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Male infertility is common enough among males in western societies,—even in those who are not using, or have previously used AAS. Some quick definitions for those newbies reading:

Infertility: inability to conceive children or young.
AAS: An abbreviation for Anabolic and Androgenic Steroids

Among those who use AAS, approximately 50% or more will become infertile while they are using AAS. Yes, that’s right, not all who use AAS are infertile. Lucky bastards. It is common enough to conceive a child while on the heaviest of steroid stacks for some males. For those men not so fortunate, preserving fertility during a cycle or post cycle is a common question asked.

Why does AAS or TRT cause infertility in some and not others?

Testosterone or AAS use impairs sperm production by initiating a negative feedback loop on the hypothalamus and the pituitary gland. These two locations are in the brain. This negative feedback causes a decrease in production of GnRH and LH. The reduction or loss of LH secretion shuts down the production of testosterone in the testes. When you alter this critical path and drop intratesticular testosterone (ITT), then sperm production can be reduced or come to a complete stop. Not all men seem to be affected by the drop in ITT, but a large portion of men will.

So if I am one of the unlucky ones, how do I fix it?

Human Chorionic Gonadotropin (hCG) therapy during AAS or TRT is a great way to prevent infertility. A dose of 500 iu 3 x weekly is a good place to start for those wanting to maintain ITT—and therefore maintain those healthy little swimmers too—well, hopefully. Some users may need less, some more, but 500 iu hCG 3 x weekly is a good place to start. There are a number of scientific papers that support this dose too. If you’re a little late to the party and you have not been using hCG with your TRT or AAS cycle, then it may take 6-12 months before you see a healthy sperm count again with this dose of hCG. If you are in no rush, this is a good place to start. It is important to note that hCG alone may not be sufficient to restore fertility in all men.

I want to get my girl pregnant ASAP. Is there anything else I can do to get things happening faster?

Yes, there is. A higher dose of hCG, dosed at 2000 iu every other day or every three days, in combination with 150 iu hMG (Human Menopausal Gonadotropin) every other day, seems to work wonders for most. If you are fortunate, you could conceive right away. Otherwise, within 3 months is common.

Anything else I should know?

Well, there is only so much I can write about this topic in a short blog post, but there are a couple of other considerations and caveats that are good to know.

1.) If the above protocols do not work for the user, there is also FSH (Follicle Stimulating Hormone) which you could use in the place of hMG . A dose of 75 iu of FSH every other day is a common dose.

2.) The dose of hCG required from individual to individual can vary greatly. Some users may see immediate benefit from 500-1000 iu doses, whereas others may need up to 3000 iu every other day. If you are in no rush, it is a good idea to start on the lower end. hCG is renowned for producing higher levels of estrogen as a result of aromatisation and this can cause unwanted side effects in some. The higher the dose, the higher the chance of adverse events.

3.) Clomid (Clomiphene citrate) has also been shown to be effective on its own or in combination with hCG. A dose of 12-25 mg daily of Clomid can be added to your fertility program to further promote FSH production—or as mentioned, it can also be used on its own if you are in no immediate rush. However, personally, I see the greatest risk of side effects with Clomid use in users, with particular notion to mood changes. A dose of 12.5 mg though is unlikely to cause issues.

4.) If the cause of infertility is a testosterone issue, simply adjusting lifestyle can resolve the issue. Anastrozole, commonly known as arimidex, has been shown to provide improvements in fertility for those who seem to be aromatising too much estrogen. Factors for excess aromatisation include diet, age, medications and body-fat levels. Personally, I would stay away from aromatise inhibitors in this context, but they can and have been used successfully as stand-alone treatments for fertility in the right context and setting.

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