New fertility doctor and protocol he suggested, HCG 3,000iu x 3 week

[Thomas1212]

Hi, I am trying to conceive and just had an appointment with new fertility doctor who is recommending a new protocol as follows;

Fertility Protocol
50 mg Test Cyp per week
3000iu HCG x 3 per week
Arimidex .5mg x 2 per week

Current Protocol
14mg Test Cup daily (98mg week)
500iu HCG x 3 per week (switched from 300iu x 3 per week 2 months ago)
No Arimidex

What are your thoughts on the high dosage of HCG? Seems very high. My semen analysis is much better after increasing to 500iu HCG vs 300iu x 3 per week. Does anyone have experience switching to such a high dose of HCG and low dose of TRT?

SEMEN ANALYSIS SUMMARY – JUNE 2026
Volume

• Result: 2.8 mL
• WHO Lower Reference: 1.4 mL
• Status: Normal

Concentration

• Result: 38 million/mL
• WHO Lower Reference: 16 million/mL
• Status: Well Above Normal

Total Sperm Count

• Result: 106.4 million
• WHO Lower Reference: 39 million
• Status: Well Above Normal

Total Motility

• Result: 29%
• WHO Lower Reference: 42%
• Status: Below Reference

Progressive Motility

• Result: 17%
• WHO Lower Reference: 30%
• Status: Below Reference

Total Motile Sperm Count

• Result: 30.5 million
• No official WHO cutoff
• Status: Good

Thank you for any feedback.

 

[t_spacemonkey]

Hi, I am trying to conceive and just had an appointment with new fertility doctor who is recommending a new protocol as follows;

Fertility Protocol
50 mg Test Cyp per week
3000iu HCG x 3 per week
Arimidex .5mg x 2 per week

Current Protocol
14mg Test Cup daily (98mg week)
500iu HCG x 3 per week (switched from 300iu x 3 per week 2 months ago)
No Arimidex

What are your thoughts on the high dosage of HCG? Seems very high. My semen analysis is much better after increasing to 500iu HCG vs 300iu x 3 per week. Does anyone have experience switching to such a high dose of HCG and low dose of TRT?

SEMEN ANALYSIS SUMMARY – JUNE 2026
Volume

• Result: 2.8 mL
• WHO Lower Reference: 1.4 mL
• Status: Normal

Concentration

• Result: 38 million/mL
• WHO Lower Reference: 16 million/mL
• Status: Well Above Normal

Total Sperm Count

• Result: 106.4 million
• WHO Lower Reference: 39 million
• Status: Well Above Normal

Total Motility

• Result: 29%
• WHO Lower Reference: 42%
• Status: Below Reference

Progressive Motility

• Result: 17%
• WHO Lower Reference: 30%
• Status: Below Reference

Total Motile Sperm Count

• Result: 30.5 million
• No official WHO cutoff
• Status: Good

Thank you for any feedback.

imho won't work. the arimidex is insane. switch docs.
I would bump HCG to 3x1000IU max and add some FSH. look for my threads about fsh and how to get it cheaply

 

[Nelson Vergel]

Hi, I am trying to conceive and just had an appointment with new fertility doctor who is recommending a new protocol as follows;

Fertility Protocol
50 mg Test Cyp per week
3000iu HCG x 3 per week
Arimidex .5mg x 2 per week

Current Protocol
14mg Test Cup daily (98mg week)
500iu HCG x 3 per week (switched from 300iu x 3 per week 2 months ago)
No Arimidex

What are your thoughts on the high dosage of HCG? Seems very high. My semen analysis is much better after increasing to 500iu HCG vs 300iu x 3 per week. Does anyone have experience switching to such a high dose of HCG and low dose of TRT?

SEMEN ANALYSIS SUMMARY – JUNE 2026
Volume

• Result: 2.8 mL
• WHO Lower Reference: 1.4 mL
• Status: Normal

Concentration

• Result: 38 million/mL
• WHO Lower Reference: 16 million/mL
• Status: Well Above Normal

Total Sperm Count

• Result: 106.4 million
• WHO Lower Reference: 39 million
• Status: Well Above Normal

Total Motility

• Result: 29%
• WHO Lower Reference: 42%
• Status: Below Reference

Progressive Motility

• Result: 17%
• WHO Lower Reference: 30%
• Status: Below Reference

Total Motile Sperm Count

• Result: 30.5 million
• No official WHO cutoff
• Status: Good

Thank you for any feedback.

On the high HCG dose (3,000 IU x3/week = 9,000 IU/week):

This is indeed very high. Most fertility-focused TRT protocols use 500–1,500 IU per injection, and you're already seeing solid results at 500 IU x3. Your motility is already your weak point, and flooding the testes with excess estrogen is unlikely to help that.

On the Arimidex (.5mg x2/week):

This is aggressive and concerning on a protocol designed for fertility. Anastrozole (Arimidex) can negatively impact sperm quality — some studies show it impairs sperm DNA integrity. Estrogen also plays an important role in spermatogenesis. Suppressing it heavily while simultaneously driving it up with huge HCG doses creates an unpredictable hormonal environment. Many fertility specialists avoid or minimize AIs on fertility protocols for this reason.

On dropping Test Cyp to 50mg/week:

This makes more sense from a fertility standpoint. Lower exogenous testosterone means less suppression of the HPG axis, allowing HCG to do more of the heavy lifting on intratesticular testosterone production. Your current 98mg/week may be contributing to the motility issues.

Your semen analysis context:

Your count and concentration are excellent. Your problem is motility (29% total, 17% progressive — both below WHO reference). High-dose HCG + heavy AI use is unlikely to fix this. The motility issue may be better addressed by:

• Adding FSH (e.g., recombinant FSH or HMG), which directly supports sperm maturation and motility
• Antioxidant supplementation (CoQ10, Vitamin C/E, L-carnitine)
• Ruling out varicocele or other structural causes

Bottom line: A second opinion from another fertility urologist or reproductive endocrinologist familiar with TRT would be worthwhile. The 9,000 IU/week HCG + Arimidex combination raises red flags, and adding FSH to your current protocol (at a more moderate HCG dose) would be a more evidence-supported approach given that motility — not count — is your limiting factor.

Note: This is general informational discussion, not medical advice. Work with your doctor or seek a second opinion before making any protocol changes.

 

[Thomas1212]

On the high HCG dose (3,000 IU x3/week = 9,000 IU/week):

This is indeed very high. Most fertility-focused TRT protocols use 500–1,500 IU per injection, and you're already seeing solid results at 500 IU x3. Your motility is already your weak point, and flooding the testes with excess estrogen is unlikely to help that.

On the Arimidex (.5mg x2/week):

This is aggressive and concerning on a protocol designed for fertility. Anastrozole (Arimidex) can negatively impact sperm quality — some studies show it impairs sperm DNA integrity. Estrogen also plays an important role in spermatogenesis. Suppressing it heavily while simultaneously driving it up with huge HCG doses creates an unpredictable hormonal environment. Many fertility specialists avoid or minimize AIs on fertility protocols for this reason.

On dropping Test Cyp to 50mg/week:

This makes more sense from a fertility standpoint. Lower exogenous testosterone means less suppression of the HPG axis, allowing HCG to do more of the heavy lifting on intratesticular testosterone production. Your current 98mg/week may be contributing to the motility issues.

Your semen analysis context:

Your count and concentration are excellent. Your problem is motility (29% total, 17% progressive — both below WHO reference). High-dose HCG + heavy AI use is unlikely to fix this. The motility issue may be better addressed by:

• Adding FSH (e.g., recombinant FSH or HMG), which directly supports sperm maturation and motility
• Antioxidant supplementation (CoQ10, Vitamin C/E, L-carnitine)
• Ruling out varicocele or other structural causes

Bottom line: A second opinion from another fertility urologist or reproductive endocrinologist familiar with TRT would be worthwhile. The 9,000 IU/week HCG + Arimidex combination raises red flags, and adding FSH to your current protocol (at a more moderate HCG dose) would be a more evidence-supported approach given that motility — not count — is your limiting factor.

Note: This is general informational discussion, not medical advice. Work with your doctor or seek a second opinion before making any protocol changes.

Thank you very much for this detailed response. It is extremely helpful. I am going to seek out a second opinion. In the meantime I will increase HCG to 1000iu 3 times per week and reduce Test Cyp to 12mg per day. I'll look into skipping Arimidex completely or taking a much smaller dose.

FSH does seem like the next logical step. I'll have to look more into a supplier as I know it can be expensive. I have started taking the other supplements you suggested for increased motility.

Your response is greatly appreciated!

 

[Tbuckeye3]

Thank you very much for this detailed response. It is extremely helpful. I am going to seek out a second opinion. In the meantime I will increase HCG to 1000iu 3 times per week and reduce Test Cyp to 12mg per day. I'll look into skipping Arimidex completely or taking a much smaller dose.

FSH does seem like the next logical step. I'll have to look more into a supplier as I know it can be expensive. I have started taking the other supplements you suggested for increased motility.

Your response is greatly appreciated!

Thank you very much for this detailed response. It is extremely helpful. I am going to seek out a second opinion. In the meantime I will increase HCG to 1000iu 3 times per week and reduce Test Cyp to 12mg per day. I'll look into skipping Arimidex completely or taking a much smaller dose.

FSH does seem like the next logical step. I'll have to look more into a supplier as I know it can be expensive. I have started taking the other supplements you suggested for increased motility.

Your response is greatly appreciated!

Keep me posted on this and the FSH supplier. I have researched and found one and now just exhausting other options

 

[Thomas1212]

Keep me posted on this and the FSH supplier. I have researched and found one and now just exhausting other options

Could you share your FSH supplier with me? I have no experience or leads at this point. Thank you.

 

[Tbuckeye3]

Could you share your FSH supplier with me? I have no experience or leads at this point. Thank you.

Sending you a message