DIR Return Create A Forum - Home
---------------------------------------------------------
Road2HardCoreIron
HTML https://road2hardcoreiron.createaforum.com
---------------------------------------------------------
*****************************************************
DIR Return to: Post Cycle Therapy
*****************************************************
#Post#: 404--------------------------------------------------
HMG VS HCG
DIR By: Road2HardCoreIron
Date: March 11, 2019, 3:51 pm
---------------------------------------------------------
Great article by Muscle Talk.
Forum HomeArticles HomeBodybuilding Steroids & Performance Drugs
Human Menopausal Gonadotropin (HMG): The Science and its role as
a Fertility Medicine
April 2013
This article is on two parts: firstly, MuscleTalk Moderator
mad_cereal_lover PhD explains the science of HMG; then
MuscleTalk member Liebow talks about his experiences with low
sex drive and poor fertility and how HMG and good advice meant
he was able to conceive again.
Part 1: The Science of HMG
By MuscleTalk moderator mad_cereal_lover PhD
To understand the use of HMG in hormone recovery, we must first
understand the processes of importance that take place in
physiological shutdown of male hormones following exogenous
testosterone (and derivates) use. To understand more about the
hypothalamus-pituitary-testicular (HPT) axis and medicines such
as human chorionic gonadotropin (HCG) please the article
Nolvadex, Clomid and HCG in Post Cycle Therapy (PCT)
When we administer certain hormones into our bodies, various
cells and organs have the ability to sense this. Your body
'sees' this increase in testosterone or similar molecules and as
a result it can sense that it is in a higher concentration than
what would be normal in the blood. As a result, it will shut
down its own testosterone production. There are various
mechanisms involved in this, but an important one is the
cessation in production of luteinizing hormone (LH) and follicle
stimulating hormone (FSH), produced by the pituitary gland.
These hormones are required for the testes to be stimulated to
produce testosterone but also play a role in sperm production.
From a blood-testosterone aspect this all seems okay to us, sure
we have shut down natural testosterone production, but we still
have testosterone in us; right? Well, one of the big problems
with regards to fertility is that the testes do not work like
that. The Leydig cells in the testes produce testosterone when
stimulated by LH. Testosterone is released from these cells
which are in close proximity to the Sertoli cells. When Sertoli
cells see a high concentration of testosterone, they are
stimulated to produce and mature sperm by the process of
spermatogenesis. A high blood concentration of testosterone will
not do this job. Thus administering anabolic androgenic steroids
(AAS) will shut down natural testosterone production which will
in turn slow down (and eventually near turn off) the proper
formation and maturation of sperm. Thus infertility is a serious
issue with use of AAS.
Classically, HCG has been seen to rectify this problem in males.
HCG is an LH analogue – it 'looks' like LH to the body and so it
can stimulate the Leydig cells to produce testosterone and in
turn, hopefully, restore fertility. In some cases this will
occur, and many people have had success from HCG therapy
relating to infertility. However, the response is not robust and
certainly with longer shut-down periods, many often find the use
of HCG (even in combination with other post cycle therapy (PCT)
medicines such as clomifene (aka clomid) and tamoxifen (aka
nolvadex), etc) to not be effective at restoring fertility.
Furthermore, what HCG lacks is to produce the important effects
that FSH inflicts upon fertility. FSH, despite its name, is
important in male fertility in two main pathways. The first
thing it does is to enhance the action of LH, by increasing the
amount of protein that will 'see' testosterone in the Sertoli
cells. The more easily these cells can see testosterone, the
more likely spermatogenesis will occur. Secondly, FSH enhances
the maturation of sperm by effects on their primary division.
These are two important aspects of the role of FSH in the male
testes that HCG is not optimal in promoting.
HMG, or its full name Human Menopausal Gonadotropin, bears
similarities to HCG in that while HCG is similar to human LH,
HMG contains actual LH. Additionally (and crucially) though, HMG
also contains purified FSH. The combination of these two
hormones perform the effects described above: induction of
natural testosterone production by Leydig cells, and subsequent
formation and maturation of sperm cells. The result is improved
and potentially recovered fertility for the male concerned.
Does HMG really work?
So often we hear about various different drugs and the science
for them is sound, but real world evidence is lacking. There are
a few studies performed on HMG over the last 25 years, and I
would like to draw your attention to two of these studies,
pointing out a few key details. The first goes back to 1985 by
Ley & Leonard and is an important study as it looks at males who
had previously encountered AAS treatment (treatment for low
hormone levels including mainly testosterone). This study is
available online and I encourage you to read it in more detail
than the brief summary I will provide here.
They looked at 13 hypogonadotropic men all of who had
undetectable levels of LH/FSH, lower than normal levels of
testosterone and azoospermia, thus were unable to currently
conceive. Obviously with the low hormonal levels there were
issues with libido as well. Furthermore, there were instances
where upon testis biopsies, Leydig cells were completely absent.
Despite this, all 13 men responded to treatment with HCG with
increasing testosterone levels. However, upon addition of HMG
treatment, most men saw a further increase in testosterone,
sometimes very large. HCG was able to increase sperm counts in
most men slightly; however, only upon addition of HMG were sperm
counts above 'normal' fertility levels (i.e. 20 million per ml)
observed. The study indicates that the addition of HMG therapy
surpasses any level that HCG treatment could achieve alone.
Admittedly this is a particular subset of men who have medical
conditions and abnormal hormone issues, but the results are
interesting nonetheless.
The second is more recent by Buchter et al in 1998. This is even
more interesting from the point of view that it looks at three
times the number of cases as the previous study and in a
different manner. Again, this study can be found online and I
encourage you to read it. The most interesting result you could
take away from this study is that in the group of men treated
who suffered from hypopituitarism, all 21 treated with HCG/HMG
achieved spermatogenesis and a large proportion (81%) was able
to successfully achieve pregnancies. The discussion of this
article is most interesting as it raises the points from its own
study and the literature that many in the field believe that to
achieve spermatogenesis and pregnancy in a
gonadotropin-compromised individual requires combinational
therapy of HCG and HMG. The important point to note is that HCG
is not sufficient alone in many cases.
Given the fact that other studies point to HMG increasing
endogenous testosterone further than HCG can, as those who have
relatively 'normal' pituitaries but have compromised their
function due to AAS use, it would be wise to consider the use of
HMG. This would not only be for purposes of fertility, but to
induce natural testosterone levels back to normal values when
they have been suppressed. Treatment in this latest study was
the use of HCG twice per week at 1000-2500IU per dose (Mon-Fri)
and HMG three times per week at 75-150IU (Mon-Wed-Fri). Thus for
bodybuilders seeking to regain fertility, spermatogenesis and
restore natural testosterone levels but wishing to keep costs
down, a weekly dose of the lower ends should be employed for at
least one month.
A schedule would involve:
Monday: 1000-1500IU HCG + 75IU HMG
Wednesday: 75IU HMG
Friday: 1000-1500IU HCG + 75IU HMG
Depending on the amount of suppression this cycle may need to be
lengthened for a further period. Please note this information is
for hypothetical purposes and neither I nor MuscleTalk
recommends the use of any prescription medicines without the
consultation of a qualified physician.
References:
Buchter et al (1998). Pulsatile GnRH or human chorionic
gonadotropin/human menopausal gonadotropin as effective
treatment for men with hypogonadotropic hypogonadism: a review
of 42 cases. Eur J Endo 139: 298-303.
Ley & Leonard (1985). Male Hypogonadotropic Hypogonadism:
Factors Influencing Response to Human Chorionic Gonadotropin and
Human Menopausal Gonadotropin, Including Prior Exogenous
Androgens. J Clin Endo Metab 61(4); 746-752.
Part 2: HMG: The Miracle Fertility Med? A Personal Story and
Lesson to Young Bodybuilders
By MuscleTalk Pro-Member Liebow
Many years ago I started off my fitness habits with boxing and
of course, like most young people, I was into looking 'big and
hench'. I naively used the AAS dianabol a few times at a very
young age (around 15) and loved the great results I achieved,
such as strength and size increases. I did not notice many side
effects and would just jump back on cycle after some time off
with no PCT. So there I was, messing myself up quite a bit
without giving it much thought. I came away from boxing to
reflect on my discipline and get on with my life – the usual
life issues such as my career and marriage, etc.
I missed the weights, and in 2010 I was back in the gym lifting
again, this time in a powerlifting fashion. I worked hard, ate
everything and progress was steady, albeit slow. In 2011, my
first child was born and I found myself slowing in the gym and
not growing much more in the size/strength department, causing
much frustration and annoyance. This time I now turned to legal
pro-hormones as I did not have a source for AAS. Again, I
achieved great results but did not run the PCT I was advised to;
instead I used an OTC product. I waited two months and jumped
back on to yet another cycle. By the end of 2011, I was eager to
try injectable meds. This time I listened to sound advice and
planned a good testosterone cycle with proper PCT and I felt I
recovered fine into 2012. The whole time I was eating everything
I saw, however I was not doing much cardio work but focused on
lifting very heavy weights. I went back on more AAS, this time
using trenbolone with again, great gains. I entered a local
novice event and did well. I was on a real high here!
Then my wife approached me during the summer of 2012 wanting to
move on with our family and have a second child. At this time,
my usual 'post cycle blues' were in action. I had no libido,
poor mood, no drive and so on. I reassured her though that in a
few weeks I would have recovered and it would be fine which
built her hopes up. Despite this I failed to recover after these
few weeks I promised her. Another few months went by, and still
nothing – I felt terrible. So I decided to throw in some
proviron to see if that would help with things. It didn't so I
turned to HCG. I tried a range of approaches over the space of
four months: 500IU EOD, 500IU ED, 1500IU EOD, and even 2500IU
EOD. I even ran clomid alongside the HCG to see if that would
help with its fertility properties, but nothing seemed to work.
So, here I was, several months after the 'talk' and I am still
heavily shutdown. This caused a serious strain on my
relationship and my wife blamed the steroids (and rightly so!).
We sought advice from the doctor and my wife was perfectly fine.
However, the doctor took one look at my parts and said "Ah, I
think I can see the problem". Cutting to the point and saving
the embarrassing details, it seems that my sperm production was
horrifically suppressed and I had only around 10,000 sperm to
one ml of semen. This was further compounded by the fact I had
no sex drive.
This news devastated me (and my wife) and I felt as though my
relationship was now about to fall apart. All of a sudden, my
muscles and hard work over the last few years seemed out of
place and plain wrong. I felt that I had been so short sighted
and did not once think about how my actions would affect others
nor did I consider the long term. I ignored so much good advice
about recovery, PCT, time on and time off. I felt like the most
moronic failure to myself and to my wife.
So was determined and made a plan to try and rebuild our
relationship, as a way to move forward. I decided (bear with
me...) to jump back on testosterone enanthate at a low dose. If
we could not have more children, we could focus again on our
intimacy and each other. I felt there was no point in having no
sex drive, so this made sense to me. Now as a desperate last
resort, I thought I would try one more medicine to see if it
would help with my fertility. I was advised to use HMG and to
also come off testosterone to help improve conception chances
(but you know how I feel about advice). A few weeks went by, and
my libido is back to sky high and once again I am pleasant to be
around, and I was starting to not feel as crap as I did
previously. A fortnight had passed and the HMG was finished.
Another few weeks pass, and we happen to notice something very
peculiar. The wife hadn't menstruated yet. This can occur at
times, so we thought nothing of it. A few days later, I am woken
up in bed at 8am by a tearful wife, holding a Clearblue
Pregnancy Test. It read 'PREGNANT 2-3 WEEKS'. I grumbled at this
and turned over, with the honest belief that I was still asleep.
After a few firm taps of encouragement
*****************************************************
Page 1 of 1