Chorionic Gonadotropin (Human)
Also known as: Choriogonadotropin alfa, Chorionic gonadotropin, hCG, Human chorionic gonadotrophin, Novarel, Ovidrel, Pregnyl
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Summary
Human chorionic gonadotropin (hCG) is a prescription glycoprotein hormone used primarily to stimulate gonadal function. In men, it is employed to induce spermatogenesis and improve fertility in conditions such as hypogonadotropic hypogonadism and idiopathic oligozoospermia. The drug is administered by injection and is approved for clinical use in several countries.
Mechanism of Action
hCG acts as an analogue of luteinizing hormone (LH). By binding to LH receptors on Leydig cells in the testes, it promotes testosterone production and supports the maturation of spermatozoa. The resulting rise in intratesticular testosterone drives spermatogenesis, which underlies its therapeutic use in male infertility.
What the Research Shows
Clinical evidence for hCG in male fertility includes a randomized, double‑blind, placebo‑controlled trial in men with idiopathic oligozoospermia, where three months of hCG combined with hMG improved sperm concentration, motility, morphology, DNA fragmentation and spontaneous pregnancy rates in participants with medium‑to‑high inhibin B levels. A separate case series of 42 men with hypogonadotropic hypogonadism or Kallmann syndrome showed that hCG/hMG therapy doubled testicular volume within 5‑12 months, induced spermatogenesis in 54 of 57 treatment courses, and resulted in pregnancies in 26 of 36 attempts. Both reports indicate that hCG can effectively stimulate spermatogenesis and achieve paternity in selected male patients.
Reported Benefits
Evidence from controlled and observational studies suggests that hCG can increase sperm count, motility, and normal morphology, reduce DNA fragmentation, and raise pregnancy rates in men with certain forms of infertility. In hypogonadotropic hypogonadism, hCG therapy restores testicular growth and enables sperm production, leading to successful pregnancies for many couples.
Limitations of the Evidence
The available data are limited to relatively small cohorts and specific subgroups (e.g., men with adequate inhibin B or defined hormonal deficiencies). Long‑term safety and comparative effectiveness versus other gonadotropin regimens remain inadequately studied. Not all patients respond, and the optimal dose, duration, and combination with other hormones have not been standardized.
Safety Considerations
Published abstracts do not detail adverse events for hCG therapy. As a hormonal agent, potential cautions include the risk of ovarian hyperstimulation in women, overstimulation of Leydig cells, and theoretical effects on hormone‑sensitive conditions. Clinicians should monitor hormonal levels and watch for signs of excessive androgen exposure, following standard prescribing guidelines.
How It Is Administered
hCG is supplied for injection and can be given intramuscularly or subcutaneously. Commercial preparations include recombinant forms (e.g., choriogonadotropin alfa) and urinary‑derived extracts. Dosing schedules vary by indication and are determined by the treating physician.
Routes of Administration
Goals & Uses
- Ovulation induction / ART triggerReproductive EndocrinologyHigh
- Luteal phase supportFertilityHigh
- Ovulation inductionReproductive EndocrinologyHigh
- Corpus luteum support in ARTReproductive EndocrinologyHigh
- Male hypogonadism treatmentEndocrineModerate
- Testosterone optimization / fertility preservation during TRTMen's Health (off Label)Moderate
- Treatment of hypogonadotropic hypogonadism in malesEndocrinology / AndrologyHigh
- Cryptorchidism treatmentPediatric UrologyModerate
Contraindications
- Hypersensitivity to hCG or excipientsAllergy/ImmunologyHigh
- Pregnancy with molar gestationReproductiveHigh
- Ovarian hyperstimulation syndrome (OHSS) riskReproductive MedicineHigh
- Estrogen‑dependent tumorsOncologyModerate
- Primary gonadal failure (hypergonadotropic hypogonadism)EndocrinologyHigh
- Uncontrolled thyroid or adrenal dysfunctionEndocrinologyModerate
- Hormone-sensitive malignancies (e.g., prostate cancer, testicular germ cell tumors)OncologyHigh
- Precocious pubertyPediatric EndocrinologyHigh
- Uncontrolled hypertensionCardiovascularModerate
Adverse Effects
- Injection site reactionsLocalCommon
- Multiple gestationReproductiveUncommon
- HeadacheNeurologicCommonPain in the head or upper neck
- Thromboembolic eventsCardiovascularRare
- GynecomastiaEndocrineUncommon
- Injection site reactionLocalCommonRedness, swelling, itching, bruising, or pain at the injection site
- Ovarian hyperstimulation syndrome (OHSS)ReproductiveUncommon
- Gynecomastia (in males)EndocrineRare
Drug Interactions
- Exogenous testosterone (TRT)Low
- AnticoagulantsLowMonitor when nausea or vomiting affects intake
- Estrogen therapyModerate
- Aromatase inhibitors (e.g., anastrozole, letrozole)Low
- Clomiphene citrateLow
- GnRH agonists / antagonistsLow
Population Constraints
- PregnancyReproductive SafetyRelative
- Renal impairmentOrgan ImpairmentRelative
- Prepubertal childrenPediatricRelative
- Elderly (>65)AgeRelative
- Pediatric useAgeRelative
- Patients with history of thromboembolic diseaseCardiovascularRelative
Regulatory Status
- European UnionApprovedApproved: infertility, luteal phase supportMarketing authorisation granted.
- United StatesApprovedApproved: infertility, ovulation induction, testosterone stimulationPrescription only.
- United KingdomApprovedApproved: infertility, ovulation inductionAvailable via specialist prescription.
FDA‑approved for infertility, ovulation induction, and as a testosterone‑stimulating agent; also approved in EU and UK for similar indications.
Evidence & Sources
- Journal ArticleModerateBayes M, Rabasseda X, Prous JR2002-01-01T00:00:00.000000Z
- Journal ArticleModerateAllison KH, Love JE, Garcia RL2006-01-01T00:00:00.000000Z
- Journal ArticleModerateBayes M, Rabasseda X, Prous JR2002-01-01T00:00:00.000000Z
- Journal ArticleModerateZhao N, et al.2019-01-01T00:00:00.000000Z
- Journal ArticleModerateBüchter D, et al.1998-01-01T00:00:00.000000Z
- Journal ArticleModerateGeorge SM, Tandon S, Kandasubramanian B2020-01-01T00:00:00.000000Z
Frequently Asked Questions
What medical conditions is hCG prescribed for in men?
In men, hCG is approved to treat hypogonadotropic hypogonadism and is used off‑label to improve sperm parameters in idiopathic oligozoospermia, often in combination with human menopausal gonadotropin.
How does hCG differ from natural LH?
hCG mimics luteinizing hormone by binding the same LH receptor, but it has a longer circulating half‑life, allowing less frequent dosing while still stimulating testosterone production and spermatogenesis.
What are common side effects of hCG therapy?
The abstracts do not list specific side effects. Generally, hormonal therapy can cause local injection reactions, headache, or signs of excess androgen; patients should be monitored for any adverse symptoms.
How is hCG administered?
hCG is injected either into a muscle (intramuscular) or under the skin (subcutaneous) using the formulation prescribed by the clinician.
Is hCG effective for all causes of male infertility?
Current evidence supports benefit in hormone‑deficient states such as hypogonadotropic hypogonadism and in men with adequate inhibin B levels. Its efficacy in other forms of infertility remains unproven.
What is Chorionic Gonadotropin (Human)?
Human chorionic gonadotropin (hCG) is a prescription glycoprotein hormone used primarily to stimulate gonadal function. In men, it is employed to induce spermatogenesis and improve fertility in conditions such as hypogonadotropic hypogonadism and idiopathic oligozoospermia. The drug is administered by injection and is approved for clinical use in several countries.
What is Chorionic Gonadotropin (Human) used for?
Chorionic Gonadotropin (Human) is educationally associated with: Ovulation induction / ART trigger, Luteal phase support, Ovulation induction, Corpus luteum support in ART, Male hypogonadism treatment, Testosterone optimization / fertility preservation during TRT, Treatment of hypogonadotropic hypogonadism in males, Cryptorchidism treatment. Educational only — not medical advice.
How is Chorionic Gonadotropin (Human) administered?
Recorded routes of administration: Intramuscular, Intravenous, Subcutaneous.
What are the potential side effects of Chorionic Gonadotropin (Human)?
Reported adverse effects include: Injection site reactions, Multiple gestation, Headache, Thromboembolic events, Gynecomastia, Injection site reaction, Ovarian hyperstimulation syndrome (OHSS), Gynecomastia (in males). This list is not exhaustive — consult a qualified clinician.
Who should avoid Chorionic Gonadotropin (Human)?
Recorded contraindications: Hypersensitivity to hCG or excipients, Pregnancy with molar gestation, Ovarian hyperstimulation syndrome (OHSS) risk, Estrogen‑dependent tumors, Primary gonadal failure (hypergonadotropic hypogonadism), Uncontrolled thyroid or adrenal dysfunction, Hormone-sensitive malignancies (e.g., prostate cancer, testicular germ cell tumors), Precocious puberty, Uncontrolled hypertension. Consult a qualified clinician before use.