Quit TRT to Improve Fertility?

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Written by George N. Touliatos, MD





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Quit TRT to Improve Fertility?


By George Touliatos, MD



Life is a miracle, and we should embrace it.





Q: Do you need to come off from TRT while you’re trying to improve your fertility and focus on fertilization, allowing your girlfriend to conceive?





A: Actually, it’s not necessary. As a matter of fact, quitting TRT will make things worse in terms of sex drive. You see, 5PDEI aka Cialis (tadalafil) and Viagra (sildenafil) aren’t enough; they just improve blood flow and erection. Libido is a matter of brain because testosterone is a cerebral hormone (Abraham Morgentaler, MD). Hence, the desire to have intercourse is purely dependent upon androgen levels (T/DHT). On the other hand, testosterone administration will shut off HPTA and testicles will inevitably shrink. This downsize will eventually cost in fertility in the long term.





Testicles consist of Leydig and Sertoli cells. The former produce testosterone; the latter spermatozoa. This reflects on LH/FSH in blood work. Known as gonadotropins, LH and FSH are produced in adenohypophysis (front lobe). During TRT, they both go down to zero, since TRT is exogenous supply. In order to maintain fertility, we need to use HCG (human chorionic gonadotropin) that kicks Leydig cells. This will produce intratesticular testosterone. That in turn will mature the sperm. We can also use HMG (human menopausal gonadotropin) that practically is synthetic FSH and kicks Sertoli cells. This combination is powerful and can become miraculous in cases of oligospermia (<20M/ml).



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We may also improve motility of spermatozoa by the use of tocopherol and zinc. Vitamin E helps with speed of flagellum of spermatocytes, while zinc is an ingredient of the prostatic fluid, that composes 80% of semen. Clomiphene citrate allegedly can assist in fertility, throughout elevation of testosterone. However, it has a negative impact on free testosterone, due to elevation of SHBG. Finally, mesterolone is supposed to increase FSH and presumably spermatozoa count. Nevertheless, as an androgen, it suppresses HPTA and LH too. Therefore, it’s not good to be used without a SERM or HCG/HMG.





As for myself, my girlfriend is three months pregnant, and I’ll be a daddy at the age of 50. I’ve never used HMG so far, but I’ve been using HCG consistently since I’ve started TRT in 2015. Plus, I’ve helped a dozen bodybuilders allow their wives to get pregnant. Life is a miracle, and we should embrace it.





George Touliatos, MD is an author, lecturer, champion competitive bodybuilder, and expert in medical prevention regarding PED use in sports. Dr. Touliatos specializes in medical biopathology and is the medical associate of Orthobiotiki.gr and Medihall.gr, Age Management and Preventive Clinics in Athens, Greece. He is the author of four Greek books on bodybuilding, has extensively developed articles for www.anabolic.org and is the medical associate for the book “Anabolics, 11th Edition” (2017). Dr. Touliatos has been a columnist for the Greek editions of MuscleMag and Muscular Development magazines and has participated in several seminars across Greece and Cyprus, making numerous TV and radio appearances, doing interviews in print and online. His personal website is https://gtoul.com/





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