Loss of fertility
Fertility is the ability to produce viable offspring. The key element of male fertility is spermatozoa: the more of them and the more active they are, the better. Follicle–stimulating hormone (FSH) has a direct effect on spermatogenesis - the higher its level, the more active the process of sperm formation is. The level of FSH can decrease (sometimes to zero) under the influence of anabolic steroids. Moreover: the reason for the decrease in the level of FSH it may be not only too high, but also too low (below normal) quantity testosterone in the blood, which creates problems with conceiving a child for men with hypogonadism.
How do Anabolic Steroids Affect Fertility
During any cycle of taking anabolic steroids, there is an inevitable suppression of their own gonadotropins - LH and FSH. These two hormones are responsible for such functions as the production of their own testosterone and also respond to spermatogenesis, while if LH is more responsible for the synthesis of testosterone, then FSH is responsible for sperm production and fertility. During the cycle, the levels of these hormones tend to zero, respectively, your testicles eventually atrophy and almost completely cease to function. During the cycle of anabolic steroids, it is extremely important to maintain the activity of the testicles and avoid complete final atrophy.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8100009/
Additional factors that reduce fertility
Age, excess weight, and the habit of smoking tobacco or marijuana, addiction to alcohol, chemotherapy, some diseases (varicocele, for example). In addition, taking medications such as the diuretic spironolactone can have a negative effect an anti-ulcer drug cimetidine, ketoconazole, antiandrogens (often used in the treatment of prostate tumors).
Problem solution
In order to stimulate the production of your own testosterone, you should take HCG during each cycle. In this case, you will be able to recover much faster after cycles.
If you want to avoid not only a drop in your own testosterone, but also a loss of fertility, and at any time have the opportunity to have a child more often, then such a drug as HMG comes to your aid. The HMG drug provides complex stimulation of testicular activity during the cycle - it has a significant effect on sperm production, testicular size, as well as libido and mood.
The drug will also help you to regain fertility if you have been using anabolic steroids for a long time without interruptions and have never done prevention of atrophy of tisticules in any form before. Studies have shown that HMG in combination with HCG really restores fertility even after long steroid cycles and during TRT. A recent meta-analysis has shown that post-cycle recovery is faster when HCG is combined with HMG. At the moment, the scheme of using HCG + HMG for fertility reversal is what modern doctors use for infertility in men.
The preservation of fertility during the cycle is a very extensive topic and requires a very detailed explanation, but here we will focus only on the main thing, but rather just mention the use of HMG for these purposes. In any case, we recommend that you consult with a specialist if you need to regain your fertility after many years of using andorogens.
Effectiveness
You should also understand that nothing gives a 100% guarantee of fertility preservation, although this scheme has been confirmed by numerous studies and clinical practice. In order to insure yourself against infertility, do a spermogram every 3 months if you constantly use anabolic steroids. It is also a good practice to freeze spermatozoa even before you start using testosterone on a regular basis.
In regard to infertility, it would be more correct no to say “infertility”, but temporary sterility (I must say that far from 100% of cases, so do not think that steroids are a guarantee of being sterile during the cycle), which is associated with a change in the hormonal background in the body. Fortunately, this is in most cases a completely reversible condition if you follow all the instructions.
Which PEDs should you use
We suggest that you use the classic scheme for preventing infertility - namely, the use of HCG and HMG together, as it is done in clinical practice. To preserve fertility and testicular activity, HMG must be used in cycles lasting more than 10 weeks. Ideally, it should be used from the 4th week to avoid any testicular atrophy.
The recommended dosage is 75-150 IU 3 times a week, preferably together with HCG at a dosage of 1000-1500 IU per week.
HCG
The main action of HCG is an effect similar to LH, but chorionic gonadotropin also has FSH activity. It is not that pronounced, but it can help in restoring fertility. In addition, due to the activity of LH, gonadotropin chorionic is able to significantly increase the level of testosterone in the blood.
HMG
Menopausal gonadotropin (HMG) contains FSH in its pure form. It is used in cases where the use of HCG does not lead to the expected result. And yes – it is the most effective means of increasing fertility. As for dosages, injections of the following volume are made to increase fertility: HCG – 1000-1500 IU every 5-7 days. HMG 75-150 IU three times a week
HMG is the drug that more than one athlete does not think about at the beginning of his career, but several unsuccessful attempts to conceive a child force athletes to go in search of a way to restore fertility. Not everyone wants to quit using testosterone and finish the cycle to solve this problem, and then athletes come to the use of HMG. If you want to conceive a child without any problems - think about it in advance - always use HCG during your cycle and periodically cycle with HMG, if possible checking your fertility level by passing a spermogram.
The only disadvantage of this drug is its price, especially if your cycles are very long or you haven't used HCG for a very long time and now you need to restore your fertility after many years of using anabolic steroids.
Provironos
Proviron is used in case of infertility to increase the quantity and quality of spermatozoa: During the full cycle of spermatogenesis, that is, for approximately 90 days, take 50-75 mg. If necessary, repeat the treatment cycle after a break of several weeks. With the help of the drug Provironos, it is possible to increase or normalize the quantity and quality of spermatozoa, as well as the concentration of fructose in the ejaculate, which increases the likelihood of fertilization.
https://pubmed.ncbi.nlm.nih.gov/2892728/
https://pubmed.ncbi.nlm.nih.gov/1900485/
Cialyn
PDE5 inhibitors (which also include Cialyn, the active substance of which is called tadalafil) are the most common treatment for erectile dysfunction (ED). These medications increase the amount of nitric oxide (NO) in the arteries, which leads to their expansion.
Men with infertility are often prescribed PDE-5 inhibitors. There is a relationship between erectile dysfunction and infertility. ED may worsen when trying to get pregnant, as sex becomes less spontaneous. Regular ejaculation can promote healthy sperm development. In addition, NO may also play a role in sperm development.
There are studies that confirm that men who took PDE5 inhibitors had a significant improvement in sperm volume, sperm count and sperm concentration. In addition, significantly more sperm could move in a straight line (improved sperm motility) and had a normal form.
There is some scientific evidence that 5 mg of Cialyn (tadalafil) improves fertility in men
https://pubmed.ncbi.nlm.nih.gov/26428642/