Update on my case (43M, NOA, confirmed SCO, bilateral microTESE negative in September 2025).

[u/hbenzi]

Update on my case (43M, NOA, confirmed SCO, bilateral microTESE negative in September 2025).

Following my negative microTESE, my andrologist started me on hCG/Ovitrelle. I'm now trying to understand what this treatment is actually doing in my case.

Before treatment (February 2026):

- FSH: 29 IU/L

- LH: 18.4 IU/L

- Estradiol: 50 pg/mL

- Total testosterone: 3.84 ng/mL

- Bioavailable testosterone: 3.83

After about 2 months on hCG (April 2026):

- FSH: 19 IU/L

- LH: 10.4 IU/L

- Estradiol: 54 pg/mL

- Bioavailable testosterone: 2.07

- Inhibin B: 11 pg/mL (down from 42.1 pg/mL previously)

After about 3 months of treatment, but with a forced 1-week interruption before the blood test (May/June 2026):

- FSH: 28.2 IU/L

- LH: 14.8 IU/L

- Estradiol: 30 pg/mL

- Bioavailable testosterone: 1.16 ng/mL

What puzzles me is that my numbers seem to be getting worse rather than better since starting hCG.

Yes, FSH and LH decreased while on treatment, but at the same time:

- Inhibin B dropped from 42.1 to 11 pg/mL;

- Estradiol increased while on hCG;

- Bioavailable testosterone went from 3.83 before treatment to 2.07 and then 1.16;

- After only one week off hCG, FSH and LH rebounded quickly.

My impression is that hCG has made the hormonal picture more complicated without providing any obvious benefit regarding testicular function. In fact, the week off treatment almost felt like a clearer picture of my baseline status: estradiol normalized, while LH and FSH rose again as expected.

I realize I may be interpreting these numbers incorrectly, which is exactly why I'm looking for feedback from others with similar diagnoses.

For those with severe NOA, Sertoli Cell Only syndrome, and a negative microTESE, have you experienced something similar on hCG? Did you stay on it long term, and if so, what was the actual goal? Has anyone undergone a second microTESE after prolonged hormonal optimization and achieved sperm retrieval despite an SCO diagnosis?

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[u/Nearby-Party-1327]

My husband has severe NOA, but no SCO so take this with a grain of salt. 

He had a failed mTese last August (2025) and in March (2026) he started taking HCG and isotretinoin. 

According to our urologist taking the HCG doesn’t “hurt” and might help stabilize his hormone levels - he also has very high FSH. 

However, the “real” medication is the isotretinoin and hoping that is what will work. 

All that being said, he just did a SA a week ago and still no sperm were found even after being on this for three months. But he’s going to get SA monthly now to see if anything changes. If we find ANY sperm in a centrifuged SA then we would try a mTese again. We may even try ESS (again!) and similarly if ANY sperm are found we would do the surgery again. 

We need proof that the surgery will work before he goes through it again. 

Also, I would do some research into Paterna if you have SCO. It’s a clinical trial that might be of interest.