Human Chorionic Gonadotropin

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evidence score

hormonal

Prescription Only

Evidence Level A

HCGhCGPregnyl+3 more

Human Chorionic Gonadotropin (hCG) is a glycoprotein hormone structurally similar to luteinizing hormone (LH). In men on TRT, exogenous testosterone suppresses the HPG axis, shutting down intratesticular testosterone (ITT) production and spermatogenesis. HCG directly stimulates Leydig cells via the LH/hCG receptor, maintaining ITT at levels sufficient to preserve spermatogenesis and prevent testicular atrophy — the primary reason it is co-administered with TRT. Coviello et al. (2005) demonstrated that 250 IU EOD maintains ITT in men receiving exogenous testosterone, while 500 IU EOD fully preserves spermatogenesis. Also used off-label for hypogonadism monotherapy in younger men wanting to avoid full TRT commitment. FDA-approved for female fertility (ovulation induction) and male cryptorchidism. Now increasingly replaced by gonadorelin in some TRT clinics due to compounding pharmacy restrictions post-2020 FDA enforcement.

Current literature links

Human chorionic gonadotropin maintains intratesticular testosterone in normal men with testosterone-induced gonadotropin suppression(2005)Low-dose human chorionic gonadotropin maintains intratesticular testosterone in normal men with testosterone-induced gonadotropin suppression(2013)Spermatogenesis recovery with hCG/FSH after testosterone-induced azoospermia(2013)

Evidence

No score yet

Safety

Unknown safety profile

Clinical Status

Approved

Last Sync

Not synced yet

Last Reviewed

Not reviewed yet

Physician Notes

Always discuss fertility goals before starting TRT. HCG is the standard adjunct for fertility preservation. 500 IU 2x/week is the most common protocol. Can increase E2 more than TRT alone.

FDA Status:FDA-approved. Compounded versions widely available via 503A pharmacies.

Monitoring

Estradiol (may increase)
Semen analysis if fertility is the goal
Testicular ultrasound if clinically indicated

Contraindications

Hormone-sensitive malignancy
Precocious puberty

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Dosing

Typical

500 IU

250 IURange2000 IU

Frequency2-3x/week (EOD or Mon/Wed/Fri)

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Pharmacology

Half-life~24-36 hours

OnsetITT increase within 24-48 hours; spermatogenesis preservation requires weeks of consistent use

DurationEffects persist ~48-72 hours per injection

Routes

subcutaneous

intramuscular

Evidence Score

—

0 studies indexed

Scoring Factors

Volume(24%)—

Quality(24%)—

Sample Size(12%)—

Consistency(14%)—

Replication(8%)—

Recency(18%)—

Evidence Levels

AScore ≥75 with at least 1 meta-analysis and 3+ RCTs

BScore ≥50 with at least 1 RCT or meta-analysis

CScore ≥25 — observational or animal evidence only

DScore <25 — very limited or preclinical data

Plain-English Snapshot

Human Chorionic Gonadotropin is currently categorized as a hormonal compound.

Evidence scoring has not been fully computed yet, so interpret this profile as preliminary.

Safety scoring is incomplete. Start conservatively and monitor carefully.

Core mechanism

LH/hCG receptor agonist on Leydig cells; maintains intratesticular testosterone and spermatogenesis during exogenous testosterone administration

Practical Context

Strongest current signals

No indexed study summaries yet.