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Author Topic: Pregnyl Decreased My Sperm Counts?!  (Read 2160 times)

Johnny111

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Pregnyl Decreased My Sperm Counts?!
« on: April 06, 2017, 11:52:03 am »
 Hi guys, glad to have stumbled across this forum, I am hoping you guys can provide me the answers as my endo seems to be stumped by my situation.

Back in November last year I was diagnosed as being secondary hypergonadal. Testosterone level was 5.8. Normal range in the UK is considered to be between 9 and 33. Was put onto Pregnyl to boost testosterone and achieve fertility due to my partner and I trying for a baby.
1st set of bloods a month after starting the HCG said test was at 12.8 within normal range. This was a dose of 1500iu every second day. Estradiol wasn't tested.
Was then put onto HCG every day to try boost further. Been on this higher dose since start of Feb. About 3 weeks ago I noticed a painful and tender lump under my right nipple. Lump has gotten bigger and is a dull achy feeling. Doctor checked it and thinks it is gynecomastia. Had blood test done, test was at 17 but Estradiol was at 77!
Had sperm test done as well due to fertility reasons and that came back low. Concentration was 6 million per ml. Classed as low sperm count. Prior to starting Pregnyl this was 29 million!
Saw my Endo who can't explain why sperm has fallen drastically. Especially when Pregnyl is used sometimes to help achieve fertility not hinder it. He couldn't give me a clear answer as to how to proceed. He said either to take a break or carry on but at the lower dose. He thinks this gyno lump, which is at least the size of a marble, will just settle down. He seemed very unsure though.
I suggested using an a.i. but he wasn't keen as again he wasn't sure if this would affect my fertility.
I now have conundrum of whether to continue on the lower dose, which will I reckon make the lump increase and not decrease in size, contrary to what my endo thinks. I can't imagine my sperm count improving either. However if I stop completely, I am worried about what will happen to my test levels. I could ask for an a.i. as well but there are no guarantees he would give it to me.
I am getting bloods again in 6 weeks and another sperm test in 3 months. I would appreciate any opinions on what anyone's personal choice or thoughts on this are.

Thanks  :)

« Last Edit: April 08, 2017, 12:30:50 am by PeakT »

Cataceous

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Re: Pregnyl Decreased My Sperm Counts?!
« Reply #1 on: April 06, 2017, 01:52:10 pm »
Welcome Johnny. I'm actually surprised you didn't see a decrease in testosterone in going to such a large dose of hCG. The pharmacodynamics of hCG are such that at higher doses testosterone levels  go down rather than up. If it were me, I would try to persuade the doctor to allow a trial of half your original dose to see if you would get better results: decent testosterone and less estradiol. Alternatively you can discuss aromatase inhibitors with your doctor. But they don't work that well against higher hCG doses because of the direct stimulation of aromatization in Leydig cells.

I hope your doctor did much broader hormonal testing to rule out certain treatable underlying causes of hypogonadism.
« Last Edit: April 08, 2017, 12:31:01 am by PeakT »
I am not a medical doctor; any suggestions are meant to be discussed with your doctor.
Age: 55, Ht: 5'10", Wt: 154 lbs
Protocol: 18 mg T enanthate subQ qod, 270 IU hCG subQ qod, 6.25 mg DHEA orally bid
5/2017 test results: TT: 800 ng/dL (348-1197), FT: 16 pg/mL (7.2-24), E2: 50 pg/mL sensitive (8.0-35.0), DHEA-S: 278 ug/dL (71.6-375.4)

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Re: Pregnyl Decreased My Sperm Counts?!
« Reply #1 on: April 06, 2017, 01:52:10 pm »

Johnny111

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Re: Pregnyl Decreased My Sperm Counts?!
« Reply #2 on: April 07, 2017, 02:51:47 pm »
Hi, thanks for replying  :)
I have had an MRI which ruled out any tumour. He said that my balls weren't the problem as my other levels seemed to be okay, possibly fsh, lh and prolactin? What other possible causes do you know of that are treatable that I could research.
I am thinking about taking a break altogether as being another option. If I do this do you know if my estradiol would come down off its own accord? Or would my t level drop and estradiol stay high? I would maybe like to see how my levels settle and if my gyno lump gets smaller. It feels less irritable having come off it for 2 days but still the same size. Ideally I'd like my endo to let me experiment with the lower dose of 500iu. If my t level drops too low so I can try balance the need of achieving a good sperm count, a t level within the normal range and a lower estradiol count!

Thanks
Johnny
« Last Edit: April 08, 2017, 12:31:20 am by PeakT »

Cataceous

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Re: Pregnyl Decreased My Sperm Counts?!
« Reply #3 on: April 07, 2017, 03:59:10 pm »
... What other possible causes do you know of that are treatable that I could research.

Read PeakT's page on causes of low testosterone for some ideas. So your prolactin was measured and found to be ok?

...
I am thinking about taking a break altogether as being another option. If I do this do you know if my estradiol would come down off its own accord? Or would my t level drop and estadiol stay high? I would maybe like to see how my levels settle and if my gyno lump gets smaller. It feels less irritable having come off it for 2 days but still the same size. Ideally I'd like my endo to let me experiment with the lower dose of 500iu. If my t level drops too low so I can try balance the need of achieving a good sperm count, a t level within the normal range and a lower estradiol count!

If you stop the hCG, both T and estradiol with drop back to baseline, though possibly at different rates. In general we find hCG monotherapy is not very popular, likely because of the estradiol problems. The TRT/hCG combo-therapy is among the most popular because it's easy to adjust testosterone while keeping estradiol under control. Anecdotally it seems that even the low doses of hCG used in this therapy are sufficient to maintain fertility in most guys.
« Last Edit: April 08, 2017, 12:31:31 am by PeakT »
I am not a medical doctor; any suggestions are meant to be discussed with your doctor.
Age: 55, Ht: 5'10", Wt: 154 lbs
Protocol: 18 mg T enanthate subQ qod, 270 IU hCG subQ qod, 6.25 mg DHEA orally bid
5/2017 test results: TT: 800 ng/dL (348-1197), FT: 16 pg/mL (7.2-24), E2: 50 pg/mL sensitive (8.0-35.0), DHEA-S: 278 ug/dL (71.6-375.4)

PeakT

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Re: Pregnyl Decreased My Sperm Counts?!
« Reply #4 on: April 08, 2017, 12:35:27 am »
Hi guys, glad to have stumbled across this forum, I am hoping you guys can provide me the answers as my endo seems to be stumped by my situation.

Back in November last year I was diagnosed as being secondary hypergonadal. Testosterone level was 5.8. Normal range in the UK is considered to be between 9 and 33. Was put onto Pregnyl to boost testosterone and achieve fertility due to my partner and I trying for a baby.
1st set of bloods a month after starting the HCG said test was at 12.8 within normal range. This was a dose of 1500iu every second day. Estradiol wasn't tested.
Was then put onto HCG every day to try boost further. Been on this higher dose since start of Feb. About 3 weeks ago I noticed a painful and tender lump under my right nipple. Lump has gotten bigger and is a dull achy feeling. Doctor checked it and thinks it is gynecomastia. Had blood test done, test was at 17 but Estradiol was at 77!
Had sperm test done as well due to fertility reasons and that came back low. Concentration was 6 million per ml. Classed as low sperm count. Prior to starting Pregnyl this was 29 million!
Saw my Endo who can't explain why sperm has fallen drastically. Especially when Pregnyl is used sometimes to help achieve fertility not hinder it. He couldn't give me a clear answer as to how to proceed. He said either to take a break or carry on but at the lower dose. He thinks this gyno lump, which is at least the size of a marble, will just settle down. He seemed very unsure though.
I suggested using an a.i. but he wasn't keen as again he wasn't sure if this would affect my fertility.
I now have conundrum of whether to continue on the lower dose, which will I reckon make the lump increase and not decrease in size, contrary to what my endo thinks. I can't imagine my sperm count improving either. However if I stop completely, I am worried about what will happen to my test levels. I could ask for an a.i. as well but there are no guarantees he would give it to me.
I am getting bloods again in 6 weeks and another sperm test in 3 months. I would appreciate any opinions on what anyone's personal choice or thoughts on this are.

Thanks  :)

HCG raises estradiol disproportionately in most men from what I have seen.  What this means is that as you testosterone rises, your estradiol would rise significantly more than with other delivery systems.  Your high estradiol (and probably decreased sperm count) is a testimony of that.  I would work with a fertility specialist if I were you - too important of a subject not to deal with someone who does this day in and day out.  Here is some info on HCG dosing, and you'll see that you are on the high side:

http://www.peaktestosterone.com/hcg_dosage.aspx
If you are on medications or have a medical condition, always check with your doctor first before making any lifestyle changes or taking new supplements. Yes, low T and E.D. are usually medical conditions.  There are potential risk with HRT:  http://www.peaktestosterone.com/testosterone_risks.aspx.
My Health History: http://www.peaktestosterone.com/My_Health_Story.aspx.
And check out my new Peak Testosterone Program on the right side of my home page: http://www.peaktestosterone.com.

Peak Testosterone Forum

Re: Pregnyl Decreased My Sperm Counts?!
« Reply #4 on: April 08, 2017, 12:35:27 am »

PLEASE SUPPORT THE SITE AND GIVE AN AMAZON REVIEW IF POSSIBLE:


Johnny111

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Re: Pregnyl Decreased My Sperm Counts?!
« Reply #5 on: April 10, 2017, 11:45:01 am »
Hi Cataceous

Doctor said my prolactin was fine. I can possibly ask him to investigate other causes. I never had a baseline estradiol level prior to treatment, which in hindsight might've been useful.
I will ask him about the hcg/trt combo but I'm not sure whether to ask him to put me on an ai first to decrease my gyno and then start again from scratch.

Thanks for the link PeakTo, very informative. I find it worrying that I've been taking 1500iu daily for a month, especially when I've bow read that it can cause desensitization. Could someone please explain what this is exactly? My LH in my last test was pretty much nothing I think.

I have decided to come off the hcg altogether. With the knowledge that you gents have compared to myself, how would you want your doctor to proceed with it if you were me? Not looking for anyone to make the decision for me but I am genuinely not sure how to move forward on this one. For example should I ask for an ai straight away or see if the lump goes away on its on, ask for bloods in 3 weeks time instead of 6, tell my doctor I want to try trt with a low dose of hcg in 3 or 6 weeks, leave everything till I get my sperm re analysed in 3 months.

Thanks guys

Johnny

Cataceous

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Re: Pregnyl Decreased My Sperm Counts?!
« Reply #6 on: April 10, 2017, 12:36:59 pm »
Generally it's better to be stabilized on a treatment protocol and know that estradiol is high before beginning an AI. It's also assumed you're unwilling to further reduce testosterone in order to avoid the AI. To me it makes no sense to start an AI when estradiol is in the process of falling to baseline. It would be way too easy to crash it.

I think your plan of waiting to stabilize and then starting TRT/hCG makes sense. You might add SHBG to your pre-TRT lab work, as it could suggest whether you need a higher injection frequency or not. See if you can figure out some objective way to monitor the size of your lump. You'll want to know if it's shrinking in response to the drop in estradiol.
I am not a medical doctor; any suggestions are meant to be discussed with your doctor.
Age: 55, Ht: 5'10", Wt: 154 lbs
Protocol: 18 mg T enanthate subQ qod, 270 IU hCG subQ qod, 6.25 mg DHEA orally bid
5/2017 test results: TT: 800 ng/dL (348-1197), FT: 16 pg/mL (7.2-24), E2: 50 pg/mL sensitive (8.0-35.0), DHEA-S: 278 ug/dL (71.6-375.4)

PeakT

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Re: Pregnyl Decreased My Sperm Counts?!
« Reply #7 on: April 10, 2017, 03:33:22 pm »
Hi Cataceous

Doctor said my prolactin was fine. I can possibly ask him to investigate other causes. I never had a baseline estradiol level prior to treatment, which in hindsight might've been useful.
I will ask him about the hcg/trt combo but I'm not sure whether to ask him to put me on an ai first to decrease my gyno and then start again from scratch.

Thanks for the link PeakTo, very informative. I find it worrying that I've been taking 1500iu daily for a month, especially when I've bow read that it can cause desensitization. Could someone please explain what this is exactly? My LH in my last test was pretty much nothing I think.

I have decided to come off the hcg altogether. With the knowledge that you gents have compared to myself, how would you want your doctor to proceed with it if you were me? Not looking for anyone to make the decision for me but I am genuinely not sure how to move forward on this one. For example should I ask for an ai straight away or see if the lump goes away on its on, ask for bloods in 3 weeks time instead of 6, tell my doctor I want to try trt with a low dose of hcg in 3 or 6 weeks, leave everything till I get my sperm re analysed in 3 months.

Thanks guys

Johnny

When it comes to fertility you need to rely on a good doctor.  Don't go by what anyone says on here. Sounds to me like you need to get a second opinion.
If you are on medications or have a medical condition, always check with your doctor first before making any lifestyle changes or taking new supplements. Yes, low T and E.D. are usually medical conditions.  There are potential risk with HRT:  http://www.peaktestosterone.com/testosterone_risks.aspx.
My Health History: http://www.peaktestosterone.com/My_Health_Story.aspx.
And check out my new Peak Testosterone Program on the right side of my home page: http://www.peaktestosterone.com.

Peak Testosterone Forum

Re: Pregnyl Decreased My Sperm Counts?!
« Reply #7 on: April 10, 2017, 03:33:22 pm »