Getting a girl pregnant after a decade of use and almost no sperm count?

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I am 36 and have been using since I was 19. I never used a large amount of gear but never came off much either. Now I am considering have a family and im pretty much shooting blanks. I seriously doubt going off completely will do much because last I tried my test levels never came back up much. So what are my options if I stay but add other medications to hopefully get her pregnant?

You say you are "shooting blanks". Presumably that mean no birth control for at least a year with no results. (clinics don't consider one having fertility issues until its been at least a year).

You'll have to decide your goals here. Maybe you can stay on some T and just add the other stuff - maybe not. But if you are serious about kids, do the full PCT (which you can look up here). Just start first with a few weeks of hcg.

After you've done this, it takes about 3 months to make sperm. So figure 5 weeks hcg + 1 week wait + 6 weeks PCT + 3 months THEN get sperm analysis [ ~6 months ]. If you wish to get T, LH and FSH, then wait a couple weeks after PCT. (LH and FSH will tell you if your hypothalmus + pituitary are working correctly. If so, then T will tell you if testes are working - fiddling around with androgens for 17 years will make these organs rather 'lazy')

You could, of course just go to a clinic. Let them see the blanks and prescribe what to do.