HCG Post-TRT Recovery & Testicular Preservation Protocol

Restore endogenous testosterone production, LH/FSH pulsatility, and testicular function after TRT or anabolic cycle discontinuation; preserve fertility in men on long-term TRT

Patient profile: Males discontinuing TRT or anabolic steroids with suppressed HPTA (low LH/FSH, testicular atrophy); males on active TRT who wish to preserve testicular volume and fertility; men planning conception within 6–12 months

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⚠️

This protocol is an educational example only. It does not apply to your specific health situation. Medical supervision is required. Peptide therapy is not approved by regulatory bodies for many of the described indications.

Protocol Stack

HCG (Human Chorionic Gonadotropin)

Primary

Dose

1500–2000 IU

Frequency

3x/week SC (Mon / Wed / Fri)

Timing

Any time, consistent

Duration

Weeks 1–3 (PCT phase) — then reduce to 500 IU 2x/week if continuing as TRT co-administration

Kisspeptin-10

Supporting

Dose

1.5 mcg/kg SC

Frequency

2x/day pulsatile (spacing min. 90 min)

Timing

Evening preferred — aligns with LH pulsatility window

Duration

Weeks 4–10 (hypothalamic reactivation phase after HCG)

BPC-157

Optional

Dose

250 mcg

Frequency

2x/day SC

Timing

Morning and evening, away from food

Duration

Weeks 1–10 (systemic anti-inflammatory support during HPTA recovery)

Monitoring Parameters

✓Total and free testosterone — baseline (day of TRT last dose), week 3, week 6, week 10
✓LH and FSH — baseline, week 3, week 6, week 10 (key markers of hypothalamic recovery)
✓Estradiol (E2) — every testosterone check (HCG aromatises readily; watch for E2 rise)
✓Hematocrit and haemoglobin — baseline and week 6 (HCG stimulates erythropoiesis)
✓PSA — baseline (mandatory before HCG in men over 45)
✓Sperm analysis — baseline and week 12 (if fertility is primary goal)
✓Testicular volume — clinical assessment at baseline and week 6

Expected Outcomes

Week 1–2: Testicular fullness returning (Leydig cell stimulation), libido beginning to improve

Week 3: Testosterone rising from suppressed baseline; transition from HCG phase to Kisspeptin

Week 6: LH/FSH pulsatility detectable; endogenous testosterone 40–70% of pre-TRT baseline

Week 10: Full HPTA recovery in most patients; testosterone at 70–100% of pre-TRT baseline

Week 12 (optional): Sperm analysis — full spermatogenesis recovery typically takes 3–6 months total

Contraindications

✗Primary hypogonadism (Klinefelter syndrome, bilateral orchidectomy) — Leydig cells absent or non-functional; HCG ineffective
✗Hormone-sensitive malignancy (prostate, testicular) or PSA > 4 ng/mL without urological clearance
✗Pituitary tumour or active pituitary pathology
✗Polycythaemia or haematocrit > 52% at baseline
✗Hypersensitivity to HCG or Kisspeptin excipients
✗Active cardiovascular event or severe hypertension

Clinical Notes

The protocol runs in two sequential phases targeting different levels of the HPG axis. Phase 1 (weeks 1–3): HCG acts as an LH mimic, directly stimulating Leydig cells in the testes — this bypasses the suppressed hypothalamus and pituitary to restart testosterone production from the bottom up. Phase 2 (weeks 4–10): Kisspeptin-10 reactivates the hypothalamic GnRH pulse generator, restoring top-down LH/FSH pulsatility. This two-phase sequence — peripheral stimulation first, then central reset — achieves faster and more complete HPTA recovery than either agent alone. BPC-157 is optional but improves GI tolerance (common during hormonal flux) and exerts systemic anti-inflammatory effects that may support receptor sensitivity. Note: clomiphene citrate (Clomid) is commonly added as a third agent in weeks 4–10 to further block oestrogen feedback at the hypothalamus; this is a prescription medication and falls outside the peptide protocol scope but should be discussed with a prescribing specialist. Avoid starting HCG within 4 weeks of the last testosterone ester injection (cypionate/enanthate) — residual exogenous testosterone will suppress LH receptor sensitivity.

Case Study

Clinical Practice Example

Male, 38, TRT user for 4 years (testosterone enanthate 150 mg/week). Planning conception — partner aged 34. Sperm analysis at baseline: concentration 1.2 million/mL (severe oligospermia), motility 18%. LH < 0.1 mIU/mL, FSH 0.3 mIU/mL (fully suppressed). Testosterone 24 nmol/L (exogenous). TRT stopped; protocol initiated 4 weeks later. Week 3: testosterone 8.1 nmol/L, LH still 0.2. Kisspeptin phase initiated (week 4). Week 6: LH 3.8 mIU/mL, FSH 4.1, testosterone 12.4 nmol/L. Week 10: testosterone 16.8 nmol/L, LH 6.1, FSH 6.8 — full HPTA recovery. Week 16 sperm analysis: concentration 18 million/mL, motility 42% (normal parameters). Partner conceived in month 8.

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