hCG and TRT (Testosterone Replacement Therapy) for Men - hCG and Fertility

It's not uncommon for men to take hCG while on TRT as hCG provides a number of unique benefits for men on TRT. There is clinical evidence that hCG can preserve fertility in men on TRT.
1. What is hCG and why might it be recommended for a patient instead of traditional injections of testosterone cypionate?
2. Are there benefits to using hCG beyond maintaining fertility?
3. What does hCG monotherapy look like?
4. Is hCG ever combined with other medicines?
To learn more, go to tctmed.com/resource/hcg-low-testosterone-fertility

[@Mountainman524]

I took a HCG due to low testosterone because of issues with my pituitary and my body responded quite nicely. My testosterone went from around 200 to 900 by just taking hCG.

[@TCTmed]

@Mountainman524: That's fantastic! Do you follow your calculated free testosterone levels, and do you have any negative issues with estradiol? Best regards, Augie Galindo, MPAS, PA-C Testosterone Centers of Texas | Managing Partner

[@LucasGreen-kb1sl]

what dose did you use?

[@Mountainman524]

@@LucasGreen-kb1slaround 2 ML a week. My body makes very low LH so in my situation it works. If your body has low LH and low testosterone HCG maybe perfect for you. I’d first try everything natural you can, diet, vitamins for testosterone etc and if no progress try HCG. It’s terrible big pharma made it so expensive and eliminated compounding pharmacies

[@IDWIE]

I’ve had two healthy kids while on TRT and HCG. No issues whatsoever.

[@TCTmed]

IDWIE: That is what I typically see as well. My third child was conceived while I was on TRT plus hCG. Best regards, Augie Galindo, MPAS, PA-C Testosterone Centers of Texas | Founding Partner

[@hankmoody5514]

that's very good to hear

[@alialidjameleddine7285]

@@TCTmed hi could you tell me abt the kinds and names of TRT have used and what are the dosage for both hcg and TRT if you don't mind

[@TCTmed]

@@alialidjameleddine7285: We typically use testosterone cypionate. Unfortunately, we do not give out dosing suggestions. Best regards, Augie Galindo, MPAS, PA-C Testosterone Centers of Texas | Managing Partner

[@dexedr1ne]

Good to hear!

[@BJJ205]

While being on TRT for a year my wife and I decided to try for a baby. Every Dr I’ve been to wants me off the TRT and that scares the crap out of me. Best I’ve ever felt the last year and a half. Started HCG combined with the TRY hoping and praying that works.

[@TCTmed]

@adamtownsend5045: Your trepidation is common. I have seen cases where testosterone reduction was necessary to achieve optimal semen analysis (SA) results. Frequent, and relatively higher doses of hCG are also often needed. Be sure to keep up with serial SAs to assess the success or failure of changes in your regimen, and best of luck to you two!! Best regards, Augie Galindo MPAS, PA-C Testosterone Centers of Texas | Managing Partner

[@alexortiz501]

Do your clinic takes any kind of insurance

[@TCTmed]

@Alex Ortiz: Yes, sir! We are contracted with major insurers. However, we do not take any federal plans like Medicare or Medicaid. Best regards, Augie Galindo, MPAS, PA-C Testosterone Centers of Texas | Managing Partner

[@dreacastaneda2046]

my husband is going to try this. any down fall you experienced as a patient?

[@TCTmed]

Combination therapy for those who want to preserve fertility is a great option. As a patient, I was pleased with my results. Success is dependent upon good management. Make sure to do your due diligence on the provider selected! Best regards, Augie Galindo MPAS, PA-C Testosterone Centers of Texas | Managing Partner

[@dreacastaneda2046]

thank you. I hope I did and I hope we are a success with it. we will be starting these injections Monday. prayers please!

[@TCTmed]

@@dreacastaneda2046 Godspeed!

[@joseeiras9849]

Can you use hcg for the rest it your life with trt? Thanck you doctor

[@TCTmed]

@José Eiras: Some texts recommend it for only one year, but there are no studies I am aware of that show any deleterious side effects with continued, monitored use. Many of our patients have taken in weekly for several years without complications. However, this is as an adjunct to TRT, not monotherapy. In general, increased dosing or frequency commensurately increases any potential risk. Finally, hCG is becoming more challenging to obtain with its recent reclassification as a "biologic." Best regards, Augie Galindo, MPAS, PA-C Testosterone Centers of Texas | Managing Partner

[@kaszapnagypeter]

I am on sports trt for a while, 175 mg a week, but no hcg. My testicles are smaller and I dont like it, but love being on testosterone. Can I add hcg even if I am already on testosterone for a while or should I come off it first? Regards Peter

[@TCTmed]

@kaszapnagypeter: You can take hCG concurrently with testosterone. We have many patients that we manage in this way. Best regards, Augie Galindo MPAS, PA-C Testosterone Centers of Texas | Managing Partner

[@kaszapnagypeter]

@@TCTmed thank you

[@TCTmed]

@@kaszapnagypeter You are most welcome!

[@kaszapnagypeter]

@@TCTmed I have another question if you don't mind it. Do you think is it a good idea to take 250 ui of hcg 3 times a week and come off testosterone during the summer? I didn't have low testosterone before I was put on the sport trt. I don't really want to use it for the rest of my life. I am 35 years old, 182cm 82 kg. So the plan is to continue to take testosterone along with HCG until May and do a PCT with clomid. The reason for taking it is I am a student at University and self-employed besides the university. I have stopped taking it in the past 3 weeks and I have a brain fog but nothing else.

[@TCTmed]

@@kaszapnagypeter I am sorry, I cannot provide dosing recommendations.

[@ToddLiles]

What are your thoughts on dosing levels?

[@TCTmed]

@Todd Liles: Unfortunately, I have many thoughts on dosing, but giving them out across the internet and not to patients I manage directly opens me up to liabilities. I would suggest finding a provider you can trust locally. Best regards, Augie Galindo MPAS, PA-C Testosterone Centers of Texas | Managing Partner

[@The-Undiluted-Report]

Great Video. I am on TRT and HCG. My TRT dose is 160mg/dl at 80mg/dl twice weekly. But my Clinic only suggested 250IU of HCG once a week and I am not sure if this is enough. Is 250IU of HCG once a week enough to maintain fertility or should I increase my dosage?

[@TCTmed]

@Momodou Touray: Thank you for the feedback! I don't recommend changing doses without speaking with your provider, and I don't give dosing recommendations here, but I can tell you that I use a higher amount than 250 IU. That said, the definitive way to assess whether your dose is adequate is to compare a current semen analysis to a pre-treatment test. I hope that helps! Best regards, Augie Galindo, MPAS, PA-C Testosterone Centers of Texas | Managing Partner

[@nosurf2day0]

I had extremely low test levels and was on trt for years. My wife and I are unsuccessfully trying to get pregnant. We discovered my FSH and LH levels were extremely low as well as my sperm count at less than 1 million. My doctor prescribed me clomid and after two months use. Post two months, my FSH and LH levels are at the upper top range for both. In addition, my testiest have more than doubled in size. My Dr whom is not a very good communicator, just prescribed me hCG after several requests. I want to change my taking Clomid because my energy levels and sexual drive are nonexistent. I’m curious, if I remember you correctly, you said people who want to get pregnant in the future or maintain testicular function are prescribed Both TRT and HCG. I am going to and ask my doctor on my six week check up, if can go back on TRT....Or should I stay off TRT until we get pregnant? I really want to get back on TRT, I just don’t feel the same my energy levels my weight everything suffers because my testosterone levels are so low. If you have thoughts, I would love to hear them. In closing, I want to thank you for this video because from you, I learned about this [HCG] drug, what I didn’t get from my doctor.

[@TCTmed]

@S K: You are most welcome, this is exactly why we post these videos. Education and information matter. The most recent guidelines from The Endocrine Society recommend that patients not use testosterone "in the near term" of trying to achieve pregnancy. That said, I do personally feel confident that men with normal fertility prior to TRT, can maintain adequate fertility while using hCG concurrently with TRT. This is not based on a group of studies, is not part of the aforementioned guidelines, but instead is derived by 8 years of TRT focused practice, my own personal experience with TRT+hCG, clinical evidence collected through observation of TCT's patient population, and the undeniable mass of anecdotal experiences chronicled in countless TRT forums online. I do not like using Clomid due to its side effect profile and failure to produce long term benefit, as you experienced. Similarly, I have not found hCG monotherapy to be very helpful with increase testosterone levels optimally, and moreover it most often fails to improve the symptoms of hypogonadism. All that said, being a father is one of the single most important aspects of my life, so just make sure you prioritize appropriately as you weight the risk/benefit balance of TRT. Best of luck to you, and Happy New Year! Best regards, Augie Galindo MPAS, PA-C Testosterone Centers of Texas | Founding Partner

[@jigglybandito9505]

What about Clomid plus TRT?

[@TCTmed]

@Jiggly Bandito: I am just not a fan of Clomid in general. It makes more sense as an alternative to TRT, but I don't like that option either. It promotes things that are not necessary for most TRT patients, and its side effect profile includes the potential for significant vision disturbance. Best regards, Augie Galindo, MPAS, PA-C Testosterone Centers of Texas | Managing Partner

[@AlexVNL]

I used clomid for a while, it worked for bumping T levels to an acceptable range, but it gave me constant headaches.

[@bagnerdecruzzjuilis8703]

Hai thanks for this insightful info. Wanna ask you if is okay to conceive baby with TRT + HCG for the fetus's good overall development, chromosomes, morphology etc? Which one better to conceive baby is with TRT + HCG or HCG alone? Whats your duration on taking HCG during TRT dosage before start to conceive baby? I am 26 years old now, on long offseason (2.5 to 3 years before competing again) and on test e TRT dose 3 weeks ago, currently doing test e only cycle (TRT dose test e 125 mg 8 weeks, 250 test e 10 weeks and keep on repeating). Planning to conceive baby next year after my wedding and another 3-5 years from now, aiming 3 kids and a competitive bodybuilder as well. Thanks for the advice in advance.

[@TCTmed]

@Bagner Decruzz Juilis: Thank you for the feedback. No matter the dose, testosterone will always have some level of suppression of normal fertility. This may or may not be curtailed adequately by concurrent hCG use. So, hCG monotherapy, while not the best for testosterone levels, is the best for promoting fertility. If you are on an androgen hiatus now, I recommend seeing a fertility specialist for a semen analysis and strongly considering sperm banking if the report is favorable. Unfortunately, I don't give any dosing advice or treatment regimens in this forum. If you are stacking other anabolics, I don't have experience with those, so I can't offer any insight. Best of luck to you and the bride-to-be! Best regards, Augie Galindo, MPAS, PA-C Testosterone Centers of Texas | Managing Partner

[@ManpreetKaur-zw4xc]

Hey dr. I am on trt from past 6 weeks. Dr gives me 160mg test and 20 units of hcg. Once a week. Having hcg that low will have any side effects?

[@TCTmed]

@Manpreet Kaur: The low dose of hCG is unlikely to have any impact at all, so if you are worried about maintaining testicular size or fertility, that may need to be addressed. Best regards, Augie Galindo MPAS, PA-C Testosterone Centers of Texas | Founding Partner

[@cgl729]

In your own opinion: why would weight loss and low t clinics try to get someone only on hCG? Is it cos it is less regulated and they can "sell" more to someone-thinking it's better than TRT when its really not?

[@TCTmed]

@cgl729: From the TRT side, hCG is safer for fertility, so if someone is particularly trepidatious about suppressing their fertility, I could see why they may trial hCG monotherapy. Aside from that, I don't see an upside for the patient. Depending on the plan structure, a given clinic could be garnering a hefty profit for hCG. For weight loss, the efficacy of this kind of therapy has been debunked. Some patients swear by it, but there is no sound physiological reason why hCG would make someone lose weight, in and of itself. Most "hCG diets" require a VLCD (very-low-calorie-diet). Any minimally active adult adhering to a diet plan that consists of

[@ajaypathak3003]

Are testicular atrophy from testosterone injection misuse(3 injection in 4 months Testoviron depot 250mg) reversible without PCT ??( last injection 14 months ago) , please reply I m depressed, i am from india and I think here are no any trt, HCG,steroids specialist doctor in whole nation, now my lh=1.5, , FSH=5.30(before injection FSH was 6.00miu/l) , Prolactin=10.11, total testosterone=160ng/dl(before injection it was 370ng/dl ) age 21 now

[@TCTmed]

@Ajay Pathak: As daunting as the issue may be, testicular atrophy secondary to TRT is largely, if not completely reversible. Typically cessation of therapy is all that is necessary. The use of hCG can speed that response but is often not necessary. Best regards, Augie Galindo, MPAS, PA-C Testosterone Centers of Texas | Managing Partner

[@ajaypathak3003]

@@TCTmed I didn't expect that I'll get my answer thank you so much❤😊 may God bless you sir wish you a very happy life. can my testicles recovere on it's own? , are my hormone levels (FSH, lh,) normal?

[@MrSmithGuy]

I have been on TRT for 18 months now, I would like to introduce HCG to regain testicular size. Can you please tell me how long I can remain on HCG?

[@TCTmed]

@MrNickguy1: The only literature that I found on the subject did not establish its safety for over one year. That means it did not say that it was unsafe to use longer, but the study looked at only one year of therapy. For the purposes of treating testicular atrophy, I typically recommend that it is only used episodically. So, you would use it long enough to reverse the side effect and then stop until the problem re-presented. Aside from the aesthetics and personal desire, there is not a medical need to maintain pre-treatment testicular volume. Best regards, Augie Galindo MPAS, PA-C Testosterone Centers of Texas | Managing Partner

[@Cutecouplespkd]

Does taking hcg 5000mcg decrease sperm production in men?

[@TCTmed]

@palakkadan1062: Using hCG typically promotes healthy sperm production and is use by fertility specialists for this specific purpose. Best regards, Augie Galindo MPAS, PA-C Testosterone Centers of Texas | Managing Partner

[@eck63s36]

Hi , I’ve been on TRT for 2 years , with using HCG now would it still bring my Testis back and be of use to me , 51 years young , Thank you

[@TCTmed]

@Eck 63s: TRT would not change the responsiveness of your testes to hCG, so if you would have responded initially, you should respond now as well. Best regards, Augie Galindo MPAS, PA-C Testosterone Centers of Texas | Founding Partner

[@Openmindallthetime143]

What dosages do you recommend to your patients if taking it with trt doc? My dr put me on hcg 1000mg a month 1 shot a month and 1 a week 200 mg test cypionate

[@kaylapearcey2527]

Mine is 500, 2 times a week with 75mg test 2 times a week. I have dropped to 250, 2 times a week for 1 month and noticed no difference in how I felt and feel that's the bare minimum but I'm just a patient not your doctor. 1000 a month is pretty useless in my opinion though. Also have tried 1 shot of test a week and found splitting it up to 2 times a week I feel better. My test is 150 per gram and any thing over about .7g hurts a little to inject. There is no drop off of energy or an doing it 2 times a week. Also have been told it converts to estrogen less when the dose is split up.

[@Bobbydigtail17]

Hey Dr. I have a question. I’m on HMG 75 IU 3x’s a week and 2500 IU HCG 3x’s a week. Both are taken on alternating days. My T level is 265. My sperm count is at over 330 Million per ML but the issue I’m having is sperm volume. I’m literally only producing about 1 ML of volume. Do you think low T is the issue?

[@TCTmed]

Bobbydigtail17: The use of hCG alongside hMG is a bit redundant. The hMG contains FSH and LH, and hCG is an LH analog, so you're getting much of the same stimulation. However, trying to raise testosterone levels with this type of medication rarely yields satisfactory results. The medications are better at supporting fertility which is why you see your sperm count responding so well. Now, as for volume, what you are measuring is ejaculate, not sperm. Only 1-5% of ejaculate is sperm, and 2-6 mL volumes are considered normal. Prostatic activity is driven by DHT and other influences, so it can be lessened in the setting of testosterone deficiency. The prostate, the seminal vesicles, and the bulbourethral glands produce all contribute to the production of ejaculate. Hydration and frequency of ejaculation play a role, as do a multitude of other factors. So, the medications you are taking seem to be doing their job, but you may want to consider that the overstimulation of the testes can be a bad thing at times, as well. Low T may be a contributing factor, but it certainly isn't the only one. Best regards, Augie Galindo, MPAS, PA-C Testosterone Centers of Texas | Managing Partner

[@dexedr1ne]

Can you start taking HCG if you've been on TRT for more than half of year and expect to restore fertility if it's been damaged/stopped?

[@TCTmed]

@dex: Yes, you should still see fertility improvement even with having been on TRT for a while, assuming your fertility was normal at the onset. Testosterone will suppress fertility, but I have not seen cases where it damages or stops it. The Endocrine Society does recommend that you stop TRT in the "near term" of attempting to achieve pregnancy. Still, I have had many patients who have successfully fathered children while on TRT+hCG. Best regards, Augie Galindo, MPAS, PA-C Testosterone Centers of Texas | Managing Partner

[@dexedr1ne]

@@TCTmed Thank you so much for taking the time to answer my question. We have 2 kids and my quality of fertility I would have considered to have been normal. We want to try for a 3rd in just over a year so that's why I have some concerns. My clinic isn't too keen on prescribing HCG but I will talk to them again.

[@TCTmed]

@@dexedr1ne You are most welcome! Find second opinions if needed. Family comes first! Best regards, Augie Galindo, MPAS, PA-C Testosterone Centers of Texas | Managing Partner

[@dsd-downshiftdave8056]

I'm 44 and want to start trt not sure if it's better to stay on it or cycle on and off every 3 months- if cycling how long and when is hcg done, if on trt permanently how is Hcg done and should I be doing Nolvadex aswell- I'm planing on doing a moderate amount of testosterone- sorry one last if I do test prop for first 3 weeks will my libido kick in on a few days or is it same as enthante thank you so much for your help

[@TCTmed]

@DSD - Downshift Dave: I can give you some general tips, but unfortunately, we only make dosing recommendations to active patients due to liability and risk concerns. That said, I don't ever recommend cycling. If you are not pushing to abuse levels, it's just unnecessary. Both propionate and enanthate act similarly, and I prefer cypionate by far. We use hCG for two main reasons; to counteract problematic testicular atrophy and to support fertility. Outside of those reasons, I do not recommend its concurrent use. I hope that helps! Best regards, Augie Galindo MPAS, PA-C Testosterone Centers of Texas | Managing Partner

[@dsd-downshiftdave8056]

@@TCTmed thanks for the reply so you're saying stay on cyp test indefinitely run HCG straight too? I thought HCG couldn't be done for more then a few weeks

[@TCTmed]

@@dsd-downshiftdave8056 No problem! No, hCG can be taken at length as well, Dosing should be held at a minimally effective dose.

[@stauros12345]

Hello and thank you for this amazing video.Im on trt for 5 months now and i started hcg for 5 weeks now.Which blood test can show me if everything is going fine???thank you in advance

[@TCTmed]

@Stauros Sotiriou: Thank you for the feedback! Many levels need to be tested, but testing specifically for hCG levels is not normally done. We always keep tabs on calculated free T, total T, estradiol, hematocrit, and PSA levels, among others. Best regards, Augie Galindo MPAS, PA-C Testosterone Centers of Texas | Founding Partner

[@stauros12345]

@@TCTmed thank you for your answer on my question.One last thing.Lh and fsh test is one of the tests that should be done or they will still be on zero count?

[@TCTmed]

@@stauros12345 When it comes to TRT, LH and FSH are only helps as diagnostic information. They have no value going forward, particular to TRT. Best regards, Augie Galindo MPAS, PA-C Testosterone Centers of Texas | Founding Partner

[@stauros12345]

@@TCTmed thank you one more time for the information.So the only test that i can do since im using hcg for fertility is a fertility test or hcg levels in blood if o got it right?

[@TCTmed]

@@stauros12345 Measuring hCG levels is unlikely to be useful. Monitoring testosterone levels via blood tests and fertility by semen analysis would likely give you the best idea of how you are responding. Best regards, Augie Galindo MPAS, PA-C Testosterone Centers of Texas | Founding Partner

[@Gforc3r]

Nice info doc! Is HCG best taken in the evening prior to sleep? Is that benefitial to receive the most of the HCG dosage? Thanks doc! Keep up the content.

[@TCTmed]

@g4s 4 ever: Thank you for the kind feedback! When it comes to hCG, there will be little difference in results whether the injection is given in the morning vs. evening. Most of the recommendations out there regarding timing of injections, has to do with hCG for weight loss. It does, however, have a relatively short half-life. So, if you are wanting to mimic the body here (hCG being an analog of LH), that can also be difficult. LH secretion precedes an increase in testosterone, but the release of LH is pulsatile and more erratic as we age. All that to say this, it probably doesn't matter what time of day you take hCG for the purposes of TRT. Keeping the day of the week consistent is likely all you need to worry about. Best regards, Augie Galindo, MPAS, PA-C Testosterone Centers of Texas | Founding Partner

[@Gforc3r]

@@TCTmed Great doc, thanks for the reply back ! Keep up the content!

[@TCTmed]

@@Gforc3r You're most welcome. Wishing you all the best!

[@robertm5969]

Great video. I've tried avoiding TRT for years by optimizing diet/exercise and supplementing with vitamin d/zinc/magnesium, but my total test has been 220-270 along with low free T. Going to consult an endo but I'm aiming for weekly TRT and hCG injections, with dosage adjusted for high normal range. Is this a good baseline treatment plan, or would additional treatments (proviron for mitigation of aromatization) also be necessary? Thank you!

[@augiegalindo]

@Robert M: Thank you for the feedback. That matches with the basic underpinnings of our approach. I typically only use hCG for protection of fertility and/or treatment of testicular atrophy. Also, you don't want to prevent aromatization. For some, it may need to be controlled, but it should never be eliminated. Best regards, Augie Galindo MPAS, PA-C Testosterone Centers of Texas | Managing Partner

[@applebirds1nthefuture646]

@@augiegalindo before starting hrt of test should I paid it with hgc if I’m worried about future fertility or wait until I’m trying to conceive with partner to hop on hcg

[@TCTmed]

@@applebirds1nthefuture646 While I don't think it is entirely necessary, I usually recommend that patients concerned about maintaining fertility start with TRT+hCG adjunctively from the beginning. Best regards, Augie Galindo MPAS, PA-C Testosterone Centers of Texas | Managing Partner

[@tblade5208]

I'm about to start a testosterone cycle but I'm concerned about fertility so should I take HCG along with test or after.?

[@TCTmed]

@T Blade: We don't manage based on cycles, but for our patients, I recommend that anyone concerned about preserving fertility do so throughout the course of their TRT. Best regards, Augie Galindo MPAS, PA-C Testosterone Centers of Texas | Managing Partner

[@tblade5208]

@@TCTmed so how do I make sure that it doesn't interfere with my fertility.?

[@augiegalindo]

The only “sure” way is to not use TRT altogether. The safest was to improve testosterone, not optimize, is by using hCG only. In my opinion, it’s best to have your fertility assessed before starting TRT. For patients with normal fertility, using hCG alongside TRT has proven, anecdotally, to sufficiently support fertility. Best regards, Augie Galindo, MPAS, PA-C Testosterone Centers of Texas | Managing Partner

[@tblade5208]

@@augiegalindo like are you saying I should use HCG instead of testosterone?

[@TCTmed]

@@tblade5208 This is safest for fertility but not the best for testosterone optimization. It all boils down to a personal choice. Best regards, Augie Galindo MPAS, PA-C Testosterone Centers of Texas | Managing Partner

[@gac4785]

Hi Doc, So if we are on trt for life, and want to keep fertility, it is best to take hcg year long as well until we decided not to have kids?

[@TCTmed]

@GAC: The Endocrine Society recommends the cessation of testosterone during the "near term" in which you desire to father a child. However, in our practice, for those with established or presumedly normal pre-TRT fertility, I routinely recommend the concurrent use of hCG with TRT from the initiation of therapy. Of course, the safest course of action is to test your pre-treatment fertility, utilize sperm banking, and proceed with caution. That said, I have had many patients who have fathered children while they were on TRT+hCG without incident or fertility intervention. Best regards, Augie Galindo, MPAS, PA-C Testosterone Centers of Texas | Managing Partner

[@randall197]

Something I'm trying to find but can't... Can you tell me how high a concentration of HcG per Ml I can go? What i mean is if I have a 5000 iu/vial and 2ml of water, can I just use 1ml of the water to get a 500iu/ml concentration or do I have to use the whole 2ml for only a 250iu/ml concentration? Is there a maximum concentration per ml?

[@avyonorpheus699]

randall williams just mix it with the 2ml and inject 20 units for your 500 iu doss ( 100 unit insulin syringe )

[@mikereynold2078]

Is HCG still effective long term (5 years +) for maintaining fertility while on TRT?

[@augiegalindo]

@Mike Reynold, from what I have seen clinically and anecdotally, I believe that it is effective long term. Now, I do not have a longitudinal, double-blind, randomized control trial to point to, but my experience in the field has led me to this conclusion. Best regards, Augie Galindo, MPAS, PA-C Testosterone Centers of Texas | Managing Partner

[@anareyvazov1148]

Have you had any experience during your practise that someone being on TRT(100 mg a week) in conjunction with HCG, has had any fertility issue ? IF you have , do you think TRT should be stopped not to risk conceiving trials?

[@TCTmed]

Anar Eyvazov: I have not seen that kind of response, but we don't specifically assess fertility. If I had a TRT patient whose spouse was having difficulty conceiving, I would most likely council them to stop TRT until those issues were better investigated by a fertility specialist. Best regards, Augie Galindo, MPAS, PA-C Testosterone Centers of Texas | Founding Partner

[@Bobbydigtail17]

Would you consider low dose testosterone 50 Mg test E 2x’s a week and HMG 75 iu 3x’s a week for fertility or will I be shut down? I don’t want to have libido or ED issues

[@TCTmed]

@Bobbydigtail17: The only way to know for sure would be to conduct semen analyses pre-therapy and post-therapy. I only give dosing recommendations to patients I directly manage, so I cannot comment on the specifics of your questions. Best regards, Augie Galindo MPAS, PA-C Testosterone Centers of Texas | Managing Partner

[@sticknmove6202]

Dr very important question to you and I'm asking with all seriousness.While on trt I am also on arimidex,but my testicles was very shrunk it scared me.I just started hcg and I noticed 2 things and I noticed it fast.My libido went way up and it put more led in my pencil.lol! Seriously,is this supposed to happen on hcg? Thanks

[@TCTmed]

@Stickn Move: I have not seen that as a typical response to hCG. Now, TRT effects don't take place overnight, so it is very possible, if not probable, that other factors had more of an impact here than did the hCG. Best regards, Augie Galindo MPAS, PA-C Testosterone Centers of Texas | Managing Partner

[@sticknmove6202]

@@TCTmed Thanks doc

[@arielrodriguez975]

If your testosterone level is around the 700 to 800 can you build muscle?

[@augiegalindo]

@Ariel Rodriguez: A total serum testosterone of 700 to 800 is at the upper end of the normal range, so yes! In fact, you can still build muscle with much lower levels. Having low testosterone may negatively affect those body processes that rely on androgenic influence, but it doesn't ultimately destroy your body's ability to achieve them. Best regards, Augie Galindo MPAS, PA-C Testosterone Centers of Texas | Managing Partner

[@arielrodriguez975]

@@augiegalindo Thank you! Also what is good total testosterone number to build muscle? Pre testosterone therapy I was around 9 and I now have 19 but had 31 before with higher doses.

[@TCTmed]

@@arielrodriguez975: Really, anything in the upper half of normal will support anabolic activity. The rest comes down to training. Just because your total testosterone number is higher doesn't mean that you automatically have a great receptor response. There is a point with abuse of anabolics where the user surpasses the point of diminishing returns. Best regards, Augie Galindo MPAS, PA-C Testosterone Centers of Texas | Managing Partner

[@vapeking466]

Is 500iu a week of hcg enough to prevent atrophy while on trt? This is what the clinic I was going to gave me but now they shut down and trying to decide what to do. I am getting testosterone from another doctor but he isnt familiar with hcg but said he would prescribe it if I want to continue it.

[@TCTmed]

@VapeKing: That is different from patient to patient, but it's not a bad place to start. Best regards, Augie Galindo MPAS, PA-C Testosterone Centers of Texas | Founding Partner

[@raywalteroutdoors]

My balls still shrunk and my semen production decreased while using HCG. I'm not freaking out. I'll give it another week and see if they bounce back. If not, I have labs next week so we'll figure out what is out of whack.

[@kemo6310]

doctor I suffer from both low testosterone and depression my doctor prescribed zoloft for my depression I am afraid it will kill my libido as I really don't have due to low t can I take zolift as I tried several others antidepressant and neither worked for me,and can you recommend a trt protocol to maintain my fertility as I want to conceive a child ,thank you for your patience

[@TCTmed]

@kemo6310: In my personal experience, I have seen a better result with Wellbutrin in terms of negative effects that may limit the success of TRT. That said, I would caution you to make your best choice on medication to treat your depression, primarily from the standpoint of optimally managing your depression. Taking care of your mental health takes precedence over testosterone treatment. Zoloft and other SSRIs are not contraindicated with TRT, so you may use whichever serves you best. You can look at options like hCG monotherapy that could simultaneously increase your testosterone levels and protect fertility. Best regards, Augie Galindo, MPAS, PA-C Testosterone Centers of Texas | Managing Partner

[@kemo6310]

@@TCTmed Thank you doctor .I tried hcg with hmg for 6 months but it only works for fertility but my testosterone remain low ,so can I use both trt and hcg?

[@TCTmed]

@@kemo6310 I use hCG concurrently with my TRT patients fairly regularly, but keep in mind that there will still be some degree of suppression of fertility. Best regards, Augie Galindo MPAS, PA-C Testosterone Centers of Texas | Managing Partner

[@kemo6310]

Thank you very much doctor

[@ploscaruvasile8033]

SUSTANON 250 / WEEK + masteron E 100 / wek and you will dont have any depression again ...

[@tijnpeeters6475]

Hey there doc, My doc put me on hcg twice a week at 1500iu x 2 for TRT. No testosterone, just hcg. Because he wanted to keep me fertile and he thought this will do the job, what’s your opinion about this?

[@TCTmed]

@Tijn Peeters: I am not a fan of hCG monotherapy. It does very little to improve testosterone production without very high, frequent injections. In my experience, though not well studied in the literature, I have found that concurrent use of hCG alongside testosterone preserved previously normal fertility satisfactorily. Best regards, Augie Galindo, MPAS, PA-C Testosterone Centers of Texas | Managing Partner

[@Mountainman524]

@Tijn Peeters How did the Mono HCG treatment work for you? Where was your LH levels before and after HCG mono treatment? Testosterone levels? I was put on 1 ML once per week but I’m wondering if that will even do anything for my low T caused by very low LH 1.0

[@gauravthombre4155]

Sir I am 18 yr old and I was diagnosed with low testosterone my testosterone was 1.25 ng/ml my doctor given me 3 hcg injections continue 3 days 2000iu and then testosterone was 6.54 ng/ml. But when I was 15 my then also my testosterone was low and doctor had given me 3 testosterone inj. Will my testosterone again come low?. Or this was permanently cure.my lh and fsh was normal (sorry for bad English)

[@TCTmed]

@Gaurav Thombre: Unfortunately, there is no permanent cure. To maintain normal levels, you will most likely need to continue ongoing treatment. I have found that hCG doses typically need to be done at least three times per week, with rather high doses. However, it does offer the benefit of not suppressing fertility during use as testosterone does. Best regards, Augie Galindo MPAS, PA-C Testosterone Centers of Texas | Founding Partner

[@MohamedAli-fu7tv]

I have a question and I'm really looking for an answer especially now that it's affecting my mood daily and my mental health. Im 20 years old and my left testicle is atrophied for a year now due varicocele and I just discovered the softness and shrinkage from a month ago because I wasn't educated enough on the subject but clearly I had the atrophy for some time now probably more than a year, so my question is: if I removed the vericocele surigically and started hcg therapy would I still be able to get my testicle function and size back?, And if so wouldn't that treatment affect my right testicle as well? (nb. I never used trt in my life) Really looking forward for your response. Thank you

[@TCTmed]

Hello! Surgical correction of a varicocele could prevent worsening of any testicular damage that may already be present but is unlikely to "salvage" previous production levels, and even hCG would not help regain anything loss. That said, it is also possible to get normal production from the unaffected testis, and the affected side is still likely to be active to some degree. Treatment with hCG or testosterone should only be used to replace natural production after a true deficiency is identified. Best regards, Augie Galindo MPAS, PA-C Testosterone Centers of Texas | Managing Partner

[@MohamedAli-fu7tv]

@@TCTmed Thank you for your reply. One last question, so if the left testi is somewhat salvagable after correction or maybe not would you recommend TRT and HCG therapy to balance the missing testosterone at the age of 20?

[@TCTmed]

@@MohamedAli-fu7tv, I would in some circumstances, but you have to weigh the impact of suppression of fertility along with everything else.

[@MohamedAli-fu7tv]

@@TCTmed but I thought CHG was there to prevent fertility suppression in the healthy testicle

[@TCTmed]

@@MohamedAli-fu7tv It does, but variably so.

[@bilalhamurabi3362]

Hi, Did you ever experience a case where longterm trt without hcg led to infertility in a Patient? Im 32 and my doc recommended to me to take Testosterone 4 years ago but the fear of being left infertile has stopped me from doing trt =/

[@TCTmed]

@Bilal Hamurabi: I have seen no evidence of this occurring. In fact, the updated position of The Endocrine Society recommends only that testosterone not be used in the "near term" of trying to achieve conception. That being said, many of my TRT patients have fathered children without issue while remaining on therapy. Many of them take hCG alongside testosterone to help mitigate the suppression of fertility. Best regards, Augie Galindo MPAS, PA-C Testosterone Centers of Texas | Founding Partner

[@bilalhamurabi3362]

@@TCTmed thank you so much. i think i will insist on hcg 500 eod then because im too afraid to lose fertility.

[@TCTmed]

@@bilalhamurabi3362 No problem!

[@muhammadsajidsaeed2665]

Sir please help me i have hcg powder with sodium chloride solution, in 5000 iu power , i have to use it multiple times, can i store mixture in fridge for a month use? As i have heard that solution in sodium chloride is for only one time use, some says that use Bacteriostatic water but here in Pakistan it is not available . Please guide me, i have to use with trt.

[@TCTmed]

@M Sajid Msc Maths: Unfortunately, only the pharmacy that made the hCG can answer that. The "beyond use dating" and stability information is often lot-specific, and yes, the preparatory diluent matters. I would recommend reaching out to the manufacturer/pharmacy. Best regards, Augie Galindo, MPAS, PA-C Testosterone Centers of Texas | Managing Partner

[@robinsus]

Do HCG suppress natural LH levels?

[@TCTmed]

@Robin: It does not appear to do so directly. However, hCG can increase testosterone, and increasing testosterone levels has a suppressive effect on LH secretion. Also, hCG attaches to LH receptors, but exhibits a much stronger response, mostly due to its much longer half-life; on the order of 30 minutes vs. 36 hours. This results in a reduction in the expression of LH receptors. Best regards, Augie Galindo MPAS, PA-C Testosterone Centers of Texas | Managing Partner

[@robinsus]

@@TCTmed thanks.

[@TCTmed]

@@robinsus, you are most welcome!

[@rawhan8602]

What about HMG it's made from the urine of postmenopausal women and have both lh and fsh

[@TCTmed]

@rawad hanna: Menotropin is still reliant on the testes being normally reactive to upper axis stimulation. Best regards, Augie Galindo MPAS, PA-C Testosterone Centers of Texas | Founding Partner

[@stauros12345]

Hello and thank you for ths very informative video.Im on trt 5 months now on 120mg cypionate and blood test showed 475nmol/l .I did also a semen analysis and it came up that im on 5 million sperm per ml of semen so i started HCG to restore things up.Im taking 500 ius day by day.Is this a good dosage for sperm to rise up again?

[@Helppeople369]

Can i take HCG without TRT ??

[@TCTmed]

@Ali Gaban: You definitely can. Monotherapy with hCG rarely gets patients where they want to be with regard to symptom management, but it is an option. In the US, hCG is getting harder and harder to come by. It has been reclassified as a biologic, which restricts its ease of manufacturing. Eventually, only commercially available brands will be available. Alternatives like kisspeptin are also on the rise, though. Best regards, Augie Galindo MPAS, PA-C Testosterone Centers of Texas | Managing Partner

[@Helppeople369]

@@TCTmed Thank you so much I live in Houston TX Where can i get kisspeptin 10 from ? And where you located at ? Can you help me get the kisspeptin 10

[@TCTmed]

@@Helppeople369, we can treat you remotely via our telemedicine program. Just head to our website (tctmed.com/remote-trt-clinic/) and fill out the contact form to get started. Best regards, Augie Galindo MPAS, PA-C Testosterone Centers of Texas | Managing Partner

[@Helppeople369]

@@TCTmed I sent my application nobody replied back to me My doctor doesn’t know what kissppeptin is And i asked my pharmacist he doesn’t know it either Is it available in pharmacies? Or specific ones only?

[@TCTmed]

@@Helppeople369 I am sorry for the failed response. Feel free to email me directly at (altered to avoid bot spam) a.galindo(@)tctmed.com. I will make sure to get you plugged in with our TM team. Best regards, Augie Galindo MPAS, PA-C Testosterone Centers of Texas | Managing Partner

[@thewaterlife9045]

Can I take HCG 5000 1st time ??

[@TCTmed]

I'm sorry, we cannot give dosing without managing your care.

[@robinhood463]

Progesteroncream has.the same Effect, i think.. My Testies are normal and my Libido increase.

[@SaturnDancer10]

HCG works right away

[@colinbrown9044]

Hey I'm in Nova Scotia, we have garbage healthcare here, can I just pay you and send lobsters for advice

[@AdeelAhmedFirefighter]

Did anyone got child after starting TRT

[@TCTmed]

@Adeel Khan: Yes sir, many. Best regards, Augie Galindo MPAS, PA-C Testosterone Centers of Texas | Founding Partner

[@AdeelAhmedFirefighter]

@@TCTmed It's a great pleasure that you have replied I live in Pakistan and It is very difficult task to find a reasonable Dr. Regarding TRT or even I don't know there is TRT centre but I am following you on KZbin I might need some help in future. Keep continue this welfare.

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