Human chorionic gonadotropin keeps the testicles working and protects fertility for men on testosterone, and can raise testosterone on its own when the signal from the pituitary is low.
Reviewed by Dr. Jason Wright, D.O. · September 23, 2026
The science
How it works
Stands in for LH
hCG acts on the same receptor as luteinizing hormone, the pituitary signal that tells the testicles to make testosterone.
Keeps the testicles working
On testosterone therapy, LH shuts off and the testicles shrink. hCG keeps them making testosterone and sperm.
Protects fertility
Men taking testosterone with low-dose hCG kept their sperm counts over a year of follow-up.
Raises your own testosterone
Without testosterone therapy, hCG can raise testosterone directly in men whose pituitary signal is low.
hCG is FDA-approved for low testosterone caused by a pituitary problem. Its use alongside testosterone therapy is off-label but well studied.
Dosing
Your dosing plan
Dr. Wright sets your exact dose within this range at your visit.
On testosterone therapy
FormInjection
Dose500 IU
ScheduleEvery other day, or 2–3 times weekly
Based onPublished studies (Hsieh 2013)
Not on testosterone
FormInjection
Dose500–1,000 IU to start, adjusted to labs
Schedule3 times weekly
Based onFDA labeling
Mixing
Form—
DoseMix the powder with the included solvent once
ScheduleThen refrigerate and use within 60 days
Based onManufacturer labeling
Lab monitoring
Form—
DoseTotal and free testosterone, estradiol, hematocrit (plus PSA if over 40)
ScheduleBaseline, at 6–8 weeks, then every 3 months
Based onClinical practice
Side effects
Side effects and what to expect
Breast tenderness or swellingUncommon · First months
A sign estradiol is rising. We check it on labs.
Acne or oily skinUncommon · First months
Usually mild.
Mood changes or irritabilityUncommon · First weeks
Let us know. The dose may come down.
Injection site sorenessCommon · After injections
Rotate sites.
Allergic reactionRare · Any time
Stop and contact the practice.
A note from Dr. Wright
Testosterone therapy shuts down the signal that tells the testicles to work, which is why men on it can lose size and fertility. hCG stands in for that signal. For men on testosterone who want to protect their fertility, it is the treatment with the best evidence behind it. It can also raise testosterone on its own when the signal from the pituitary is low.
Dr. Jason Wright, D.O. · Board certified, American Board of Cosmetic Surgery
Cost & access
Getting started with hCG (Pregnyl)
hCG (Pregnyl)
Pregnyl 10,000 IU kit: powder vial plus solvent, mixed once · FDA-approved brand · Labeled in your name
Pregnyl 10,000 IU kit (powder vial with 10 mL solvent)$280
Questions
Common questions
Who is this for?
Men on testosterone therapy who want to keep testicular size and fertility, and men not on testosterone whose low testosterone comes from a low pituitary signal.
Who shouldn’t take it?
Men with prostate cancer, male breast cancer, or another hormone-sensitive tumor. We also review a history of blood clots and heart disease.
My testosterone is prescribed somewhere else. Can I still get hCG?
Yes. We coordinate with your testosterone prescriber and need your recent labs before starting.
Do I have to mix it?
Yes, once. hCG comes as a powder with its own solvent. You mix it the first time, keep it in the refrigerator, and use it within 60 days. Your guide walks you through it.
Why isn’t it compounded like your peptides?
Since 2020 the FDA treats hCG as a biologic, which pharmacies can’t compound. Yours is the FDA-approved brand, Pregnyl.
Will it help me lose weight?
No. Its FDA labeling states it has not been shown to help with weight loss, and we don’t prescribe it for that.
Research
Supporting studies
Low-dose hCG preserved sperm production in men on testosterone therapy
