hCG

What hCG does

hCG stimulates the testes or ovaries and is approved for selected fertility uses. Small studies during testosterone therapy do not guarantee sperm production or pregnancy, and weight-loss benefit is unproven. It acts through the luteinizing hormone receptor. Risks include hormone-related effects and ovarian hyperstimulation.

• hCG is approved for some men with low testosterone from weak brain hormone signals, and to help women ovulate. (Drug label)
• Ovidrel is approved to trigger final egg maturation during fertility treatment. (Drug label)
• In small studies of men on testosterone therapy, hCG helped preserve the testes' own testosterone and semen, but fertility was not proven. (Studied in a trial)
• Men on testosterone therapy report fuller testes or better sexual symptoms. (Reported by users)

Uses in the sources

• Urinary hCG is approved for selected male hypogonadotropic hypogonadism and ovulation induction. (Drug label) (source)
• Recombinant hCG is approved to trigger final egg maturation after ovarian stimulation. (Drug label) (source)
• Clinicians publish off-label TRT add-on and sperm-recovery regimens. Evidence remains limited. (Clinician-published) (source)

hCG dosage

Typical reported dose: 500–1000 units three times a week, then twice a week

• Male hypogonadotropism: six-week schedule: 500 to 1000 USP units 3 times a week for 3 weeks, then the same dose twice a week for 3 weeks three times weekly, then twice weekly, into muscle. Drug label. Studied in: Selected cases of male hypogonadotropic hypogonadism. (source)
• Male hypogonadotropism: longer course: 4000 USP units 3 times weekly for 6 to 9 months; may be reduced to 2000 USP units 3 times weekly for an additional 3 months three times weekly, into muscle. Drug label. Studied in: Selected cases of male hypogonadotropic hypogonadism. (source)
• Urinary hCG: ovulation trigger: 5000 to 10,000 USP units 1 day following the last dose of gonadotropins single trigger dose, into muscle. Drug label. Studied in: Appropriately stimulated infertile women without primary ovarian failure. (source)
• Ovidrel: 250 mcg trigger: 250 mcg one day following the last dose of the follicle stimulating agent single trigger dose, under the skin. Drug label. Studied in: Women undergoing assisted reproduction or ovulation induction. (source)
• Ovitrelle: 24–48-hour trigger: 250 mcg 24 to 48 hours after the last FSH or hMG dose single trigger dose, under the skin. Drug label. Studied in: Women after optimal follicular stimulation. (source)
• TRT study: 125 IU every other day: 125 IU every other day every other day, under the skin. Studied in a trial. Studied in: Healthy men also receiving testosterone enanthate 200 mg IM weekly. (source)

These are doses reported in labels, trials or user reports, not a personal plan. Check the source behind each one.

Work out syringe units with the dosing calculator

How to mix hCG

Comes as: Urinary hCG lyophilized vial labelled in IU, Ovidrel 250 mcg/0.5 mL single-dose prefilled syringe.

Mixed with: Use supplied diluent. Pregnyl has 0.9% benzyl alcohol with saline; Novarel supplies bacteriostatic water..

• Pregnyl: 10,000 IU vial; label allows 1–10 mL supplied solvent. Gently dissolve; do not shake or freeze.
• Novarel: 5,000 or 10,000 USP-unit presentations; follow the exact product instructions.
• Ovidrel is ready to inject and single use; discard leftovers.
• The mg vial-size field is empty because IU cannot be converted to mass by one universal factor.

Before mixing: Pregnyl: 15–30°C. Novarel: room temperature. Ovidrel: 2–8°C; patient storage up to 30 days at ≤25°C is permitted.

After mixing: Pregnyl: 2–8°C, discard after 60 days. Novarel: 2–8°C, use within 30 days. These limits are product-specific.

hCG side effects and risks

Reported side effects

• Injection-site pain, bruising or irritation: 49/335 (14.6%) with Ovidrel 250 mcg versus 92/328 (28%) with urinary hCG., mild (source)
• Ovarian hyperstimulation syndrome: 250 mcg: 4/236 (1.7%) ART; 3/99 (3.0%) OI. At 500 mcg: 8/89 (9.0%)., serious. Severe pain, rapid weight gain, vomiting or breathlessness needs urgent care. (source)
• Stomach or pelvic pain: Ovidrel ART: 10/236 (4.2%) abdominal pain., moderate (source)
• Nausea or vomiting: Ovidrel ART: nausea 8/236 (3.4%); vomiting 6/236 (2.5%)., mild (source)
• Breast growth, tenderness or acne in men: hCG/hMG: breast growth 16/182 (8.8%); acne 11/182 (6.0%)., moderate. These combination rates do not predict risk with low-dose hCG/TRT. (source)
• Water retention or swelling: unknown, moderate. Review sudden swelling, weight gain or blood-pressure change. (source)
• Headache, irritability, low mood or restlessness: unknown, moderate (source)
• Severe allergy: unknown, serious. Airway swelling, wheeze or collapse needs emergency care. (source)
• Blood clot, ovarian twisting or rupture: unknown, serious. Chest pain, one swollen leg or sudden severe pelvic pain needs urgent care. (source)
• Sperm suppression despite higher doses: Eight man study: mean 88±24 to 22±7 million/mL on 5,000 IU IM twice weekly; one azoospermic with added testosterone., serious (source)

Stop and get help if

• Severe pelvic pain, fast weight gain, vomiting, low urine output or breathlessness: Get urgent assessment for ovarian hyperstimulation.
• Chest pain, coughing blood, one swollen leg or sudden weakness: Seek emergency care for a possible blood clot.
• Throat swelling, wheeze, widespread hives or collapse: Seek emergency care for possible anaphylaxis.
• Sudden one-sided pelvic pain, fainting or shoulder pain during fertility therapy: Urgent assessment for torsion, bleeding or ectopic pregnancy.
• Fainting or palpitations while fasting or on a very low-calorie hCG diet: Get urgent assessment for dehydration or electrolyte problems.

Who should avoid it

• pregnant: Ovidrel is contraindicated in pregnancy; urinary hCG is not indicated once pregnancy is confirmed.
• breastfeeding: Use during nursing is not established; the adult self-use screen blocks it.
• tryingToConceive: Fertility use requires a semen or ovulation plan, not a size assumption.
• under18: Historic pediatric indications do not establish adult self-use regimens.
• hormoneSensitiveCancer: Sex-hormone-dependent breast, prostate or reproductive-tract tumors can be a contraindication.
• other: Prior serious hCG or excipient allergy can recur.
• other: Pituitary/hypothalamic tumors or uncontrolled thyroid/adrenal disease require assessment before gonadotropins.
• other: Primary ovarian failure, unexplained bleeding or unexplained ovarian enlargement can preclude ovulation induction.
• other: Pregnyl and Ovitrelle are contraindicated when reproductive-organ malformations are incompatible with pregnancy.
• other: Pregnyl and Ovitrelle are contraindicated when uterine fibroids are incompatible with pregnancy.
• other: Ovitrelle must not be used in postmenopausal women because an effective response cannot be obtained.
• other: Withhold an ovulation trigger when follicles, ovary size or estradiol indicate excessive response.
• heartCondition: Androgen-related water retention can worsen heart disease.
• kidneyDisease: Water retention can worsen kidney disease; renal-impairment data are limited.
• uncontrolledBloodPressure: Use cautiously with hypertension because of fluid retention.
• seizureDisorder: Urinary hCG labeling calls for caution with epilepsy.
• other: Prior clot, thrombophilia or family clotting history raises concern during fertility stimulation.
• eatingDisorderHistory: The hCG diet can reinforce harmful restriction; hCG adds no proven weight-loss benefit.
• testedAthlete: Prohibited at all times in males under WADA S2.2.1.
• other: Ovitrelle product information contraindicates active blood-clot disease.

Interactions

• Testosterone and anabolic steroids: TRT suppresses LH/FSH and can suppress sperm despite hCG. Fertility protection is not guaranteed.
• FSH or hMG: Published combinations can help selected patients; ovarian over-response and multiple pregnancy require monitoring.
• Other hCG products: Same biological pathway. Duplicate doses add exposure without a proven stacking advantage.
• Clomiphene or tamoxifen: Used in published recovery combinations; small series cannot isolate the added benefit.
• Aromatase inhibitors: Sometimes used for high estradiol; avoid automatic use without reviewing symptoms and hormones.
• Anticoagulants and injections: Review injection bruising, especially with IM dosing. No hCG-specific pharmacokinetic interaction established.

Product quality risks

• FDA warns that weight-loss drops, pellets and sprays marketed as hCG are unapproved.
• Researchers identified hCG in illegally distributed products; identity alone did not establish sterile or reliably dosed stock.
• No representative potency or contamination survey of current online hCG supply was found.

What to expect

One review covers 44 studies in men with hormone deficiency; female fertility research is broader. Sperm evidence during testosterone therapy is limited, and newer large studies did not measure fertility.

Key studies

• TRT: 125, 250 or 500 IU: Preserved testicular testosterone did not establish fertility protection. (source)
• Very low-dose hCG: 15–125 IU: Very low doses raised testicular testosterone, without proving a fertility regimen. (source)
• TRT: 26-man semen cohort: Preserved semen in a small cohort does not guarantee fertility during TRT. (source)
• Sperm recovery after testosterone: Sperm often returned with combined care; the separate hCG effect is unknown. (source)
• Older men: 5,000 IU twice weekly: Hormone and lean-mass changes did not improve strength or function. (source)
• Male fertility: 44 gonadotropin studies: hCG plus FSH-based regimens can induce sperm in hormone deficiency. (source)

hCG FAQ

• Is hCG FDA-approved? Yes: Pregnyl (selected male hypogonadotropic hypogonadism, ovulation induction and historic pediatric cryptorchidism.); Novarel (selected male hypogonadotropic hypogonadism, ovulation induction and historic pediatric cryptorchidism.); Ovidrel (final follicular maturation and ovulation after appropriate stimulation.). The 2020 transition did not ban approved hCG. No weight-loss indication; TRT fertility add-on use is off label.
• How do people take it? Into muscle, three times weekly, then twice weekly. 6 weeks. Source: drug label.
• What's the difference between hCG and Gonadorelin? hCG: a fertility hormone with limited testosterone add-on evidence and no proven weight-loss benefit. Gonadorelin: a short-acting fertility hormone used in tests and specialist pump therapy. Why people pair them: forum users sometimes combine both with TRT; no controlled advantage was found.
• Can I take it with Gonadorelin? Forum users sometimes combine both with TRT; no controlled advantage was found. Combining reproductive hormones can obscure which drug caused a change. Source: reported by users. Ask a doctor before combining anything.
• Is it banned in sport? Yes. It is banned in and out of competition (WADA 2026). The S2.2.1 restriction applies to male athletes. The ingredient, formulation and athlete-specific therapeutic use exemption must be checked with the antidoping authority.
• How long does a mixed vial last? Pregnyl: 2–8°C, discard after 60 days. Novarel: 2–8°C, use within 30 days. These limits are product-specific.