Help interpreting blood work during and immediately after PCT

[kaizoku]

@Zyzż_

Feeling great!

Currently taking 200iu HCG EOD (to assist with sperm production)

Along with the following vitamin/supplement stack ED:
6mg Boron
90mg Pycnogenol
100mg Coq10
2000mg Vit C
10000mg Vit D
ZMA with 30mg Zinc/450mg Mag

Wife should be ovulating in a week or so and I plan on giving her the business a couple times a day before/after. If she doesn't get pregnant this time around I'll stay on the HCG for another month and try again next month. If it doesn't happen then I'll stop the HCG and just let things take their course.

 

[kaizoku]

Been feeling good but didn't get the wife pregnant last month, still waiting to find out if it happened this time.

Dropped the HCG yesterday.

Just going to let things take their course from here.
Might go get blood work in another month just to see where I am.

 

[kaizoku]

Figured I'd throw an update in here.

Still feel good...strong morning wood and libido most days.
Haven't been taking anything for the last 2 months other than coq10, vitamin c and d, and boron.

Latest blood work
Test 334
E2 18 (ultrasensitive test)
LH 3.6
FSH 4.5

Found out I have a varicocele also, which could be contributing to my low test levels. Supposed to get that fixed in the next few weeks.

 

[Worf]

sucks about the varicocele , hope the procedure goes well

 

[Dr JIM]

Bc not all varicceles are created equal the impact on TT levels
varies also.

Varicoceleotomy/ectomy is generally more beneficial in males w infertility bc the enhanced vascular flow impedes sperm development and/or maturation.

To that end, the effects of reversal are not as pronounced on those with low TT levels.

Yes the improvement in TT levels is often statistically significant BUT are not necessarily clinically
relevant.

WTH does that mean?

While a 10% increase in your TT level, from say 500 to 550ng/dL,
maybe statistically significant, such an improvement will NOT improve your libido, enhance LBM
or effect your overall quality of life.

Jim

 

[kaizoku]

Urologist rescheduled on me...going in next week to get this varicocele looked at and explore my options.

If sperm count/motility are good, just gonna leave it alone.

 

[kaizoku]

And what make you believe these labs are not reflective of effective HTPA recovery?

I mean low dose TRT is not going to end your virility for months on end and at your dosages recovery may require a couple months, which is why “PCT” is unwarranted.

Yea I know but, but, but surprise surprise surprise contrary to “low T” blog misinformation a TT level above 300ng/dL is NORMAL for many folk!

Stop focusing on the “level” and obtain a sperm count, bc chances are (unless you have infertility issues in the past) it should be fine.

Jim

Had semen analysis done.
Fertility looks like I'm basically shooting blanks.

1.5m/ML
33% motility
1% Kruger strict morphology

Doc pulled bloods for test, LH and FSH yesterday.
Follow up appt in 2 weeks to discuss my options.

 

[kaizoku]

Wish I could edit the thread title because this is turning into a saga of recovery and fertility.

Latest bloodwork came back:
TT: 291 ng/dl (300-781)
FSH: 4.4 mIU/mL (1.6-8.0)
LH: 4.1 mIU/mL (1.5-9.3)

Doc told me my options are either surgery to repair the small varicocele (he was really pushing surgery even though he said I only had a 25% chance it would do anything) or "do not pass go, go straight to IVF"

Asked him about Clomid/HCG/HMG combo and after some back and forth he agreed to 50mg Clomid 3x per week for 3 months and reevaluate, and flat out wouldn't even acknowledge HCG and HMG as treatment options.

When I asked about treating the low T after fertility is fixed and I get my wife pregnant he said my #s weren't low enough for test and I could take the clomid indefinitely to raise test.

Obviously I'll be finding a new doctor (reproductive endocrinologist vs urologist) in the next 3 months who will be more forward thinking.

 

[Worf]

Wish I could edit the thread title because this is turning into a saga of recovery and fertility.

Latest bloodwork came back:
TT: 291 ng/dl (300-781)
FSH: 4.4 mIU/mL (1.6-8.0)
LH: 4.1 mIU/mL (1.5-9.3)

Doc told me my options are either surgery to repair the small varicocele (he was really pushing surgery even though he said I only had a 25% chance it would do anything) or "do not pass go, go straight to IVF"

Asked him about Clomid/HCG/HMG combo and after some back and forth he agreed to 50mg Clomid 3x per week for 3 months and reevaluate, and flat out wouldn't even acknowledge HCG and HMG as treatment options.

When I asked about treating the low T after fertility is fixed and I get my wife pregnant he said my #s weren't low enough for test and I could take the clomid indefinitely to raise test.

Obviously I'll be finding a new doctor (reproductive endocrinologist vs urologist) in the next 3 months who will be more forward thinking.

You would be smart to do this. It's so sad to hear these stories about self serving doctors who aren't really willing to help their patients. These folks are more concerned about what anti depressants or "tests" they can do on you, but when that information is right there in front of their face they decline to treat. They will operate and scan until your bank account is empty but when there's a simple solution to an issue they "dont think it's necessary". Find a doctor with your well being in mind, not a doc that is stuck in 1980's medical text. This is why so many have to take it into their own hands or find a trt specialist. The new trend in men's health is finally starting to lean in our favor. Worst case you can treat your self by sourcing your own meds and blood tests. The sperm tests are most likely another story.

You can source HCG/FSH on your own. Personally I'd recommend HCG 500 IU 3xweek and clomid 25mg 3x week. It's a pretty damn good fertility cocktail and the price is reasonable.

Good luck man

Had semen analysis done.
Fertility looks like I'm basically shooting blanks.

1.5m/ML
33% motility
1% Kruger strict morphology

Doc pulled bloods for test, LH and FSH yesterday.
Follow up appt in 2 weeks to discuss my options.

Did they say how many million sperm? over 10 million to 1 ml is considered fertile. Over 20mil has extremely high success rate for conception

 

[kaizoku]

You can source HCG/FSH on your own. Personally I'd recommend HCG 500 IU 3xweek and clomid 25mg 3x week. It's a pretty damn good fertility cocktail and the price is reasonable.

Good luck man

Did they say how many million sperm? over 10 million to 1 ml is considered fertile. Over 20mil has extremely high success rate for conception

Thanks. Got a pretty good stash of HCG and already started at 500iu EOD and 25mg Clomid ED as soon as I got home from the doctor.

Clomid is from reliablerx (already had on hand) because my brainiac doc sent my pharmacy a script for clomipramine (OCD treatment drug) instead of clomiphene.

Sperm count was 1.5 million/mL, so I'm making some, but not much.
Going to give this cocktail a try while I look for a fertility doc, and if that doesn't work I'll drop the $$$ on HMG.

~$1500-$2000 for 90 days of generic HMG vs $20k-40k for IVF.
Totally worf it in my opinion.

 

[The Terminator]

Thanks. Got a pretty good stash of HCG and already started at 500iu EOD and 25mg Clomid ED as soon as I got home from the doctor.

Clomid is from reliablerx (already had on hand) because my brainiac doc sent my pharmacy a script for clomipramine (OCD treatment drug) instead of clomiphene.

Sperm count was 1.5 million/mL, so I'm making some, but not much.
Going to give this cocktail a try while I look for a fertility doc, and if that doesn't work I'll drop the $$$ on HMG.

~$1500-$2000 for 90 days of generic HMG vs $20k-40k for IVF.
Totally worf it in my opinion.

Good thing you looked and made sure it was not the right medication cause that clomipramine would have given you severe ed/libido loss, which would make attempting a pregnancy quite challenging.

Did the dr give any reason for not wanting to prescribe hCG or hmg or just ignored their existence? Sounds like they’d be better for male fertility than clomifene.

 

[Dr JIM]

Wish I could edit the thread title because this is turning into a saga of recovery and fertility.

Latest bloodwork came back:
TT: 291 ng/dl (300-781)
FSH: 4.4 mIU/mL (1.6-8.0)
LH: 4.1 mIU/mL (1.5-9.3)

Doc told me my options are either surgery to repair the small varicocele (he was really pushing surgery even though he said I only had a 25% chance it would do anything) or "do not pass go, go straight to IVF"

Asked him about Clomid/HCG/HMG combo and after some back and forth he agreed to 50mg Clomid 3x per week for 3 months and reevaluate, and flat out wouldn't even acknowledge HCG and HMG as treatment options.

When I asked about treating the low T after fertility is fixed and I get my wife pregnant he said my #s weren't low enough for test and I could take the clomid indefinitely to raise test.

Obviously I'll be finding a new doctor (reproductive endocrinologist vs urologist) in the next 3 months who will be more forward thinking.

Sorry fella but based on your semen analysis even IVF is unlikely to make much a difference and that’s what your Urologist is trying to tell you.

I hope it works out but keep thinking something must and can be done exclusive of was recommended by your urologists -as in Clomid - to achieve an onjective end point PREGNANCY, and chances are you'll end up spending tens thousands on ineffective therapy, esp if the drugs are not legitimate US Pharmas.

Try to underdtand a sperm count of one mil doesn’t mean squat unless they are motile and morphologically sound. And collating a bunch of bad sperm in a vial for IVF, May increase the risk of genetic defects should pregnancy be achieved

And in your case since all THREE parameters (number, motility and morphology) are grossly abnormal Genetics becomes the most likely
cause of infertility and unfortunately that’s a problem no amount of drug or surgery can remedy.

I’m not saying give up but try to LISTEN
to what your docs are saying, rather than ignoring their advice simply bc they are not offering what you want to HEAR.

And the most meaningfull question to as any fertility specialist; what is the PREGNANCY RATE with this form of therapy.

Good luck


Jim

 

[The Terminator]

Oh I just remembered someone here said they were basically sterile after years blast/cruising but after working with dr Scally got his count to 20 million. Obviously idk what the difference in your situation and his are but seems like there’s always hope. Here’s the link to where I read it, should take you directly to it but if it doesn’t it’s post #8 Proposed “feel good” blast!

 

[Worf]

Thanks. Got a pretty good stash of HCG and already started at 500iu EOD and 25mg Clomid ED as soon as I got home from the doctor.

Clomid is from reliablerx (already had on hand) because my brainiac doc sent my pharmacy a script for clomipramine (OCD treatment drug) instead of clomiphene.

Sperm count was 1.5 million/mL, so I'm making some, but not much.
Going to give this cocktail a try while I look for a fertility doc, and if that doesn't work I'll drop the $$$ on HMG.

~$1500-$2000 for 90 days of generic HMG vs $20k-40k for IVF.
Totally worf it in my opinion.

Youre better off with hcg & FSH separate rather than HMG. Its more cost effective IME. FSH is pure Folicile Stimulation Hormone(directly responsible for sperm production) where as HMG is a mix of hcg and fsh. Clomid and HCG is a very good start. I'd be very damn careful if a doctor cant prescribe the right meds and isnt interested in using HCG for fertility treatment. Clomid on its own has a very high success rate but the sides can bother some. HCG/FSH fertility treatment has over 70% success based on studies. Just because they are doctors doesnt mean they have your best interest in mind.
Good luck

 

[Dr JIM]

HCG/FSH fertility treatment has over 70% success based on studies.
Good luck

Post that study/ies ?

Define success ?

Last but not least, the individual reproducibility of any infertility study, must take into consideration a variety of factors most important of which are LABS and SEMEN

And based upon the OPs labs and semen analysis alone the success rate is no where close to 70%!

Finally with deference to those trying to help the OP needs to understand the greatest hope of achieving
the desired result, is unequivocally achieved thru the use of medical specialists, rather than following
the advice of untrained and inexperienced PED forum/blog members.

Jim

 

[Dr JIM]

And I’ll also say Clomid is well tolerated by the overwhelming majority of infertility patients (male and female alike) bc a reasonable therapeutic dosage, of a US Pharma product, is used and prescribed.

Jim

 

[Worf]

Successful fertility treatment with gonadotrophin therapy for male hypogonadotrophic hypogonadism
Single case study success but there is a reference to 80% success rate. This case may be relevant since the patient was ASIHH guy

Medical treatment of male infertility
success rate 80-94% but doesnt specify concentration of sperm in ejaculate

https://www.fertstert.org/article/S0015-0282(16)47127-X/pdf Reference to HCG only and dated 1983, obviously hcg only is not as successful

Induction of Spermatogenesis and Fertility during Gonadotropin Treatment of Gonadotropin-Deficient Infertile Men: Predictors of Fertility Outcome Approximately 40% conception non IVF, 50% achieved >20million/ml sperm concentration

https://www.kup.at/kup/pdf/11275.pdf
71% pregnancy with various gondatropin combinations
http://www.bioline.org.br/pdf?rm12063
62.5% pregnancy rate, a study on varicocele patients

 

[Dr JIM]

Successful fertility treatment with gonadotrophin therapy for male hypogonadotrophic hypogonadism
Single case study success but there is a reference to 80% success rate. This case may be relevant since the patient was ASIHH guy

Medical treatment of male infertility
success rate 80-94% but doesnt specify concentration of sperm in ejaculate

https://www.fertstert.org/article/S0015-0282(16)47127-X/pdf Reference to HCG only and dated 1983, obviously hcg only is not as successful

Induction of Spermatogenesis and Fertility during Gonadotropin Treatment of Gonadotropin-Deficient Infertile Men: Predictors of Fertility Outcome Approximately 40% conception non IVF, 50% achieved >20million/ml sperm concentration

https://www.kup.at/kup/pdf/11275.pdf
71% pregnancy with various gondatropin combinations
http://www.bioline.org.br/pdf?rm12063
62.5% pregnancy rate, a study on varicocele patients

Anyone can post a study and quote abstract results, but few can apply that same data to an individualized patient.

I challenge you to CAREFULLY review the medical therapy vs varicocele study and apply that data to THE OP!

You may also want to read the other studies more carefully bc any infertility study worth quoting must have a CONTROL group and use PREGNANCY rate as the primary end point.

 

[kaizoku]

Decided to just go through with the varicocele repair surgery.
Had it done yesterday.

 

[kaizoku]

Surgery recovery is going well.

Still a little sore and swollen but considering my ballsack was the size of a grapefruit for a week after the surgery everything is going great.

Been following doctor's orders too.
50mg of pharma clomid M/W/F.
Follow up semen analysis and bloodwork in 3 months.