Human Chorionic Gonadotropin (hCG) is a hormone that plays a critical role in improving testosterone levels in hypogonadal men and preventing the loss of fertility in men using testosterone replacement therapy (TRT). Below is a detailed look at these two significant roles.

hCG Role in Improving Testosterone Levels in Hypogonadal Men

1. Mimicking Luteinizing Hormone (LH) Action

The structure of HCG is very similar to that of the luteinizing hormone (LH). In men, it works like LH to stimulate the Leydig cells in the testes. This stimulation leads to the production of testosterone, the primary male sex hormone.

2. Treatment of Secondary Hypogonadism

HCG may be used as a monotherapy in younger males with secondary hypogonadism. It aids in boosting testosterone production by the testes. While this treatment can be expensive as a standalone therapy, it is frequently used in conjunction with TRT as a cost-effective way to normalize testosterone levels.

3. Reactivating Upstream Hormones

HCG has the potential to reactivate upstream hormones like pregnenolone and progesterone that testosterone replacement therapy can suppress. This activity helps balance the overall hormone profile in hypogonadal men.

Role in Preventing Loss of Fertility in Men Using TRT

1. Preservation of Spermatogenesis

TRT can lead to a reduction in intratesticular testosterone (ITT) and impair spermatogenesis (sperm production), leading to infertility in some men. HCG co-administration helps maintain ITT during TRT, supporting continued spermatogenesis and preserving fertility.

2. Mitigating Testicular Atrophy

Long-term use of testosterone can reduce testicular size, leading to atrophy. HCG is used to prevent or reverse this condition. The usual dose of 350–500 IU two times a week can be effective in combating testicular atrophy, though published data on this specific use is scarce.

3. Assisting in Steroid Abuse Recovery

For individuals who have abused steroids, HCG may be used for 6–8 weeks before clomiphene to accelerate the natural production of testosterone and restore fertility.

What is Human Chorionic Gonadotropin (hCG) and How it Can Help Men?

  • HCG (human chorionic gonadotropin) is produced by the human placenta, a sterile product derived from the urine of pregnant females. Pharmaceutical companies and compounding pharmacies produce recombinant DNA formulas.
  • In men, HCG mimics LH from the pituitary to stimulate Leydig cells in the testes to produce testosterone.
  • It can have an additive effect on testosterone replacement therapy's ( TRT)  increases in estradiol, hematocrit, and/or acne
  • The normal lyophilized vial contains 5,000 or 11,000 units of HCG produced by compounding pharmacies (commercial products cost 3X compounding). The vial is sent with bacteriostatic water for reconstitution.
  • Used by fertility specialists to induce ovulation to harvest eggs and sperm production.
  • The latest data show that men on TRT + HCG were able to remain fertile. (TRT + 500 IU HCG every other day)
  • The usual dose of 350–500 IU two times a week is for the prevention or reversal of testicular atrophy. No data has been published on this use.
  • Anecdotal effect on raising sex drive in men No data.
  • HCG acts as a Leydig cell stimulator and cell volumizer. Testicles regain size but do not grow beyond baseline size.
  • Continuous testosterone can reduce fertility in over 50% of TRT users and testicular size by 10–30%. HCG may reverse those two issues.
  • Noticeable testicular size reduction can be a more common complaint in men with a smaller testicular size at baseline. It may not be important to some older men or men who are not worried about fertility. 
  • HCG may be used in patients who have abused steroids for 6–8 weeks before c l omiphene to attempt to accelerate the natural production of testosterone.
  • May be used in younger males as the sole method of testosterone treatment with secondary hypogonadism. All men respond differently to HCG's ability to boost T production by testes. It is expensive as monotherapy and frequently used with testosterone replacement since that combination may be more cost-effective in normalizing testosterone and fertility.
  • HCG has the potential to reactivate upstream hormones like pregnenolone and progesterone that testosterone replacement therapy has shut down.
  • HCG may not work well in some men who have primary hypogonadism, i.e. dysfunction of the Leydig cells in the testes.

Introduction: Understanding Human Chorionic Gonadotropin (hCG)

Human Chorionic Gonadotropin (hCG) is an essential hormone that plays various roles in human reproduction and hormone regulation. This article explores the nature of hCG, its applications, and its significance in men's health.

What Is Human Chorionic Gonadotropin (hCG)?

The human placenta produces the sterile substance HCG, which comes from pregnant women's urine. Pharmaceutical companies and compounding pharmacies produce various recombinant DNA formulas.

The Role of hCG in Men's Health

Testosterone Production

In men, hCG mimics LH from the pituitary gland, stimulating Leydig cells of the testes to produce testosterone. This can have an additive effect on testosterone replacement therapy's (TRT) increases in estradiol, hematocrit, and/or acne.

Fertility Enhancement

  • Used in Fertility Treatment: Fertility specialists often use hCG to induce ovulation and sperm production. The latest data shows that men on TRT + hCG were able to remain fertile (TRT + 500 IU hCG every other day). hCG increases 17-OH-progesterone which is linked to sperm production in the testicles.
  • Dosage for Prevention or Reversal of Testicular Atrophy: The usual dose is 350–500 IU two times a week for the prevention or reversal of testicular atrophy. However, no data has been published on this use.

Other Effects

  • Anecdotal Effects on Sex Drive: Some reports suggest hCG might raise sex drive in men, though there's no substantial data.
  • Reactivation of Upstream Hormones: hCG may reactivate upstream hormones like pregnenolone and progesterone that are shut down by testosterone replacement therapy.
  • Primary Hypogonadism: hCG may not work for some men who have primary hypogonadism, which means that the Leydig cells in their testes do not work right.

Commercial and Therapeutic Aspects of hCG

  • Commercial Products: Normal lyophilized vials contain 5,000 or 11,000 units of hCG by compounding pharmacies, costing three times less than commercial products.
  • Steroid Abuse Treatment: hCG may be used in patients who have abused steroids for 6–8 weeks before clomiphene to attempt to accelerate the natural production of testosterone.
  • Monotherapy in Young Males: May be used as the sole method of testosterone treatment in younger males with secondary hypogonadism.

How Does hCG Work in Men?

HCG as a Leydig Cell Stimulator

HCG acts as a Leydig cell stimulator and cell volumizer. Testicles regain size but do not grow beyond baseline size. Continuous testosterone can reduce fertility in over 50% of TRT users and testicular size by 10–30%. HCG may reverse these two issues5.

buy hcg trt

HCG + TRT Studies

A comprehensive understanding of how hCG works with TRT can be found in the following key studies:

  1. Testosterone+ HCG Preserves Healthy Sperm in Men on Testosterone Replacement Therapy by Tung-Chin Hsieh et al. This study explains the preservation of sperm parameters in hypogonadal men on testosterone replacement therapy with concomitant low-dose human chorionic gonadotropin (hCG)

  2. Low-dose human chorionic gonadotropin maintains intratesticular testosterone in normal men with testosterone-induced gonadotropin suppression. Randomized controlled trial by Coviello AD, et al. This study investigates how low-dose hCG maintains intratesticular testosterone within the normal range in healthy men with gonadotropin suppression.

Conclusion: The Versatility of hCG

Human Chorionic Gonadotropin (hCG) plays a multifaceted role in men's health, including fertility preservation, testosterone production, and the possible enhancement of sex drive. Its complex nature and diverse applications make it a vital aspect of medical study and therapeutic application.

 

Citations



Concomitant intramuscular human chorionic gonadotropin preserves spermatogenesis in men undergoing testosterone replacement therapy. - PubMed - NCBI

Exogenous testosterone: a preventable cause of male infertility - Crosnoe - Translational Andrology and Urology

Maintenance of spermatogenesis in hypogonadotropic hypogonadal men with human chorionic gonadotropin alone. - PubMed - NCBI

Effects of three different medications on metabolic parameters and testicular volume in patients with hypogonadotropic hypogonadism: 3-year experie... - PubMed - NCBI

  Safety of Human Chorionic Gonadotropin Monotherapy for Men with Hypogonadal Symptoms and Testosterone >300 ng/dL 

 Human Chorionic Gonadotropin monotherapy for the treatment of hypogonadal symptoms in men with total testosterone > 300 ng/dL.

Fertility induction in hypogonadotropic hypogonadal men.

Indications for the use of human chorionic gonadotropic hormone for the management of infertility in hypogonadal men.

Clomiphene citrate and human chorionic gonadotropin are both effective in restoring testosterone in hypogonadism: a short-course randomized study.

The Effect of Human Chorionic Gonadotropin Therapy on Semen Parameters and Pregnancy Rate after Varicocelectomy.

[Anabolic steroid induced hypogonadism in men: overview and case report].

Testicular responses to hCG stimulation at varying doses in men with spinal cord injury.

Age and duration of testosterone therapy predict time to return of sperm count after human chorionic gonadotropin therapy.

Serum estradiol after single dose hCG administration correlates with Leydig cell reserve in hypogonadal men: reassessment of the hCG stimulation test.

 

 

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