 mg/day for 2 months, clomid has also been shown to successfully reverse testosterone deficiency symptoms, restore testosterone levels, LH surges and the hypothlamic-pituitary-gonadal axis in a 30 year old male patient whose axis was previously shut off with multiple anabolic steroid abuse. 10. Could a GnRH stimulant be better suited to prevetn Azoospermia during TRT? J Urol, 2013. Eur J Endocrinol, 2002. Blood values were collected 1–2 months after treatment initiation and semi-annually thereafter. All Rights Reserved. [2] It is notable that in the survey 40% of respondent were at younger ages when ‘Late Onset Hypogonadism’ is generally not believed to be occurring. In common with anabolic steroid use, TTh exogenously elevates testosterone levels and suppress LH and FSH, and thereby can cause infertility. But you can send me an email and I'll get back to you soon. Fertility test proves that I'm sub-fertile. Clomid mono-therapy is an effective way to increase T levels in the physiological range, and is cheaper that T gel. However if you are concerned with fertility… Find out what unit: ng/mL or pg/mL – Androgel® 1% (5 gm daily) = $265 As hormone... Hi Monica, I am 56 and live in the UK. 78(3): p. 330-7. Test yourself with a questionnaire, TRT and Fertility – how to get the best of both worlds - Clomid and HCG - part 2. However, one of the few side effects of the therapy is infertility, due to the suppression of natural testosterone synthesis. Creatine As Cancer Fighter & Immune Booster? Subjective follow up of patients receiving clomid was performed via telephone interview using the ADAM questionnaire. Liu, P.Y., et al., Rate, extent, and modifiers of spermatogenic recovery after hormonal male contraception: an integrated analysis. Copyright © 2021 Ageless Forever. 1. It was concluded that doses of HCG that ware far lower than those typically used clinically (1,000–2,000 IU SC three times weekly) increased ITT concentrations in a dose-dependent manner in normal men with experimental gonadotropin deficiency.[1]. J Androl, 2002. 5(4): p. 998-1012. Readers Note: There’s a lot of internal links in this article that will lead people to important pages for... Clinical practice guidelines rely heavily on results from randomized controlled trials (RCTs), which is the gold standard for medical... Flax Oil and Estrogenic Compounds: Should Men Avoid Flax Oil? In a study men with normal reproductive physiology were randomized to receive 200 mg T enanthate weekly in combination with either saline placebo or 125, 250, or 500 IU hCG every other day for 3 wk. Barber, The role of obesity and type 2 diabetes mellitus in the development of male obesity-associated secondary hypogonadism. 68(1): p. 149-53. 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. 14. No impact on semen parameters was observed as a function of testosterone formulation. Just loved this, and will recommend this site to my friend who also trains, and is interested in the ‘real’ advanced knowledge on the subject. Shabsigh, A., et al., Clomiphene citrate effects on testosterone/estrogen ratio in male hypogonadism. Previously I got my g/f pregnant quickly. Moskovic, D.J., et al., Clomiphene citrate is safe and effective for long-term management of hypogonadism. The ITT levels increased in a dose-dependent manner, with very low-dose HCG administration Moreover, blood levels of HCG were significantly correlated with both ITT and blood testosterone levels. Tenover, J.S. Today, Monica is sharing her solid experience by doing dietary consultations and writing about topics related to bodybuilding, fitness, health and anti-aging. www.BrinkZone.com, and is also a web designer and videographer. 14(1): p. 10-5. Int J Endocrinol, 2013. 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? Higher rates of recovery are seen with shorter treatment duration, shorter-acting testosterone preparations, higher sperm concentrations at baseline, faster suppression of spermatogenesis, and lower blood LH levels at baseline. Testosterone (also referred to as “T”) is a hormone produced in men by the testes (testicles). Are Fertility Problems Caused by TRT Permanent? 38(4): p. 512-8. blood lipids, lipoproteins, glucose, fat mass, libido, psychological symptoms etc etc. 104 men with hypogonadism (defined as testosterone below 300 ng/mL) or infertility, were divided into two groups: Int J Impot Res, 2003. With the rise in testosterone supplement use, fertility doctors are warning men who would … Fertil Steril, 1995. 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. 1. By day 4 the mean serum testosterone level had risen to 178% +/- 13% (SEM) of a mean basal level (first five samples). Just through your blog, I came to know about Ovulation calculator. Testicular atrophy is a sign that the testes are deprived of LH and FSH, and that endogenous testosterone production is impaired. Asian J Androl, 2013. 15(3): p. 156-65. Results: Lennartsson, A.K., et al., Sex steroid levels temporarily increase in response to acute psychosocial stress in healthy men and women. 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. Cooke, R.R., et al., Serum forms of testosterone in men after an hCG stimulation: relative increase in non-protein bound forms. – Clomid (50 mg every other day) = $83. J Sex Med, 2008. It has given me appropriate knowledge about fertility and pregnancy. Testosterone Replacement Therapy (TRT) and Fertility – how to get the best of both worlds - part 1. This stimulates the production of sperm. 12. 5(4): p. 998-1012. Metabolism, 1973. Wolf, Are salivary gonadal steroid concentrations influenced by acute psychosocial stress? 153(5): p. 1628-30. Thanks for what you have shared with us, The patient received twice-weekly injections of 10,000 IU of HCG and daily injections of 75 IU of HMG (menopausal gonadotropins) for 3 months. [7] The pituitary thereby sees less estrogen and makes more LH due to removal of negative feedback inhibition. 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. 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. While this effect is considered generally reversible, you might want to avoid testosterone therapy if you plan to have biological children. The importance of blood work cannot be overstated. Int Braz J Urol, 2012. 12(4): p. 258-63. What Low Testosterone … She works a dietary consultant, health journalist and writer for. [18] Therefore, during clomid treatment it is important to monitor the GH/IGF-1 axis and levels of SHBG and free testosterone, in addition to total testosterone levels and symptoms. http://www.brinkzone.com/mens-health/testosterone-replacement-therapy-trt-and-fertility-how-to-get-the-best-of-both-worlds-part-1, Testosterone and Prostate Cancer – Bye Androgen Hypothesis, Welcome Saturation Model – Time For a Paradigm Shift. The term bioidentical hormone does not have a standardized definition and thus often confuses patients and practitioners. Get New Posts From Brinkzone Sent To Your Inbox! Your email address will not be published. No claim or opinion on this website is intended to be, nor should it be 18. [8-10] Stress induced cortisol elevation, by increasing SHBG, lowers the free active fraction of testosterone and thereby reduces its action.[11]. Testosterone Replacement Therapy and Male Fertility If testosterone levels are lower than normal and you are experiencing infertility, your fertility doctor may suggest testosterone … Of the men 19 were treated with injectable testosterone and 7 were treated with transdermal gel. In trials run by fertility clinics, patients who had experienced low … After obtaining institutional review board approval, we retrospectively reviewed the medical records of hypogonadal men who desired fertility preservation during TRT and presented to a … Therefore it might not be directly applicable to fertility issues related to TTh. When supplementing testosterone, despite normal-to-high blood levels of testosterone, intra-testicular testosterone levels necessary to maintain spermatogenesis may be too low. The unit of the measure tells if it is free or total T. Great article. Studies on male hormonal contraception using testosterone give insights into the effect and time to recovery of spermatogenesis with cessation of testosterone supplementation. 28 Suppl 2: p. 52-9. These studies proved that by concomitant hCG administration with TRT spermatogenesis, and thus potentially fertility could be preserved. Realizing the importance of nutrition for maximal results in the gym, she went for a major in Nutrition at the University. 2013: p. 816740. Ageless Forever is a prominent anti aging clinic & wellness center in In many cases, the reduced sperm count caused by taking TRT will not be permanent. Millions of men in the United States use testosterone replacement therapy (TRT) to treat low testosterone (Low T). [1] Year 2006 is was estimated that more than 13.8 million men over 45 years of age visiting a primary care doctor in the United States have symptomatic androgen deficiency. Clomid group – average age 42 years, receiving 50 mg clomid every other day. TRT was combined with intramuscular injections of human chorionic gonadotropin (500 IU) every other day. 11. Off-label Prescribing in Medicine – GH Notable Exception! There were no adverse events reported. This large analysis of 30 studies shows full reversibility within a predictable time course, and that various predictors affect the rate, but not the extent, of recovery. Schoofs, D. and O.T. BJU Int, 2012. Bremner, The effects of normal aging on the response of the pituitary-gonadal axis to chronic clomiphene administration in men. Concurrent testosterone replacement and human chorionic gonadotropin use may preserve fertility in hypogonadal males who desire fertility preservation while on testosterone replacement therapy. If you have low testosterone, one way to improve sperm count is with gonadotropin injections. Clin Endocrinol (Oxf), 2013. Both intra-testicular testosterone and FSH are required for quantitatively normal spermatogenesis. Tan, R.S. 8. 189(2): p. 647-50. Growth Hormone Treatment - Dosing and Monitoring, Do you have low-T? 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. Butzow, T.L., L.M. Hsieh, T.C., et al., Concomitant intramuscular human chorionic gonadotropin preserves spermatogenesis in men undergoing testosterone replacement therapy.
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