How does HCG work for male infertility treatment. What are the common side effects of HCG in men. Is HCG more effective than other fertility medications for increasing testosterone. Where can men obtain HCG for infertility treatment.

Understanding HCG and Its Role in Male Fertility

Human Chorionic Gonadotropin (HCG) is a hormone medication that plays a crucial role in treating male infertility. It functions similarly to luteinizing hormone (LH), which stimulates testosterone production in the testicles. However, HCG has a longer half-life of 30 hours compared to LH’s 30 minutes, making it a more potent option for increasing testosterone levels.

How does HCG compare to other fertility medications? HCG, like clomiphene and anastrozole, works by boosting endogenous testosterone production. However, it may be more effective in cases where the pituitary gland doesn’t respond well to clomiphene. HCG can typically raise testosterone levels higher than anastrozole, provided the baseline LH levels are not above 20 IU/L.

Key Benefits of HCG for Male Infertility:

• Increases testosterone production
• Longer-lasting effects compared to natural LH
• Potentially more effective than other fertility medications in certain cases
• Can be used when pituitary response to clomiphene is inadequate

HCG Administration and Dosage for Men

HCG is administered via injection, either intramuscularly or subcutaneously. The typical protocol involves injections three times per week, with a common starting dosage of 2,000 IU per injection. However, dosages can vary widely, ranging from 500 IU to higher amounts based on individual needs and response.

Are there specific guidelines for HCG dosage adjustment? Doctors usually recommend follow-up testing two weeks after starting HCG or after any dosage changes. Based on the results of blood hormone tests, the dosage can be adjusted to optimize treatment effectiveness while minimizing potential side effects.

HCG Administration Tips:

1. Follow the prescribed injection schedule consistently
2. Use proper injection techniques to minimize discomfort
3. Store HCG according to manufacturer instructions
4. Monitor for any side effects and report them to your healthcare provider
5. Attend regular follow-up appointments for dosage adjustments

Potential Side Effects of HCG in Men

While HCG can be an effective treatment for male infertility, it’s important to be aware of potential side effects. One notable side effect is the possibility of increased estradiol levels in some men. This occurs due to the conversion of testosterone to estradiol by the aromatase enzyme.

Can HCG cause gynecomastia in men? In some cases, the elevated estradiol levels resulting from HCG treatment may lead to gynecomastia, which is the enlargement of breast tissue in males. This side effect underscores the importance of regular monitoring and dosage adjustments during HCG therapy.

Common Side Effects of HCG in Men:

• Increased estradiol levels
• Potential gynecomastia
• Injection site reactions (pain, redness, swelling)
• Headaches
• Mood changes
• Fluid retention

Comparing HCG to Other Male Fertility Treatments

When considering HCG for male infertility, it’s essential to understand how it compares to other available treatments. While HCG, clomiphene, and anastrozole all work to increase testosterone production, they have distinct mechanisms of action and potential benefits.

How does HCG differ from clomiphene and anastrozole in treating male infertility? Unlike clomiphene and anastrozole, HCG does not increase FSH production. This difference may not be clinically significant in men whose FSH levels are already elevated. However, HCG is generally considered more potent in driving increased testosterone production, making it potentially more effective for men who haven’t responded adequately to other treatments.

Comparative Advantages of HCG:

• More powerful testosterone stimulation
• Effective when pituitary response to clomiphene is poor
• Can achieve higher testosterone levels than anastrozole in many cases
• May be beneficial for men with low LH levels

Availability and Access to HCG for Male Infertility Treatment

Obtaining HCG for male infertility treatment can be challenging due to various factors affecting its availability. A nationwide shortage, attributed partly to its popularity as a weight-loss supplement, has made HCG less accessible through local pharmacies.

Where can men obtain HCG for infertility treatment? HCG is typically available through specialty pharmacies. Some compounding pharmacies, such as Empower Pharmacy in Texas, have received waivers to continue producing HCG despite FDA restrictions. It’s crucial to obtain HCG through legitimate medical channels and under the guidance of a healthcare professional.

Factors Affecting HCG Availability:

• Nationwide shortage due to off-label use for weight loss
• FDA restrictions on compounding pharmacies
• Limited availability at local pharmacies
• Need for specialty pharmacy orders
• Potential insurance coverage limitations

HCG and Its Impact on Testosterone Levels

HCG’s primary mechanism of action in treating male infertility is its ability to stimulate testosterone production. By mimicking the action of LH, HCG encourages the Leydig cells in the testicles to produce more testosterone, which can have positive effects on sperm production and overall male fertility.

How quickly does HCG increase testosterone levels in men? The peak onset of increased testosterone typically occurs about 72-96 hours after HCG administration. This relatively rapid response makes HCG an attractive option for men seeking to boost their testosterone levels quickly.

Effects of HCG on Male Hormonal Balance:

• Stimulates Leydig cells to produce testosterone
• Can lead to rapid increases in serum testosterone levels
• May indirectly improve sperm quality through increased testosterone
• Can potentially restore natural testosterone production in men with suppressed LH
• May help maintain testicular function during exogenous testosterone therapy

Long-Term Considerations and Monitoring for HCG Therapy

While HCG can be an effective treatment for male infertility, long-term use requires careful monitoring and consideration of potential risks and benefits. Regular follow-up appointments and hormone level testing are essential to ensure the treatment remains effective and safe over time.

What are the long-term effects of HCG use in men? Long-term effects can vary, but may include sustained improvements in testosterone levels and fertility. However, prolonged use may also lead to desensitization of Leydig cells or other hormonal imbalances. It’s crucial to work closely with a healthcare provider to monitor for any adverse effects and adjust treatment as needed.

Long-Term Monitoring Recommendations:

1. Regular blood tests to check hormone levels
2. Periodic semen analysis to assess sperm quality
3. Monitoring for signs of gynecomastia or other side effects
4. Adjusting dosage based on ongoing response and tolerance
5. Considering intermittent use or cycling of HCG to prevent desensitization

In conclusion, HCG offers a potent option for treating male infertility by boosting testosterone production. While it can be highly effective, its use requires careful consideration of potential side effects, availability challenges, and the need for ongoing monitoring. Men considering HCG for infertility treatment should work closely with their healthcare providers to determine the most appropriate treatment plan and ensure optimal results while minimizing risks.

As research in male fertility treatments continues to evolve, new insights into the long-term effects and optimal use of HCG may emerge. Staying informed about the latest developments and maintaining open communication with healthcare providers will be crucial for men undergoing HCG therapy for infertility.

The journey to addressing male infertility can be complex, but with proper medical guidance and the appropriate use of treatments like HCG, many men can successfully improve their fertility and achieve their family-building goals. As with any medical treatment, individual responses may vary, and personalized care remains paramount in achieving the best possible outcomes.

HCG / Human Chorionic Gonadotropin for Male Infertility — Male Infertility Guide

Introduction to HCG / Human Chorionic Gonadotropin for Male Infertility

Luteinizing hormone (LH) is the hormone from the pituitary gland which tells the Leydig cells in the testicles to make testosterone. Human chorionic gonadotropin (HCG) is a medication which has a similar structure and essentially the same hormonal action as LH. However, HCG has a much longer half-life (30 hours) than LH (30 minutes), with a peak onset of increased testosterone of about 72-96 hours after administration. [Madhusoodanan V. IBJU 2019] Since HCG works by increasing LH activity, if the LH is already elevated (over 20 IU/L) then HCG will likely not be effective at increasing testosterone levels.

Like clomiphene and anastrazole, HCG works to increase endogenous production of testosterone. It is considerably more expensive than the two oral medications and must be given by injection (usually about 3 times per week subcutaneously). However, it can sometimes be more effective when the pituitary gland is not responding to clomiphene, and is generally able to raise testosterone levels higher than can anastrazole (as long as baseline LH levels are not elevated above 20 IU/L). Like clomiphene, HCG can increase estradiol to abnormally high levels in some men through the conversion of testosterone to estradiol by the aromatase enzyme.

A common question is whether HCG is more effective than clomiphene or anastrazole in treating male infertility. Remember that these medications do not directly improve sperm quality, but rather exert their effect by increasing testosterone production (and, in the case of clomiphene and anastrazole, possibly FSH levels if these are low). Therefore, a man whose testosterone is pushed back up into the normal range by either clomiphene, anastrazole, or HCG should have the same potential clinical benefit to sperm quality. However, HCG is generally considered to be a more powerful medication in the sense of driving increased testosterone production, and therefore it may be effective in men whose testosterone levels have not risen sufficiently with clomiphene or anastrazole. Another difference is that, unlike clomiphene and anastrazole, HCG does not increase FSH production, although this should not matter clinically in men whose FSH is already elevated.

COMMERCIAL AVAILABILITY OF HCG

Commercially, HCG comes in several different formulations. In men Pregnyl, and Novarel are most commonly used, but generic HCG is also made by compounding pharmacies. The three are essentially equivalent in terms of dosing and potency. All three of these medications use HCG extracted from the urine of pregnant women. Other forms of HCG that are less commonly used in men include Ovidrel, Follutein, Profasi, Choragon, and Choropex. Note that blood LH levels often do not increase in men taking HCG, as the exogenous hormone does not display much cross-reactivity with most commercial laboratory assays.

HCG is not available at most local pharmacies due to a nationwide shortage, and typically needs to be ordered through specialty pharmacies. The shortage is attributed to the popularity of HCG as a weight-loss supplement, despite controlled studies failing to show any evidence that HCG use actually enhances weight loss. Currently, the FDA deems as fraudulent the marketing of HCG as a weight loss enhancement. The popularity of HCG has also risen through its use by “rejuvenation” clinics for men seeking an improved quality of life and/or sexual function, as well as body builders, who often use HCG between cycles of anabolic steroid use to maintain testicular function. A 2019 FDA ruling has also made HCG unavailable by most compounding pharmacies, which has served to further worsen the shortage of HCG in the United States. Of note, a handful of compounding pharmacies were granted a waiver from the HCG production ban, one of which is the Empower pharmacy in Texas.

HCG may be covered by your insurance company, but if you do not have insurance coverage for your medications, the pricing of HCG from some regional and fertility-specific pharmacies is reviewed in the “Fertility Medications Cost” section of this website.

Fertility Medications Cost

HOW HCG IS USED

HCG must be given by injection, either intramuscular (IM) or subcutaneous (SQ). Protocols for injection schedules differ, but most experts recommend three times per week. A typical starting dosage is 2,000 IU three times per week. As with clomiphene and anastrazole, I usually recommend follow-up testing two weeks after starting HCG, or two weeks after any change in dosage or medications. Dosages can then be adjusted depending on the findings of the follow-up blood hormone tests.

HCG dosages can vary widely, from 500 IU to 4,000 IU three times a week. Here is a sample range of dosages:

• 500 IU three times a week

• 1,000 IU three times a week

• 1,500 IU three times a week

• 2,000 IU three times a week (typical starting dosage)

• 2,500 IU three times a week

• 3,000 IU three times a week

• 3,500 IU three times a week

• 4,000 IU three times a week

SIDE EFFECTS of HCG

Most men taking HCG do not have any adverse side effects and multiple studies have concluded that it is a safe and effective treatment for hypogonadism. [Lee JA. TranslatAndrolUrol 2018]. A study of 175 men taking HCG injections found that none of them had any significant adverse side effects. [Tsujimura A. TheAgingMale 2005]. No side effects or complications were also seen in a study of 20 men taking HCG for hypogonadism. [Madhusoodanan V. IBJU 2019]

Rare potential side effects include headaches, weight gain, hypertension, cataracts, acne, dizziness, restlessness, insomnia, mood changes (depression, irritability) and pain at the injection site.

Breast tenderness and/or enlargement (gynecomastia) can occur but should be rare if estradiol levels are monitored and kept within the normal range.

Patients who experience significant adverse side effects should stop their medication and contact your doctor for further guidance.

Hematocrit Levels

Increases in hematocrit have been noted in men taking HCG injections, though rates of polycythemia are low. [Tsujimura A. TheAgingMale 2005]. I recommend monitoring hematocrit levels with a goal to keep the hematocrit at 54% or less. For more information see the website section “Erythrocytosis/Polycythemia”

Erythrocytosis/Polycythemia

Use With Other Hormonal Medications

HCG is commonly used with anastrazole in the treatment of hypogonadism, since they work on increasing testosterone levels by different mechanisms. Men with elevations in their estradiol levels while taking HCG may also benefit from the aromatase-inhibiting activity of anastrazole as well. Clomiphene and HCG both work by increasing LH-effect, so these medications are not commonly used together (unless the clomiphene is being utilized to increase an inappropriately low FSH level). Low-dose HCG is also used frequently with men on exogenous androgens to maintain some basal testicular function. For more information on this, see the “Exogenous Androgens/Anabolic Steroids” section of this website.

Exogenous Androgens/Anabolic Steroids

HCG Injection Instructions

HCG can be given either subcutaneously (SQ) or intramuscularly (IM). Both of these are felt to be equally effective, but the SQ approach uses a smaller needle size and is felt to be more comfortable. On rare occasions, a patient who is not responding as expected to SQ HCG injections may have a better effect with trying IM injections of HCG.

Basic injection teaching videos can be found at: www.villagefertilitypharmacy.com

Go to “Medication Injection Lessons” in right upper corner

Scroll down and click on “HCG”, “Novarel”, or “Pregnyl” (whichever you have been prescribed)

Most commercial formulations of HCG (e.g. Pregny and Novarel) come in 10,000 unit vials that need to be mixed by the patient prior to use. Some compounding pharmacies send HCG in different size vials (up to 50,000 IU). These pharmacies will need to provide you with individualized instruction on how much HCG to inject depending on your prescribed dosage.

The following are some basic instructions for men taking HCG using a standard 10,000 IU vial.

The HCG will come as a powder inside a sealed bottle. This powder is mixed with a sterile fluid called ‘diluent’, into which the HCG powder dissolves. The appropriate amount of fluid is then taken into a syringe and is injected subcutaneously into the upper outer thigh, lower abdomen, or upper outer arm region (as shown in the “Subcutaneous Injection Lessons” video on above listed website). The dosing instructions for the video directions are designed for women who typically use the entire vial (10,000 IU) in one injection to trigger ovulation. So, although the injection techniques are the same, slight modifications need to be made for males who typically use the HCG three times a week for prolonged periods of time.

In general, 1cc to 2cc are generally used for SQ injections (more than this can cause an uncomfortable raised area at the injection site). Each vial of powder contains 10,000 IU of HCG. The amount of fluid that needs to be injected depends on the amount of diluent used to dissolve the powder. The amount of diluent used can be modified according to the dose of HCG being used. The following chart gives the recommended diluent and injection amounts for each dosage.

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Human Chorionic Gonadotropin (HCG) | Victory Men’s Health

HCG – HCG stands for Human Chorionic Gonadotropin, and it is a natural hormone that has been found to mimic the effects of Luteinizing Hormone (LH) in males. LH plays a vital role in the synthesis and secretion of testosterone. When HCG is utilized to treat male infertility or hypogonadism, it gets to work on mimicking the effects of LH. This, in turn, means that it stimulates the natural production of testosterone from within the testes.

HCG
injections are approved by the U.S. Food
and Drug Administration (FDA) to treat specific medical conditions in both
women and men.  In men, hCG injections are FDA-approved for a type of hypogonadism in which the
body doesn’t adequately stimulate the testes to produce the sex hormone testosterone.  
HCG is incredibly safe, so during the treatment, the male in question
will likely not suffer from any adverse side effects at all.

HCG is sometimes used during
testosterone replacement therapy because testosterone replacement therapy can lower
sperm
production due to the feedback loop on
both the hypothalamus and pituitary gland. 
In men still wanting to have children hCG therapy can help preserve
sperm production by maintaining intra-testicular testosterone levels. Not only
will hCG help to restore your fertility and sperm production, but it can reduce
the testicle shrinkage.   Using hCG with
TRT can restore your testicles to their normal, healthy size and function.

Studies have shown that in healthy normal testosterone men selected to undergo TRT, it was shown that their intra-testicular testosterone levels dropped by 94% while on therapy. However, in those who received HCG injections along with TRT, their intra-testicular testosterone levels only dropped 7%. Additionally, in men who received TRT and a higher dose of hCG every other day, had an increase in intra-testicular testosterone by 26% from baseline was observed. This proved that co-administering low dose hCG could maintain intra-testicular testosterone in those undergoing TRT. It was later shown that not only is intra-testicular testosterone increased with co-administration hCG but the sperm count is preserved as well at one year follow up.

According to the American Urological Association, HCG is appropriate for those men with testosterone deficiency who also desire to maintain fertility.  Some of the main uses and benefits of hCG injections include:

• Correcting
  undescended testes.

• Regulating
  testosterone production.

• Recovering from diseases or medical conditions that affect the body’s testosterone production.

• As a part of
  hormone replacement therapy.

• Weight loss, as
  increasing testosterone levels can help with exercise.

• Maintaining your
  testicular size.

• Repairing sexual
  dysfunction. Male sexuality is heavily linked to testosterone levels.

It is important to note that injectable medication provides a more reliable delivery than other drug administration methods of HCG on the market.  HCG drops or supplements are NOT a viable alternative to medical-grade HCG.  An HCG injection is injected subcutaneously into the fat tissue in the lower stomach or the fat pad of outer glute with a small insulin syringe.  Injectable hCG is available through prescription only. 

Thanks to the testosterone replacement therapy & HCG therapy, you may experience normal intra-testicular testosterone production, leading to increased fertility and overall health!

Active substance CHORIONIC GONADOTROPIN (GONADOTROPINUM CHORIONICUM)

• Pharmacological properties
• Indications GONADOTROPIN CHORIONIC
• Application of GONADOTROPIN CHORIONIC
• Contraindications
• Side effects
• Special instructions
• Interactions
• Overdose
• Diagnosis
• Recommended alternatives
• Trade names

Medicinal preparations containing the active substance GONADOTROPIN CHORIONIC

Pregnyl ^®

powder for solution for injection 1500 IU bottle with solvent in 1 ml vials, No. derived from the placenta and obtained from the urine of pregnant women. Human chorionic gonadotropin stimulates steroidogenesis in the sex glands due to a biological effect similar to that of human LH. In men, it causes an increase in testosterone production, in women – an increase in estrogen production, especially progesterone after ovulation. In some cases, it can be used in combination with menotropin. When using human chorionic gonadotropin, antibody formation does not occur.

Hypogonadotropic hypogonadism in men, male infertility due to insufficient spermatogenesis, delayed sexual development of boys associated with insufficiency of the gonadotropic function of the pituitary gland, cryptorchidism not due to anatomical occlusion, induction of ovulation in female infertility associated with anovulation or disorder follicle maturation, controlled hyperstimulation for preparation of the follicle for puncture in assisted reproduction programs.

IM immediately after preparation.

In men with hypogonadotropic hypogonadism, use at a dose of 1000-2000 IU 2-3 times a week.

If fertility problems are the main indication, an additional drug containing follicle stimulating hormone can be given 2 to 3 times a week.

For some forms of cryptorchidism, chorionic gonadotropin is given to children under the age of 2 years at 250 IU 2 times a week for 6 weeks; at the age of up to 6 years – 500-1000 IU 2 times a week for 6 weeks; over the age of 6 years – 1500 IU 2 times a week for 6 weeks. If necessary, the treatment can be repeated.

For ovulation induction in infertile women, human chorionic gonadotropin is usually administered as a single dose of 5,000–10,000 IU.

For luteal phase support, 2-3 repeated injections of 1000-3000 IU each within 9 days after ovulation or embryo transfer (eg, on days 3, 6, and 9 after stimulated ovulation).

presence or suspicion of androgen-dependent tumors (carcinoma of the prostate or breast in men), genital malformations incompatible with pregnancy, fibrous tumors of the uterus incompatible with pregnancy, ovarian enlargement or cysts not due to polycystic ovary syndrome, gynecological bleeding of unknown etiology, carcinoma of the ovaries, uterus or breast, ectopic pregnancy within the previous 3 months, thromboembolic disease in the active phase, primary ovarian failure, genital malformations incompatible with pregnancy, after menopause.

possible skin rashes; in men, after use in high doses, water and sodium retention is sometimes noted, which is regarded as the result of an excessive level of androgens, thromboembolism, hydrothorax, nausea, diarrhea, weight gain, gynecomastia in men.

Treatment of male patients with LH leads to an increase in androgen production, therefore human chorionic gonadotropin should be used with caution in prepubertal boys to avoid precocious puberty and premature closure of the epiphyses.

Patients with latent or overt heart failure, impaired renal function, hypertension, epilepsy or migraine should be under constant medical supervision, as increased androgen production can lead to exacerbation or relapse of these diseases.

Pregnancy following ovulation induction with gonadotropic drugs increases the risk of miscarriage and multiple pregnancies.

have not been studied.

not described.

Human Chorionic Gonadotropin test for men (hCG, beta-hCG, b-hCG, Human Chorionic) in St.

Petersburg

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Biomaterial and collection method

9008 6

Type	Center	Home	Self
Venous blood

Deadline: up to 1 day.

Download sample analysis

Human chorionic gonadotropin for men (hCG, beta-hCG, b-hCG, Human Chorionic) is a hormone that is produced by cells of the placenta in the female body. An analysis for hCG is prescribed for women to confirm pregnancy. In the male body, an increase in the level of the hormone can be caused by tumors, including testicular teratoma, colorectal cancer, etc. An analysis for hCG for men and non-pregnant women is prescribed as part of a comprehensive diagnosis of tumor diseases.

General rules

• Do not eat fatty foods a few hours before the test, preferably not eat for 4 hours;
• Shortly before taking blood, drink 1-2 glasses of plain non-carbonated water;
• If possible, stop taking medication at least one day before testing;
• When taking tests while taking medications, this fact must be indicated on the referral form;
• Do not play sports on the day of the test;
• Exclude increased emotional stress;
• A few minutes before taking blood, take a comfortable position (sit down), relax, calm down;
• Refrain from drinking alcohol for 72 hours prior to testing;
• Do not smoke for at least 30 min. before taking blood;
• Clarify the optimal days of the menstrual cycle (or gestational age) for donating blood for follicle-stimulating hormone (FSH), luteinizing hormone (LH), progesterone, estradiol, androstenedione, 17-hydroxyprogesterone, prolactin, as well as for specific markers inhibin B and anti-Müllerian hormone ( indicate on the referral form)

Taking blood from children under 7 years old

• Remember that the best time to take a blood test is in the morning, the norms of all tests were developed precisely for the time interval from 8 to 11 am.
• Donate blood for tests should be strictly on an empty stomach. At least 8 hours should elapse between the last meal and blood sampling. With children, this rule is quite difficult to follow, but it is quite possible. It is impossible to drink juices, tea, eat cookies in the morning, this can significantly distort the results. You can only drink water. Take something tasty with you so that you can eat immediately after leaving the treatment room.
• The child’s diet 1-2 days before the blood test should exclude fatty and fried foods, sweets.
• For better blood supply to blood vessels, it is advisable to give the child 100-200 ml of water 30 minutes before blood sampling (for children from 1 year old).
• After the analysis, think about how you can please the child for good behavior. A small surprise gift will help smooth out the unpleasant impressions about the hospital.

Blood sampling from children from 1 day to 12 months

• When taking blood for analysis in infants, try to adjust it to the break between feedings, closer to the second feeding.
• 30 minutes before the procedure, the child should drink 50 ml of the liquid that you usually give him.
• At the time of blood sampling, the child’s hands must be warm. If you come from the street or it is not so warm in the room, the child’s hands need to be warmed. This is a mandatory and very important condition, because the amount of blood that will be received by the health worker depends on its implementation.
• Immediately prior to blood sampling, the child should be positioned in such a way that he is as comfortable as possible. It should take a couple of minutes before the nurse starts drawing blood. This time is enough for the baby to calm down and get used to the surrounding space a little.

Test code	Test name	Unit	Reference values ​​
66.1	Beta hCG (for men)	ng/ml

Important!
If an examination is to be performed using the CITO service, pack the sample in a separate bag and label with the CITO sticker.

Collection and Transport Recommendations

Vacuum Tube, Clotting Activator Gel (yellow cap), 4 ml

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Sample Processing room temperature (35-40 min.)

Centrifuge at 2000-2200g for 10 min.

After centrifugation, transfer serum, store and transport -20

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Sample storage

at +2…+8°C

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Sample transport

at +2…+8°C

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Human chorionic gonadotropin (hCG)
Human chorionic gonadotropin is a hormone that plays a huge role in the development of the fetus after it is implanted on the surface of the uterus. Elevated levels of human chorionic gonadotropin in the blood serum can be a sign of various pathologies. Specifically, the body mounts an autoimmune response by producing anti-hCG immunoglobulins. Thus, measuring the level of the hormone and antibodies to it allows us to assess the causes of the pathology and the possibility of treatment.

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