HCG
HCG is an FDA-approved prescription hormone used in fertility care and for certain men with low testosterone. It is not a weight-loss drug, despite decades of marketing that says otherwise.
- Legal lane: FDA-approved, prescription only
- Evidence grade: A for approved uses. No evidence for weight loss.
- Form: injection into muscle or under the skin
- Brands: Pregnyl, Novarel, Ovidrel
What it is
Human chorionic gonadotropin is a hormone made by the placenta in early pregnancy. As a drug, it works by imitating luteinizing hormone (LH), the pituitary signal that triggers ovulation in women and testosterone production in the testes.
What it is approved for
- Triggering ovulation in fertility treatment
- Hypogonadotropic hypogonadism in men, where the testes work but the pituitary signal is missing
- Undescended testicles in boys
Use alongside testosterone therapy
Testosterone therapy shuts down the body's own LH signal, which shrinks the testes and can stop sperm production. Clinicians prescribe HCG off-label to keep the testes active. In one case series of 49 men whose sperm counts had collapsed on testosterone, an HCG-based regimen restored sperm production in 47.
Not for weight loss
The FDA requires HCG labels to state that it has not been shown to be effective for obesity, and that there is no substantial evidence it increases weight loss beyond what calorie restriction achieves. Over-the-counter "HCG diet" drops are not approved products.
Reported dosing
The prescriber sets the dose, and it varies widely by purpose.
| Use | Reported dosing | Where it comes from |
|---|---|---|
| Male hypogonadotropic hypogonadism | 1,500 to 5,000 IU, two or three times a week | Range used across clinical studies, per a published review |
| Alongside or after testosterone therapy | About 1,000 to 3,000 IU a week in total, split into doses | Small published studies; practice varies |
| Ovulation trigger | A single dose, often 5,000 to 10,000 IU | Fertility clinic practice, timed by the clinic |
Side effects
- Men: breast tissue growth, acne, fluid retention and mood changes.
- Women in fertility treatment: ovarian hyperstimulation syndrome, which can be serious, and a higher chance of multiple pregnancy.
Legal status and supply
The FDA-approved brands are the clear legal route. HCG was reclassified as a biologic in March 2020, which sharply restricted compounding. Sources disagree on what compounding remains permitted, and some pharmacies still list it, so ask which product you are being dispensed. Many sports bodies prohibit HCG.