Author Topic: Fertility and stopping TRT (Read 16394 times)

Danceny · « **on:** November 17, 2012, 06:47:09 am »

Hi there,

Lee, thank you for your informative e-books and other resources.

I went to my GP about 9 months ago with the usual symptoms and tested at total T of 360. (I'm 35.) He gave me a 400mg shot "to try" and I seemed to respond. Retested about 3 months later at 280, got another huge 400mg shot and seemed to respond again. So he went ahead and prescribed me test enanthate, and I've been shooting about 50mg every 5 days* with so-so results. Libido is still weaker than I'd like, and I still rarely get morning erections, but it's better, and mood/cognitive/insomnia symptoms are definitely improved.

* I first tried 60mg and tested 2 days after injection (supposedly when blood levels peak with IM injection) in the low 900s, so backed off the dosage to 50mg (0.25 cc).

Anyway, a couple of questions:

1. I still want kids. Have I sterilized myself? My doc said that fertility is likely to be off already with low T and that replacing to physiologic levels won't suppress it further -- and may help. If I understand what I've read here, this is NOT the consensus view.

2. I'd like to get off the juice; I feel I started on it hastily and uninformed. But I keep reading that TRT "is for life", or at least that discontinuing it is potentially harmful and requires additional drugs/medical supervision. Does TRT kill natural T production permanently? What resources are there for discontinuing?

Any help is appreciated.

PeakT · « **Reply #1 on:** November 17, 2012, 08:17:39 am »

Sorry about the trials and tribultions. Let me jump right to your two questions:

1. I don't agree with your doc on this. His logic is only good if there is no alternative for you that will restore fertility and that is not the case unless I am missing something here. I guess if you were diagnosed with primary hypogonadism then things like Clomid become more debatable, but you didn't mention that, so I doubt that is your situation, right? So, anyway, assuming you are secondary, then you do have alternatives to HRT and you can read several of the recent threads on Clomid for some examples of that. I would go to your doctor and say, "Why can't I consider Clomid?" (I can't tell you what to do, of course, but I can tell you to have a talk about all of this so you can get truly informed. And, of course, if you feel your doc is unknowledgeable, get a second opionion.)

2. Reasonable HRT does not kill production as far as I know. There is, though, a painful transition period where the person's HRT ramps up to its old levels and, of course, the old levels weren't good to begin with, so you know what that means. However, if you were to go on Clomid, this will help.

If you can afford it, I'd go to a fertility specialist. This can be a very emotional topic for many couples, esp. women, so I'd get an expert involved.

Peak Testosterone Forum · « **Reply #1 on:** November 17, 2012, 08:17:39 am »

Danceny · « **Reply #2 on:** January 14, 2013, 10:03:23 pm »

I wasn't diagnosed primary or secondary. What test makes the distinction? I assume the results wouldn't be valid now, since exogenous T messes up the whole HPT axis.

Anyway, I went back to my doc and got a semen analysis, and I'm sterile:

sperm conc M/mL (20-400) 0.14 (Geez!)
sperm morph (30-100%) 40 (normal?)
sperm motility % (40-100%) 37
sperm motility index (120-400) 74

In the meantime, I kept feeling that my testicles were shrinking and discounting that as paranoia. But now I'm certain they have.

So, I've made an appointment with a urologist about getting off TRT. I really wish I hadn't messed around with this; I could've just taken Cialis for the ED and lived with the mood/cognitive symptoms. From what I read, restoring fertility is long road (6-18 months) and iffy at that. Any suggestions on what to discuss with the urologist?

Thanks again for your help.

PeakT · « **Reply #3 on:** January 15, 2013, 04:10:41 am »

Yeah, that should be the first question a doc should ask a patient that he/she's thinking of going on HRT: is there a chance you want to have kids?

Well, you should be able to get off the HRT and go with some alternative that will restore your fertility. There are no guarantees of course, but talking to a fertility doc with some experience would be a good idea. My guess is that with Clomid and HCG the transition could be relatively painless and your testicular size could be maintained.

Now are Clomid and HCG safe for decades? Well, I don't think anyone knows the answer to that q. And keep this in mind about Clomid:

http://www.peaktestosterone.com/Clomid_Risk

But just quitting HRT cold turkey can be pretty painful - it can take months to get back to where you were at. That's why it would be nice to use some alterative way to keep those testosterone levels up in the meantime.

Let us know what you find out.

Also, "just living with low testosterone" with the aid of Cialis is debatable. I'm not saying that's not an option, of course. But just keep in mind that your reads with 280/360 are very low and can put you at risk for many medical conditions. And Cialis is rife with side effects and risks as well. So it's not a no brainer and is something you should research and discuss with a pointy-headed doc...

Peak Testosterone Forum · « **Reply #3 on:** January 15, 2013, 04:10:41 am »

feelgood · « **Reply #4 on:** January 15, 2013, 02:03:24 pm »

definitely look into clomid and/or HCG to recharge/super charge your fertility again...

Clomid took my sperm count numbers from very low into the way high end, and it improved the quality.

My urologist said HCG (which i'm on now) is even more powerful/good for sperm.

399 · « **Reply #5 on:** January 15, 2013, 08:41:30 pm »

your sperm is being temporarily suppressed by the hrt, there's no reason to think you were sterile before going on it. you may have been borderline low on sperm just like t, but the hrt definitely reduces or eliminates sperm counts

Danceny · « **Reply #6 on:** January 21, 2013, 11:57:06 am »

I saw the urologist, and he told me just to wait 3-6 months for sperm and T production to come back (and for my nuts to regain full size). Wouldn't offer me any drugs to hasten the process (he said that spermatogenesis is a process that takes several months regardless) or to mitigate the symptoms of HRT cessation. I mentioned hCG -- had to remind him how it acts on the HPTA (!) -- and he said he wouldn't prescribe it, that I'd need to see an endocrinologist for that and get a detailed workup of hormones.

Think I should look for a doc who'll give me hCG / Clomid, or just ride this out?

Thanks

PeakT · « **Reply #7 on:** January 21, 2013, 02:41:28 pm »

I can only tell you that from what I've read it's not fun to "ride out" those six months. I can't really adivse you on pharmaceuticals though. Some of the HRT clinics prescribe HCG now, so that's a pretty easy way to find it if you have the money.

Btw, don't get too mad at your urologist. HCG is kind of a specialty: it requires special monitoring and a little expertise that your doctor may feel like he's not int'd in. I think doctors should be interested in it if they are going to prescribe HRT for this and a couple of other situations. But that's just my two cents...

Danceny · « **Reply #8 on:** March 24, 2013, 06:53:48 pm »

Thanks again for all the info. Been off TRT for a couple of months (last injection Jan 11) and so far feel OK but haven't retested my levels.

I have another question: My wife is concerned about the effects on my sperm (once they come back). She says she read something suggesting that it can increase the risk of birth defects. Any research on this?

PeakT · « **Reply #9 on:** March 25, 2013, 05:34:32 pm »

Quote from: Danceny on March 24, 2013, 06:53:48 pm

Thanks again for all the info. Been off TRT for a couple of months (last injection Jan 11) and so far feel OK but haven't retested my levels.

I have another question: My wife is concerned about the effects on my sperm (once they come back). She says she read something suggesting that it can increase the risk of birth defects. Any research on this?

Clomid or HRT? I haven't heard of anything on either. In the case of HRT with bioidentical testosterone, I would be surprised. Or are you talking about Clomid?

Danceny · « **Reply #10 on:** March 25, 2013, 05:52:43 pm »

Just HRT (testosterone enanthate). I stopped the injections in January and have not taken Clomid or anything else to "cycle off." Is there a concern with Clomid?

PeakT · « **Reply #11 on:** March 25, 2013, 05:58:11 pm »

Quote from: Danceny on March 25, 2013, 05:52:43 pm

Just HRT (testosterone enanthate). I stopped the injections in January and have not taken Clomid or anything else to "cycle off." Is there a concern with Clomid?

Again, I know of none with either, but you certainly need to ask a pointy-headed fertility specialist a question like that. I do know that Clomid is quite widely used for male fertility, so I certainly hope not!

Let us know if you find out anything.

Clomid can affect vision though:

http://www.peaktestosterone.com/Clomid_Risk

Peak Testosterone Forum · « **Reply #11 on:** March 25, 2013, 05:58:11 pm »

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