u/Legitimate_Address_8

Pretty desperate - have IHH rather than CHH but can’t find any other place to put this and have help. Know this is a bit long, but any help would be really appreciated

I was diagnosed with HH at 18 and started TRT, which I did for about 5 years or so. During this time, my levels stayed at around:

500 ng/dL Total T
60 pg/mL Free T
0.7-2.41 mIU/mL FSH (higher number was early on, then plummeted)
0.2-1.51 mIU/mL LH (higher number was early on, then plummeted)
48 mIU/mL
32 nmol/L SHBG
4.6 g/dL Albumin

Since then I switched over to hCG (3,333 3x/week) a year and a half ago. Before adding FSH, I was at:

700 ng/dL Total T
66 Estradiol

Started FSH (75 3x/week) 5 months ago with the following results:

3.2 FSH
1.1 LH
58 Estradiol

SA taken two weeks ago came up completely empty, stating:

1.5 mL Semen volume
Incomplete Semen Liquefaction
High Semen Viscosity
8.5 pH
No sperm found

Lifestyle changes are priority #1, as I’m overweight and don’t eat healthy anymore. Doing those and taking some supplements.

Doctor said not much else to do, besides a microTESE and wants to stop treatment after.

I want to understand what’s happening - my understanding was that if I had primary HH, hCG wouldn’t be working at all. Since it’s able to be converted to T, would this mean that there should be some hope?

Pretty desperate, so know this is a long post but any help or advice would be greatly appreciated. Doctor wasn’t interested in explaining and wanted to stop altogether.

I was diagnosed with HH at 18 and started TRT, which I did for about 5 years or so. During this time, my levels stayed at around:

500 ng/dL Total T
60 pg/mL Free T
0.7-2.41 mIU/mL FSH (higher number was early on, then plummeted)
0.2-1.51 mIU/mL LH (higher number was early on, then plummeted)
48 mIU/mL
32 nmol/L SHBG
4.6 g/dL Albumin

Since then I switched over to hCG (3,333 3x/week) a year and a half ago. Before adding FSH, I was at:

700 ng/dL Total T
66 Estradiol

Started FSH (75 3x/week) 5 months ago with the following results:

3.2 FSH
1.1 LH
58 Estradiol

SA taken two weeks ago came up completely empty, stating:

1.5 mL Semen volume
Incomplete Semen Liquefaction
High Semen Viscosity
8.5 pH
No sperm found

Lifestyle changes are priority #1, as I’m overweight and don’t eat healthy anymore. Doing those and taking some supplements.

Doctor said not much else to do, besides a microTESE. I want to understand what’s happening - my understanding was that if I had primary HH, hCG wouldn’t be working at all. Since it’s able to be converted to T, would this mean that there should be some hope?

For context, been on 3,000 per week hCG for a year and a half and 75 per week FSH. Most recent numbers were:

FSH - 3.2
LH - 1.1
T - 700
Estra - 50

For the SA, had no sperm found and:

1.5 mL
8.5 pH
Incomplete Semen Liquifaction
High viscosity
<1 WBC

Any hope moving forward? Had pubertal delay, diagnosed with IHH and no genetically abnormalities. Had TRT for 7/8 years before moving to hCG

29M