What is human chorionic gonadotropin (hCG)?

Human chorionic gonadotropin, or hCG, is a peptide hormone that replicates the signaling action of luteinizing hormone (LH) in the body. During testosterone replacement therapy, exogenous testosterone suppresses the pituitary gland's natural LH production, which can lead to testicular atrophy and reduced sperm output. hCG works by binding to the same receptors that LH targets, maintaining Leydig cell stimulation in the testes and preserving testicular volume and spermatogenesis.

Clinicians typically prescribe hCG as an adjunct to TRT rather than as a standalone treatment. It is administered via subcutaneous or intramuscular injection in doses ranging from 500 to 2,000 IU per week, depending on individual response and fertility goals. Men pursuing testosterone replacement therapy who wish to retain reproductive capacity or minimize testicular shutdown often benefit from concurrent hCG use.

The medication does not replace testosterone; instead, it sustains the endocrine environment within the testes themselves. Some patients use hCG throughout their entire TRT course, while others employ it strategically during planned breaks from therapy or when attempting to restore natural hormone production. Response varies based on baseline fertility, duration of prior testosterone use, and individual sensitivity to the hormone.