By Mike Kocsis | 7 minutes read | Last updated: September 23, 2025 Categories: Testosterone
Medically Reviewed by Dr. George Touliatos
Men use hCG injections for different purposes, such as to improve testosterone levels, reduce hypogonadism symptoms and improve sexual function.
Seeing the effectiveness of hCG injections, many physicians have started using them with testosterone replacement therapy (TRT). Pairing hCG with testosterone is often done to protect fertility, keep the body’s own testosterone production active and avoid other TRT side effects.
But, what are the true benefits of combining TRT and hCG? What does science say about it? Should you take hCG injections with testosterone? Read the article to find out.
TRT and its effects: Why men need hCG with TRT?
Though TRT is beneficial in many ways, like many other therapies, it comes with some side effects.
When you receive external testosterone, it interrupts your natural or internal testosterone production. Your testes stop generating internal testosterone, and over time, they reduce in size as well because they are not being functional for a long duration.
Typically, testes receive signals from the pituitary gland (located in the brain) to begin testosterone production. This signal comes in the form of luteinizing hormone (LH) produced by the pituitary gland.
LH works with the FSH (follicle-stimulating hormone) to produce testosterone and maintain its levels. FSH is also required for sperm production.
Exogenous testosterone is known to cause testosterone-induced gonadotropin suppression, where GnRH, LH and FSH production decline. As a result, testes stop producing testosterone, leading to low endogenous testosterone levels, low sperm count and eventually infertility.
Men planning to have children cannot do so if they are on TRT alone. But fortunately, scientists have come up with a solution for this TRT side effect. Human chorionic gonadotropin hormone (hCG) injections can help men on TRT improve their natural testosterone and sperm production.
Using hCG with TRT: Mechanism of action
hCG, also called the pregnancy hormone, has been approved by the FDA for certain male and female health issues. It is commonly prescribed for infertility, male hypogonadism and undescended testicles.
hCG has a molecular structure similar to LH so it mimics the action of LH within the body. By doing so, hCG stimulates testosterone formation and sperm production, helping men maintain fertility.
LH has a biological half-life of 20 minutes. This makes it a poor medication as you would have to take it every 20 minutes to maintain its levels in the blood.
In contrast, the biological half-life of hCG is 24 to 36 hours. It means you will have to take this injection around 2 times per week to keep its levels stable in your blood. This makes hCG a favourable alternative.
When you combine hCG with TRT, you don’t experience TRT side effects like testicle shrinkage and low sperm count. Your testes produce testosterone naturally and serum testosterone levels stay normal.
TRT without hCG can reduce intratesticular testosterone levels by 94%. But when you take hCG with testosterone, you may notice only a 7% decline in testosterone levels.
6 Benefits of hCG on TRT
Men report the following effects of using hCG with TRT:
1. Support natural testosterone production
TRT diminishes natural testosterone production but HCG reverses this effect by acting like LH and signalling the testicles (Leydig cells) to produce testosterone.
2. Healthy sperm count
By triggering intra-testicular testosterone production, human chorionic gonadotropin (hCG) promotes sperm production (also called spermatogenesis).
In men undergoing TRT alone, sperm count can decline drastically.
3. Prevent testicular atrophy
With TRT, testicles stop receiving signals from the brain; therefore, testicular size reduces as they now have less reason to work.
HCG helps prevent this TRT side effect by maintaining testicular function and making them synthesise testosterone.
4. Fertility preservation
TRT suppresses sperm production and eventually leads to little to no sperm in the ejaculate. Fortunately, HCG can help restore male fertility by reversing TRT’s effect.
5. Improve libido
HCG can cause enhanced sexual function and sexual desire when it’s given with hormone replacement therapy.
6. Mental alertness
HCG can bring about hormonal balance that often gets disturbed with TRT. This supports cognitive function and may improve overall mental health.
What are the other benefits of hCG injections for males?
Enlisted below are a few more benefits of hCG injections.
- HCG injections are used to improve sexual function in men who do not find any improvement in their sexual function even after taking testosterone.
- They are used to treat undescended testes, an abnormality where testes don’t descend from the abdomen to the scrotum during foetal development.
- HCG injections are used to restore testosterone levels that have been affected by surgery or a medical treatment you recently had.
- Bodybuilders often take steroids to increase muscle mass fast. One of the many side effects of these steroids is male infertility and testicular shrinkage. Doctors may prescribe hCG to bodybuilders to treat infertility and help prevent steroid side effects.
Some hCG supplements sold over the counter are marketed for unapproved uses like weight loss programs or so-called hCG diets. These claims aren’t supported by research and such products are best avoided.
What does the research say about combining hCG with TRT?
Some small-scale studies have been done on hCG therapy and testosterone.
In a 2013 study, researchers gave testosterone injections to 19 men with testosterone deficiency and transdermal testosterone gel to 7 men with low testosterone. All participants also received 500 IU hCG every 2 days.
Researchers measured levels of free testosterone and estradiol and semen parameters before and during treatment.
They concluded that no men experienced a change in semen parameters but their hormone levels rose during the treatment. Low-dose hCG helped men on TRT preserve fertility.
In a 2018 study, researchers concluded that hCG could treat hypogonadal men, whether you give it alone or with TRT. They said that it could restore spermatogenesis (conversion of germ cells into sperm in testes) in men whose fertility is affected due to steroid usage.
hCG side effects: Is hCG safe?
Generally, these injections are well tolerated by men, but some may experience a few side effects. Here are the common side effects of hCG injections.
- Increase in the breast size (gynecomastia)
- Acne
- Redness of skin at the injection site
- Headaches
- Nausea and vomiting
- Stomachache
- Mood swings
Some of these side effects will go away on their own in a short time period when your body becomes used to hCG. However, some may take more time and require a doctor’s attention. Your doctor may lower your hCG dose to tackle such side effects.
In very rare cases, the recipient may develop blood clots, mild skin rashes, and anaphylactic reactions. Contact your doctor immediately if you notice these side effects.
Also, hCG is an FDA-approved prescription medication and should only be taken under the supervision of a healthcare provider.
Due to HCG’s side effects, it is not a suitable treatment for all. Men with medical conditions like sleep apnea, heart problems, prostate cancer, breast cancer, brain tumours and blood clots should not take hCG as it can worsen their symptoms.
Discuss your medical history in detail with your doctor to help them decide whether you are the right HCG candidate. They may prescribe hCG alternatives like clomiphene citrate or enclomiphene if they think these are more suitable for you.
How often to take hCG on TRT?
You should take hCG two to three times a week, depending on your TRT protocol. Your doctor will adjust the injection frequency according to your body’s response, testosterone concentration and overall health.
Where and how to inject hCG injections?
HCG injections are taken like insulin injections. It means you inject them into your lower abdomen, where fat is accumulated.
Before taking the hCG injection, add 5ml bacteriostatic water to the dried hCG vial. Do not shake the mixture vigorously, or the molecules will get destroyed on the spot. Fill your syringe and inject the mixture into your abdomen.
Other suitable hCG injection sites are: the side or back of upper arms and the front of thighs.
Recommended hCG dosage: How much hCG to take with TRT?
The recommended dose of hCG is 350 to 500 IU depending on your TRT protocol and doctor’s instructions.
Work with your doctor to adjust the hCG dose to get the best possible results.
What is the best time to take HCG injection for TRT?
You can take HCG injection at any time of the day depending on what you find more convenient.
Can you take hCG and testosterone in the same day?
Yes, you can take HCG and testosterone injections on the same day. Some protocols have them taken on the same day, others on alternating days. Timing is about your convenience and keeping hormone levels stable.
How long does hCG take to work in males?
HCG will take up to 6 hours to show its effect. It will stay in your bloodstream for up to 2 days, and then its level will start declining. You will have to take another injection to keep hCG levels stable.
However, more sustained hCG effects like sperm count improvement can take several months to develop.
Keep your hCG kit in the refrigerator and out of the reach of children. Once an hCG vial has been opened, use it within 30 days as it will expire in a month after mixing water in it.
Takeaway
Men who are on testosterone but worry about their declining sperm count can restore their fertility by combining hCG injections with TRT. hCG acts like the body’s own LH, supporting the testes in maintaining intratesticular testosterone levels like in normal men.
If you have been diagnosed with hypogonadism at a young age and desire fertility while you are on TRT, you should talk to your doctor about hCG injections and find out if they are right for you. Share your fertility woes with your healthcare provider so they can design the best TRT hCG treatment plan for you.
If you have low testosterone levels and you are looking to get the benefits of hCG on TRT, you can contact us to find out more. We help men treat hypogonadism and improve their overall quality of life!
References
Smit, D.L., Verdegaal, T. and Bond, P., 2025. Efficacy of human chorionic gonadotropin hormone in restoring spermatogenesis in men using non-prescribed androgens: a retrospective analysis of real-world data. F&S Reports.
Singhania, N., Devi, K.B., Kaur, J., Bhansali, A., Gorsi, U., Sachdeva, N., Arora, S., Rai, A. and Walia, R., 2024. Effect of combined low dose human gonadotropic hormone, follicle stimulating hormone, and testosterone therapy (LFT regimen) versus conventional high dose human gonadotropic hormone and follicle stimulating hormone on spermatogenesis and biomarkers in men with hypogonadotropic hypogonadism. Endocrine Practice, 30(10), pp.978-986.
Hsieh, T.C., Pastuszak, A.W., Hwang, K. and Lipshultz, L.I., 2013. Concomitant intramuscular human chorionic gonadotropin preserves spermatogenesis in men undergoing testosterone replacement therapy. The Journal of urology, 189(2), pp.647-650.
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About the Author: Mike Kocsis
Mike Kocsis has an MBA with a focus on healthcare administration and is an entrepreneur and medical case manager for Balance My Hormones which offers medical services in the UK and Europe. Mike has over 20 years of experience in the healthcare sector, much of that working with people who have hormone imbalances. Mike has appeared on podcasts and radio and is an expert speaker on the subject of hormone imbalance. He specialises in Testosterone Replacement Therapy and Hormone Replacement Therapy (HRT) and has helped thousands of people suffering from hormone imbalances recover and regain control of their lives. You can follow him on LinkedIn and on the Balance My Hormones YouTube Channel.
Last update: September 23rd, 2025
