HCG is a drug that is almost identical to luteinizing hormone and is used to stimulate the testes to produce testosterone. HCG is prescribed for low testosterone in doses of 1000 to 4000 i.u. injected intramuscularly once or twice per week. HCG is sometimes given in combination with Urofollitropin, a synthetic version of follicle stimulating hormone, to help induce sperm production1,2. Steroid users will sometimes use HCG as replacement for LH as levels of this hormone drop during a cycle. This is proposed to help to keep normal testosterone production as well as normal testicular size. There is evidence in the literature that HCG will help to maintain spermatogenesis during the use of AAS but little evidence that normal testosterone secretion will be maintained3,4. Users mistakenly associate testicular size with testosterone production when it is more likely an indicator of functional spermatogenesis. HCG is also used as post-cycle therapy to try to restart testosterone production following a cycle. There are many different dosing regimens used for this purpose. Aside from the above regimen, which is the usual way in which HCG is prescribed by physicians, athletes will sometimes use 1000-2000 i.u. once per week for three weeks,. Another option is to use 3000 i.u. initially, 3000 i.u. 5 days later, and then 1500 i.u. for two injections 5 days apart. The problem is, since HCG is nearly identical to LH, it can also be suppressive. Therefore, some have seen better results from using smaller doses (500 i.u.) every five days and still others choose to either decrease dose over time or increase the time between doses to try to trick the body into producing more normal levels of LH. A recent study demonstrated that low doses of HCG (250 to 500 IU) given every other day could maintain intratesticular testosterone at normal levels which is required for normal testicular function5.
1. Kliesch S, Behre HM, Nieschlag E: Recombinant human follicle-stimulating hormone and human chorionic gonadotropin for induction of spermatogenesis in a hypogonadotropic male. Fertil Steril. Jun;63(6):1326-8, 1995
2. Matsumoto AM, Karpas AE, Bremner WJ: Chronic human chorionic gonadotropin administration in normal men: evidence that follicle-stimulating hormone is necessary for the maintenance of quantitatively normal spermatogenesis in man. J Clin Endocrinol Metab. Jun;62(6):1184-92, 1986
3. Karila T, Hovatta O, Seppälä T. Concomitant abuse of anabolic androgenic steroids and human chorionic gonadotrophin impairs spermatogenesis in power athletes. Int J Sports Med. 25(4):257-63, 2004
4. Menon DK. Successful treatment of anabolic steroid-induced azoospermia with human chorionic gonadotropin and human menopausal gonadotropin. Fertil Steril. 79 Suppl 3:1659-61, 2003
5. Coviello AD, Matsumoto AM, Bremner WJ, Herbst KL, Amory JK, Anawalt BD, Sutton PR, Wright WW, Brown TR, Yan X, Zirkin BR, Jarow JP. Low-dose human chorionic gonadotropin maintains intratesticular testosterone in normal men with testosterone-induced gonadotropin suppression. J Clin Endocrinol Metab. 90(5):2595-602, 2005