Why (and how) I take fertility-friendly TRT 👉

Why (and how) I take fertility-friendly TRT

By Gabriel Alizaidy, MD, MS and Scientific Director at Maximus

Before I started my optimization journey, my testosterone measured at 860 ng/dL—well above the clinical threshold for hypogonadism. By every standard, on paper, I was completely fine.

But I wasn't thriving.

Every morning felt like a negotiation with my own body just to function at a basic level. Coffee had gone from something I enjoyed to something I needed just to get through the day. By 2 PM, I was reaching for more stimulants just to stay at baseline. Not to perform well. Just to exist at an acceptable level.

Sleep never delivered on its promise. Eight hours in bed translated to maybe five hours of actual rest. I’d tried every strategy I could find: macro tracking, supplements, blackout curtains, Oura ring, strength training 4-5x per week. I’d exhausted the fundamentals.

I was okay. Functional. Normal.

But okay isn't optimal, and normal is just a statistical average that includes metabolically broken individuals alongside the healthy.

The problem everyone faces

When I started looking into testosterone optimization, I hit the same wall every man hits:

Traditional TRT forces you to choose between performance now or fertility later.

Injectable testosterone: Most potent. Most suppressive. Even with HCG support, injectables consistently suppress LH and FSH to near-zero levels. HCG can help maintain some fertility, but I wasn’t looking for some. Family came first, full stop. That was non-negotiable.

The solution: Fertility-friendly TRT

The method I chose

Topical Testosterone + Enclomiphene: After looking at every option, this combination made the most sense.

Adding enclomiphene to topical testosterone preserves your fertility markers while delivering real performance benefits. We have the clinical data to prove it. Your brain keeps sending LH and FSH signals to your testes, which means spermatogenesis and testicular function stay intact. Daily application gives you a predictable rise and fall that mimics your body’s natural circadian rhythm.

The real question was whether this protocol would keep my fertility markers in range while raising my testosterone enough to actually feel different.

My results after 10 months

What 1500 ng/dl actually feels like