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Goal: Maintain testicular volume and function during TRT Approach: HCG 500 IU subcutaneously every other day (3x weekly) Begin same time as testosterone therapy Continue for duration of TRT Monitoring: Baseline testosterone, estradiol, LH, FSH Recheck at 6 weeks, then quarterly Adjust based on estrogen response Expected results: Maintained testicular size Preserved fertility potential Possible slight testosterone boost above TRT alone Protocol for fertility restoration on TRT Men on TRT who want to conceive face a decision

Qu et al., 2010), suggesting that iron bioavailability influences adhesin expression