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What it is
A glycoprotein hormone produced in pregnancy, prepared for medical use from urinary sources or by recombinant methods.
How it is proposed to work
Acts as an LH analogue at the LH/hCG receptor. In males this stimulates Leydig cells to produce intratesticular testosterone directly, which is why it maintains testicular volume and spermatogenesis during exogenous androgen therapy that would otherwise suppress them.
Approved medical uses
Hypogonadotropic hypogonadism, prepubertal cryptorchidism and ovulation induction, depending on product and jurisdiction. Explicitly not approved for weight loss — labelling in several jurisdictions states there is no substantial evidence it increases weight loss beyond caloric restriction alone.
Human research
Each entry states what the study found and, separately, what it cannot show.
- Human observational2013n = 26
Semen parameters in hypogonadal men on testosterone replacement with concomitant hCG
Finding. No differences in semen parameters were detected: "No differences in semen parameters were observed during greater than 1 year of followup", and "No patient became azoospermic during concomitant testosterone replacement and human chorionic gonadotropin therapy." The regimen was intramuscular low dose hCG every other day alongside testosterone given as weekly intramuscular injection or daily topical gel. Serum and free testosterone rose significantly during treatment (p <0.0001 and p = 0.02) while estradiol did not change significantly (p = 0.11). Nine of 26 men contributed to a pregnancy with their partner during follow-up, an uncontrolled count in a single treated cohort. The authors conclude that low dose hCG "appears to maintain semen parameters in hypogonadal men on testosterone replacement therapy."
Limitation. A retrospective review of clinical records rather than a prospective trial, in 26 men with a mean follow-up of 6.2 months; the abstract is internally inconsistent about duration, giving mean followup as 6.2 months while the semen parameter sentence refers to greater than 1 year of followup. The abstract describes a single treated cohort measured against its own pre-treatment values with no untreated comparator, so maintenance of semen parameters cannot be separated from what would have happened without hCG. Co-administration of hCG with testosterone therapy is off-label in most jurisdictions. Intratesticular testosterone appears in the paper's rationale but not in its stated list of evaluated measures (serum and free testosterone, estradiol, semen parameters and pregnancy rates), so this paper does not itself support an intratesticular-testosterone claim; the randomised evidence for that is a separate 2005 study which in turn did not assess spermatogenesis.
- Systematic review1995
Meta-analysis of hCG for obesity (Simeons therapy)
Finding. Reviewing published reports of eight controlled and 16 uncontrolled trials of hCG as adjunctive therapy for obesity (the Simeons therapy), the authors concluded that "there is no scientific evidence that HCG is effective in the treatment of obesity; it does not bring about weight-loss of fat-redistribution, nor does it reduce hunger or induce a feeling of well-being". Of the 12 studies scoring 50 or more points for methodological quality, one reported hCG to be a useful adjunct; the authors note that the studies scoring 50 or more points were all controlled.
Limitation. This is a criteria-based meta-analysis: trials were located by computer-aided search and citation tracking of published papers, then scored for the quality of their methods and for the authors' own stated conclusions on weight loss, fat redistribution, hunger and feeling of well-being. Methodological scores ranged from 16 to 73 points against a maximum of 100, which the authors read as "suggesting that most studies were of poor methodological quality".
Preclinical research
Animal and laboratory work. Useful for generating hypotheses; it cannot establish that something works in people.
No preclinical studies catalogued.
Potential safety concerns
- CautionEstablished
Can raise oestradiol through increased testicular aromatisation. This is the effect that prompts people to add aromatase inhibitors, which is where self-management commonly goes wrong.
- SeriousEstablished
Ovarian hyperstimulation syndrome is a recognised and potentially serious risk in fertility use, requiring monitored administration.
- CautionEstablished
Weight-loss protocols using hCG persist commercially despite clearly negative evidence and explicit labelling to the contrary.
Known interactions and contraindication considerations
- Interacts with any therapy affecting the HPG axis, including testosterone and SERMs.
- Aromatase inhibitors are frequently combined; doing so without measuring oestradiol risks over-suppression.
This list is not exhaustive and is not a substitute for a clinician reviewing your full medication history.
Regulatory status
Status is shown per jurisdiction and is accurate only as of the date stated. Where a compound is approved, the approval is bound to a specific formulation, manufacturer and indication — shown in the detail column.
| Jurisdiction | Standing | Detail |
|---|---|---|
United States FDA | Approved as of 1 Jun 2026 |
Labelling explicitly rejects weight-loss use. Use alongside testosterone therapy is off-label. |
European Union EMA | Approved as of 1 Jun 2026 | Approved for fertility and related endocrine indications; specifics vary by product and member state. |
India CDSCO | Approved as of 1 Jun 2026 | Prescription-only. Approved indications follow the fertility and endocrine uses above. |
How it is being used
What the grey community actually runs, the reasoning they give, and our read on whether it follows from known biology. This is observation, not evidence, and not a recommendation.
Maintaining testicular function during testosterone therapy
What is run
Administered several times weekly alongside testosterone, spread through the week rather than in a single dose.
Their mechanistic reasoning
That exogenous testosterone suppresses LH, so the testes stop receiving their signal; supplying an LH analogue keeps Leydig cells stimulated, preserving testicular volume and intratesticular testosterone.
Reported in the community’s own terms. Not our position.
Stacked with
- Testosterone therapy—This practice exists only in that context — it is a countermeasure.
- Aromatase inhibitors—Added for oestradiol management. The single most common place this practice goes wrong when self-managed.
Regimen shape
- Dose
- figure withheld
- Scale
- International units
- Route
- Subcutaneous injection
- Frequency
- Several times weekly
- Timing
- Spread through the week rather than a single administration
- Duration
- Continuous, for as long as the underlying therapy runs
Our read
The physiology is correct and this is used in supervised clinical practice for exactly this reason. It is among the strongest reasoning in this entire library. The failure mode is not the concept but the execution — specifically, adding an aromatase inhibitor because hCG raises oestradiol, and doing so without measuring oestradiol. Over-suppression causes real harm to bone density, lipids, mood and libido, and it is entirely avoidable with a blood test.
What the community reports
The comparison is between how sure the community is and how much is actually known — evidence strength, not direction. A compound can have solid research that came out negative.
Close to consensus, and it is one of the few places where community practice, clinic protocols and endocrinology broadly agree. Disagreement is about specifics rather than about whether to do it.
Commonly reported as helping
- Maintained testicular volume, the most objective and verifiable report here
- Preserved fertility markers in people who tested
- Improved libido and sense of wellbeing, reported by some
Also reported, when it goes wrong
- Rising oestradiol, prompting people to add aromatase inhibitors
- Over-suppression of oestradiol when they do that without testing — a very common report
- Injection frequency described as inconvenient
- Acne and mood changes
Why these reports can mislead
Testicular volume is one of the few things in this library a person can genuinely observe, so those reports carry more weight than most. Wellbeing and libido reports are far softer and are confounded by the underlying testosterone therapy changing at the same time.
Direct quotations are not published here yet. We will only carry verbatim reports once they are sourced, dated and checked — an unattributed quote is a testimonial, and testimonials are exactly what this section exists to replace.
Watch for, in this use specifically
- Never run an aromatase inhibitor without measuring oestradiol. Guessing is how people end up worse off than before they started.
- Underlying testosterone therapy needs haematocrit and prostate monitoring regardless.
- If fertility is the actual goal, say so — it may change the approach entirely.
Active clinical trials
No registered trials currently tracked for Human chorionic gonadotropin.
What remains unknown
The questions that would change our assessment if they were answered.
- What is the optimal approach for preserving fertility during androgen therapy, compared with alternatives?
- How much does maintained testicular volume predict preserved fertility over years?
References
- 1.Hsieh TC, Pastuszak AW, Hwang K, Lipshultz LI. Concomitant intramuscular human chorionic gonadotropin preserves spermatogenesis in men undergoing testosterone replacement therapy. J Urol. 2013;189(2):647-50.PMID 23260550doi
- 2.Lijesen GK, Theeuwen I, Assendelft WJ, Van Der Wal G. The effect of human chorionic gonadotropin (HCG) in the treatment of obesity by means of the Simeons therapy: a criteria-based meta-analysis. Br J Clin Pharmacol. 1995;40(3):237-43.PMID 8527285doi
Editorial change history
When we change a grade or a regulatory note, we log it here rather than editing quietly.
Dossier created.
Spotted something wrong? Tell us — we publish corrections.