I'm sorry to hear about your boyfriend's problem. However, he is not alone. Low T is much more common than many realize. I would highly recommend you seek the advice of a Urologist or Endocrinologist. Both are specialists in this area.
Low T treatment (often referred to as HRT or hormone replacement therapy), isn't a "one and done" thing. Your Doc's reluctance to tweak therapy unfortunately shows that he doesn't know what he's doing.
First of all, conventional protocol calls for the gel as first level of treatment. The gel provides a more even keeled response....Daily applications of T. Also, one can very easily change the amt of treatment by the amt they apply per day. Androgel comes in a pump, thus, one can change the # pumps. One never knows where the cut off or change between the # of applications, can make a big difference. The amt needed to raise one's T is not an exact science by any means.
Secondly, shots are usually reserved for those who either don't respond to the gel initially, or with those who the gel becomes ineffective after using for a while. The problem with shots is that they provide a lot of hormone at once, and then the patients levels decline over time. Thus, more likely to be peaks and valleys. Conversely, the gel is more consistent, given the daily application.
Lastly, regardess of the treatment, it can take a while for one's levels to stabilize. It's quite common for adjustments to be made in order to get the patient completely dialed in. This is why protocol recommends a follow up appointment 30 days after initial treatment and then at 6 months. Blood testing at both intervals is used to determine how the treatment is responding. Once a person gets dialed in, appointments are either every 6 months or yearly, depending on the preference of the Dr.
These periodic appointments are required because raising one's T level can be difficult. Not only is each person different re: how much they may need to raise T a certain amount, but more importantly, HRT treatment isn't about the "number" or T level, but about the symptoms. Good HRT Docs treat the symptoms and not the overall T level. Sure the particular # is a good general indicator, but two people many need completely different levels. For example, one person may do fine at 500, while the next may not.
I hope this gives you some basic information on HRT. Again, I highly recommend you get your boyfriend to either a urologist or a endocrinologist. It will be worth the effort.
Best of luck to you.