Hey all

Just seeking advice on the hormonal treatment.

I’ve always had elevated FSH/LH levels and low testosterone levels. All my chromosome testings are normal. My cause is idiopathic and I’m 27 with BMI 30. Been azoospermic for the last 4 years.

My underlying health issues are non alcoholic fatty liver, thymic atrophy, osteoporosis (higher risk) and pineal cyst. I honestly believe that they are results of low testosterone. Never had them prior to my diagnosis. Gained weight (due to excess estrogen?) throughout my hypogonadism period.

Currently on Clomid medication but not seeing any positive results. Took TRT for a month due to my fatty liver inflammation more weight gains but came off for fertility reasons. Further tested on my insulin, glucose and growth hormone levels, and all related bloodworks came out normal. Only deficient in vit D and lipid studies (cholesterol).

Potentially want to come off from Clomid and maybe start on TRT HCG HMG under my endocrinologist’s supervision???

I experienced TRT alone with great results because it helps me improving my underlying health conditions, however there’s a downside of TRT that it might cause me infertile permanently. That’s why I wanna keep my FSH/LH replaced with HCG/HMG if sounds a good idea? Gotta let my pituitary gland retire?

On the last day of my TRT, I saw my fsh level significantly dropped from 26 to 18. Does that mean my spermatogenesis is alive but asleep? my LH always been remained the same during TRT use. I know my numbers somehow represent SCOS without confirming a biopsy. Can’t be 100% sure on this.

Also, got left sided varicocele minor microliathiasis inside both testes. I know the fact that white stones in the testes used to be germ cells? Is this not SCOS? I only care about my Sertoli cell to be alive and produce sperm at some point. Then freeze some? The only issue here is my leydig cell damage or dysfunction, perhaps I have to take testosterone from the outside?

Microtese is one of the options but I will keep this as a last resort. Probably need to raise my testosterone levels up first and then jump onto this????

Stem cell therapy is third another option for me. There’s a doubt of efficacy and safety in using that and I have seen only one journal on the website. Will take this after exhausting all options. Don’t know much about it

My 2 questions here are:

What’s your experience like with your TRT HCG HMG? Outcomes? Side effects? I can’t source them anywhere but have an appointment with an endocrinologist in 1.5months time. Will request this treatment if seems appropriate. Dr Peru in Istanbul has this protocol but pushing it here in Australia.

Another question:

The concentration of testosterone in the testes is really high and produces sperm at an efficient time. If I take all these listed injections, does that mean that I will produce sperm in a year or two because it’s a slower sperm production??? Maybe I’m wrong. If sperm isn’t coming out due to testicular atrophy, will jump on the microtese. That’s my plan.

Thank you.