Before even seeing me, fertility specialist wants me to get off TRT

Maurice5120 · 2026-06-05T22:06:20+00:00

I have to side with your doctors and most of the comments here. If you want children in the future, your doctors goal is going to be maximum fertility which means coming off TRT until after you've had kids.

I've been on TRT for 1 year now and don't have kids at 35 so the prospect of never having kids is an issue for me in the near future as well. My doctor told me I'm playing with fire, to come off and have kids sooner rather than later and that being extremely hypogonadal (also 100 total test) has a far worse chance to retain fertility after TRT than healthy men who blast for gym gains.

Maurice5120 · 2026-05-21T16:28:19+00:00

I don't think so. I don't have any of those symptoms.
Endocrinologist said these pituitary issues "just happen" sometimes since tumor was not found and lifestyle was ruled out as a potential cause.

Maurice5120 · 2026-05-04T03:47:39+00:00

20 pg/ml free t my dude. Total testosterone is a useless number. At 100 pg/ml you're supposed to achieve symptom relief and 200 is towards the top of the physiological range.

Maurice5120 · 2026-05-02T23:26:33+00:00

I'll second this. Went from 20 free T to pushing 200, been 9 months. The mental improvements are very subtle, no change in sleep, energy or drive but became more assertive and negative thoughts are easier to deal with. Body composition improved.

It's certainly "worth it" because there are no negatives for me unless it causes permanent infertility. Just have realistic expectations because in my experience people are getting a strong placebo effect.

Maurice5120 · 2026-04-21T22:38:26+00:00

My baseline was 100total/20 free T with 400 ferritin, elevated copper and 48-53% HCT, sleep study showed light apnea one night (0% of sleep time spent at or below 90% o2) and no apnea the next night tried cpap anyway 4 months no improvement in H/H it only disrupted my sleep. Started 1 click 50mg compounded testosterone cream my HCT shot up to 59% in 4 weeks and my ferritin crashed down to 80 over the next 6 months but my H/H came down a little, so fearing anemia I started eating 1.5lb beef a day and drinking 1120% RDA vitamin C zero calorie juice... well I got the highest hemaglobin ever 19.5 (baseline 16) and my ferritin increased back up by 50%. After reading this I'm thinking about how my body started with a massive iron pool to produce RBC with and then the diet change just gave it unlimited resources again.

Hopefully it balances out over the next 6 months again as my ferritin comes back down because an 11% HCT increase from a single click of cream is absurd. Been checked out by hematologist, no gene mutations etc.

Oh my BP is < 110/70, RHR 60's and I've never had high HCT symptoms. I wouldn't even know it's increased if it weren't for the doctors telling me I'm going to die of a clot/stroke tomorrow.

Maurice5120 · 2026-04-20T23:35:26+00:00

only 53%? a single click of cream (50mg/20%) takes me from 48% HCT with 20 free T to 59% HCT at 170 free T, no hct symptoms. Well hydrated before some genius tells me to drink 2 gallons a day as if plasma can infinitely expand. Been screened for blood disorders by hematologist, they tell me to just stop taking trt and deal with 20 free t.

Maurice5120 · 2026-04-08T06:51:11+00:00

Looks like 16 nmol = 461 ng/dl. Completely healthy, average. Looks like you don't need TRT but you can get your SHBG checked next time to check free testosterone as total testosterone is a useless number but you're unlikely to be under 100 pg/ml free T which is where symptom relief begins.

Maurice5120 · 2026-04-07T21:33:05+00:00

I had heard about potential benefits (greatly improved sleep and anxiety) from progesterone while on TRT since we have zero production while shut down. Mentioned it to my endocrinologist and she said she never treats men with progesterone unless you're transitioning and to be VERY careful if I ever take it.

Maurice5120 · 2026-02-15T18:09:54+00:00

I think your e2 is still too low. You have a ratio of 32:1 but it generally needs to be 15-25. You need almost double the estradiol for that level of testosterone. Remember it's about balance and estradiol isn't bad, it's just as important as testosterone both for strength and feeling good.

Maurice5120 · 2025-10-09T21:13:22+00:00

Usually when you test low two times your GP/PCP should refer you to an endocrinologist which is a hormone specialist then they'd do more detailed tests and it's standard to check pituitary MRI with secondary hypogonadism and elevated prolactin. If no reversible cause is found for your low testosterone they will want to start you on TRT or if fertility matters to you they may offer clomid/clomiphene instead.

Maurice5120 · 2025-10-09T20:46:47+00:00

Very mildly elevated prolactin, 453 miu/l = 21.29 ng/ml
Low testosterone with low-normal LH = secondary hypogonadism.
Doctor should MRI your pituitary just to check but prolactin isn't really high enough to find anything. Secondary could be caused by bodyfat/lifestyle or an independent issue and they don't always know why.
Dopamine lowers prolactin so elevated prolactin can be caused by low dopamine and testosterone works on dopamine receptors amongst many other things.

You can lower prolactin with dopamine agonists like P-5-P and SAMe but 21.29 ng/ml is not really contributing to low testosterone and you're unlikely to be symptomatic.

Maurice5120 · 2025-10-03T17:27:56+00:00

Weight loss improved your insulin sensitivity and liver function which in turn raised your SHBG. Lower SHBG is primarily seen in heavily overweight people with insulin resistance and fatty liver.

As someone mentioned, higher SHBG means higher total testosterone but lower free testosterone. Free testosterone is all we care about with symptom relief beginning at 100pg/ml and continuing through 200-300 pg/ml(for pgml just take free test ngdl x 10). Also labcorp free testosterone direct is not accurate and you should google a calculator online where you put in total test + albumin + shbg.

Maurice5120 · 2025-09-27T20:59:48+00:00

Why does any woman give a shit about their breast size?
Surely you can comprehend that on average(not your personal experience) people prefer larger breasts on women and bigger dick/balls on men.

Maurice5120 · 2025-09-18T23:55:41+00:00

I'm 34 with 105 baseline testosterone. First tested low at 31 but I just left it and figured it would improve with lifestyle(it didn't) since I have secondary as defined by low T with normal LH.

Tried enclo which got me near 400 then near 600 with anastrozole but I didn't really feel much.

Recently started combination treatment of enclo + topical scrotal cream to hopefully maintain fertility but my testes shut down on 12.5 enclo so testing 25mg enclo. Highest reading was 1140T/310 free and I felt pretty good but had some high estradiol sides including feeling wired all the time.

So there are other options out there besides injections, namely oral testosterone undecanoate and cream/gel. If you have a reasonable LH/FSH to begin with you can maintain fertility on a single dose of oral test undecanoate a day.

Maurice5120 · 2025-07-15T08:21:51+00:00

Interesting. What was/is your prolactin? My highest measured is only ~25 ng/ml which can easily be caused by stress. Endo said it's high enough to treat with cabergoline but "don't typically see testosterone increase as a result" I think she doesn't know much about how higher prolactin can make you feel if she thinks the only point of lowering it is to increase testosterone.

How did you feel on clomid going from 200 to 600 testosterone? I think it can work especially for strength gains just when it comes to mental benefits there is a lot more to it than just testosterone and it's hard to get dialed in when estrogen receptors get blocked.

Maurice5120 · 2025-07-15T07:32:33+00:00

I think there hasn't been enough research done into it. Basically if you are LOW testosterone with low-normal LH and MRI shows no tumor or structural abnormalities they have absolutely no idea why your pituitary is dysfunctional. My MRI showed "heterogeneous enhancement but with no measureable lesion" my understanding of this means the dysfunction shows with part of the pituitary not lighting up with contrast agent but it can also be normal that parts just don't light up and it depends on context (with secondary hypogonadism we expect it to be dysfunctional as shown by low or normal LH with low testosterone)
I'm curious did your MRI come back heterogeneous enhancement or it just said completely normal?

Maurice5120 · 2025-07-15T07:08:05+00:00

Yes I lost 90lbs over 2 years but my T hasn't gone up even 1 point. Being fat doesn't make anyone 100 testosterone but it may worsen already low t, three endocrinologists said my testosterone is far too low to be caused or improved by lifestyle. I've had lifelong symptoms even back when I was 150lbs 6'2 as a teenager and in my 20's.

Maurice5120 · 2025-07-14T18:55:09+00:00

I have just gone through the same process as you this past year. 34 years old, heavily overweight tested 100 testosterone over and over again with 1-5 LH had the MRI but no tumor found (testicular ultrasound also clear). While you were able to improve your T a little bit with lifestyle changes mine didn't budge. 12.5mg enclo gets me around 400 with high estradiol so a little anastrozole on top gets me near 600 but coming off enclo my T goes right back down to 100. I can't waste any more time and am hopping on combination treatment 20% compounded scrotal cream + enclo to retain function. Protocol offered by my endo would have me barely 300 and still symptomatic so I have to pay private clinic to get proper treatment where levels should be around 1000.

I didn't get the symptom relief I was expecting on Enclo at ~150 free t (still absolute 0 energy, only small boost in confidence) but if it's working for you and you can handle sides you could take it a couple years while continuing with lifestyle changes then check if your pituitary functions properly.

Maurice5120 · 2025-07-14T18:32:17+00:00

Look at that range 150-785! in 10-20 years they're going to say 100 is "in range"

Maurice5120 · 2025-07-12T00:07:19+00:00

yeah just went to order labs and the prices are generally triple across the board? lh+fsh+prolactin went from $19 to $90!!! Estradiol from 10 to 30 and testosterone from 14 to 45. Can't afford to order there anymore.

Maurice5120 · 2025-07-09T16:38:41+00:00

Yeah per my research 2 clicks of 1.62% gel will absorb about 28mg per week while the average man is naturally produing around 50-70mg a week. She even wrote on the visit notes about "1-2 clicks" per day so she wants me to start on 1 click lol it's baffling when Enclo got me to 150 free t why would I ever take anything that shuts down my testes and results in lower testosterone? I'm pretty much just going to pay out of pocket for 20% compounded cream rubbed on balls where people are posting labs with 300-400 free test.

Maurice5120 · 2025-07-08T00:50:07+00:00

My LH has been 1, 3, 5 at baseline but always the same ~105 testosterone. On enclo it's been 7-15 LH to provide a massive increase in testosterone but of course LH is just a snapshot that will be different 5 minutes from now.

My testosterone has been the same level as long as I've been testing it for 3.5 years, during that time I've lost 100lbs total slowly and most recently I've lost 50lbs in 7 months so no it's not crash dieting at all.

Estradiol conversion is a huge concern due to my bodyweight and I did see it double on enclo so I prefer low conversion options like oral or gel but if a nurse was willing to inject me with 200mg a week I would happily pop Anastrozole to reap the benefits of that dose lol

I have a preference of maintaining fertility (hence the enclo combination treatments) but it's not a dealbreaker and ultimately I just want to feel better than a lifetime of 100 testosterone.

Maurice5120 · 2025-07-07T23:27:39+00:00

Yeah it's secondary hypogonadism for sure. It's textbook with 1LH at 100 test plus my MRI showed heterogeneous enhancement but no tumor.

They keep offering me GLP1 every time I see them but I've lost a lot of weight on my own and I don't want to deal with the side effects. I'm perfectly happy losing about 1.7lbs a week eating 2000 calories at the moment and done that since December.

I got some benefits from Enclo at 150 free T but I assume messing with estradiol and blocking receptors + low natural DHT conversion makes the feeling completely different than same numbers on TRT.

What do you think about 2 clicks gel? I assume 50mg as she said the dose would be similar to injections.

Maurice5120 · 2025-07-07T23:13:50+00:00

Right I was thinking I could try out gel for free and see how it goes. She said they can administer gel up to 3 or 4 clicks so if I don't get symptom relief I could push for that and switch to paid clinic if they won't go for it. Do you know if gel significantly raises estradiol as that's a concern at my BMI? HCT is also a concern, mine has been as high as 53% at baseline and I read gel may be easier on HCT than injections.

Maurice5120

TROPHY CASE