What is the Origin of TRT Fertility Protocol?

This clinical practice is a necessity arising from the widespread use of TRT, which, while correcting hypogonadism, often causes secondary infertility due to central suppression of the HPG axis. The protocol represents the adaptation of standard TRT to prioritize reproductive function. It is a development in male reproductive endocrinology.

What is the Mechanism of TRT Fertility Protocol?

Exogenous testosterone suppresses Luteinizing Hormone (LH) and Follicle-Stimulating Hormone (FSH) secretion from the pituitary, halting testicular testosterone production and sperm maturation. The protocol counters this by using Human Chorionic Gonadotropin (hCG) to mimic LH and stimulate testicular function, often combined with an agent like Clomiphene Citrate to promote endogenous FSH/LH release. This combined approach bypasses the central suppression while providing adequate testosterone.

TRT Fertility Protocol

Meaning

A specialized clinical regimen designed to mitigate the suppressive effect of exogenous testosterone replacement therapy (TRT) on endogenous spermatogenesis, allowing a man to maintain fertility while receiving testosterone treatment. This protocol typically involves the concurrent use of adjunctive hormonal agents to preserve testicular function. It is a necessary modification for men on TRT who desire to father children.