Summary
Human chorionic gonadotropin is a placental glycoprotein hormone that mimics LH, approved by FDA for ovulation induction, cryptorchidism, and hypogonadotropic hypogonadism in men (Pregnyl, Novarel, and the recombinant Ovidrel). Retrospective data show low dose hCG preserves sperm production in men on testosterone therapy, and it reliably induces spermatogenesis in hypogonadotropic men, but a criteria-based meta-analysis found no evidence it helps weight loss and FDA states hCG diet products are illegal. On March 23, 2020 hCG transitioned to regulation as a biologic, which ended compounded hCG because biologics cannot be compounded under 503A or 503B.
What is HCG (human chorionic gonadotropin)?
HCG (human chorionic gonadotropin) is a glycoprotein hormone of the placenta (heterodimer of alpha and beta subunits, about 237 amino acids) that acts on the LH receptor; regulated as a biologic since 2020. It is also known as hCG, Chorionic gonadotropin, Pregnyl, Novarel, Ovidrel (choriogonadotropin alfa), Chorionic gonadotropin for injection.
How does it work?
hCG binds the LH/hCG receptor on testicular Leydig cells and ovarian theca and granulosa cells. In men it drives intratesticular testosterone production, which sustains spermatogenesis even when pituitary LH is suppressed by exogenous testosterone. In women a single large dose mimics the LH surge and triggers final oocyte maturation and ovulation. Its long half-life (about 24 to 36 hours) allows dosing 2 to 3 times per week rather than the pulsatile delivery GnRH requires. It has no established mechanism affecting fat metabolism.
| Cluster | Sexual health and reproductive |
|---|---|
| Routes | Intramuscular injection (Pregnyl, Novarel labels); Subcutaneous injection (Ovidrel prefilled syringe; also common off-label practice with urinary hCG); Oral drops, pellets, and sprays sold for the hCG diet contain no meaningful hCG and are illegal per FDA |
| Conditions studied | Fat loss and body composition; Male hypogonadism (low testosterone); Infertility and assisted reproduction |
| Record | v3, draft, verified Sep 23, 2026 |
FDA-approved uses of HCG (human chorionic gonadotropin)
Yes, by prescription. The Pregnyl and Novarel labels cover prepubertal cryptorchidism not due to anatomic obstruction, selected cases of hypogonadotropic hypogonadism in males, and induction of ovulation in anovulatory infertile women after pretreatment with menotropins. Ovidrel covers final follicular maturation in assisted reproduction and ovulation induction. The urinary labels state that hCG has not been shown to be effective for obesity. Since March 2020 hCG is regulated as a biologic, and FDA states biologics cannot be compounded, so compounded hCG from 503A pharmacies is no longer lawful. Over the counter hCG diet drops and pellets are illegal according to FDA. [5] [6] [7] [8] [10]
What does the evidence say about HCG (human chorionic gonadotropin)?
hCG is standard of care for triggering ovulation in assisted reproduction and for inducing puberty and fertility in men with hypogonadotropic hypogonadism, supported by decades of trials and label evidence. In a 42 patient series, hCG plus hMG induced sperm in most hypogonadotropic men with results equal to pulsatile GnRH. A retrospective study of 26 men on testosterone therapy given 500 IU hCG every other day found no decline in semen parameters and no azoospermia over 6 months. For obesity, a criteria-based meta-analysis of 24 trials concluded there is no scientific evidence that hCG causes weight loss, fat redistribution, reduced hunger, or improved well-being. For testosterone recovery after anabolic steroid use, evidence is limited to case series and expert reviews.
| Evidence type | Indexed studies | Participants (human) |
|---|---|---|
| Human randomized trials | 2 | n/a |
| Human observational studies | 2 | 68 |
| Animal studies | 0 | n/a |
| All indexed studies | 4 | 68 |
Human evidence
Hsieh 2013: retrospective review of 26 hypogonadal men on testosterone (injection or gel) with concomitant intramuscular hCG 500 IU every other day; serum testosterone rose from 207 to 1,056 ng/dL, semen parameters were unchanged over more than a year of follow up, no patient became azoospermic, and 9 of 26 contributed to a pregnancy. Büchter 1998: hCG/hMG or pulsatile GnRH in 42 hypogonadotropic men induced sperm in 54 of 57 courses and pregnancy in 26 of 36. Amory 2008: in gonadotropin suppressed normal men, graded hCG doses maintained intratesticular testosterone in a dose dependent way. Lijesen 1995: meta-analysis of 8 controlled and 16 uncontrolled trials of hCG for obesity; of 12 higher quality studies only one favored hCG, and the authors concluded there is no evidence of benefit for weight, fat distribution, hunger, or well-being.
Animal evidence
hCG stimulates testosterone secretion and spermatogenesis in rodents and primates through the LH receptor and induces ovulation in many species. Animal work established the LH receptor pharmacology and the absence of any lipolytic effect.
Key studies
| Study | Design and population | Outcome | Grade |
|---|---|---|---|
| Concomitant intramuscular human chorionic gonadotropin preserves spermatogenesis in men undergoing testosterone replacement therapy2013 PMID 23260550 | Retrospective single center review, hCG 500 IU intramuscularly every other day with testosteronen = 26 Hypogonadal men (mean age 35.9) on testosterone injection or gel | Testosterone rose from 207 to 1,056 ng/dL; semen volume, density, motility, and forward progression unchanged over more than 1 year; no azoospermia; 9 of 26 contributed to pregnancy | Evidence: Human observational evidence |
| Serum 17-hydroxyprogesterone strongly correlates with intratesticular testosterone in gonadotropin-suppressed normal men receiving various dosages of human chorionic gonadotropin2008 PMID 17462643 | Prospective dose ranging study with testicular aspirationHealthy men with gonadotropins suppressed by exogenous testosterone | hCG maintained intratesticular testosterone in a dose dependent manner; serum 17-hydroxyprogesterone tracked intratesticular testosterone | Evidence: Human RCT evidence |
| Pulsatile GnRH or human chorionic gonadotropin/human menopausal gonadotropin as effective treatment for men with hypogonadotropic hypogonadism: a review of 42 cases1998 PMID 9758439 | Single center case seriesn = 42 Men with hypogonadotropic hypogonadism or hypopituitarism | Sperm induced in 54 of 57 treatment courses and pregnancy in 26 of 36 courses; hCG/hMG and pulsatile GnRH performed equally | Evidence: Human observational evidence |
| The effect of human chorionic gonadotropin (HCG) in the treatment of obesity by means of the Simeons therapy: a criteria-based meta-analysis1995 PMID 8527285 | Criteria-based meta-analysis of 8 controlled and 16 uncontrolled trialsAdults with obesity treated with hCG plus very low calorie diet | Of 12 higher quality (all controlled) studies only one favored hCG; no evidence hCG produces weight loss, fat redistribution, reduced hunger, or improved well-being | Evidence: Human RCT evidence |
Conditions studied
| Condition | Grade | Note |
|---|---|---|
| Fat loss and body composition | Evidence: Human RCT evidence | Controlled trials of the hCG diet found no added weight loss, fat redistribution, or hunger reduction beyond the very low calorie diet; FDA says hCG is not approved for weight loss. |
| Male hypogonadism (low testosterone) | Evidence: Human RCT evidence | FDA approved for hypogonadotropic hypogonadism in males; in a 26 man retrospective series, low dose hCG with testosterone maintained semen parameters for over a year. |
| Infertility and assisted reproduction | Evidence: Human RCT evidence | FDA labeled to induce ovulation in anovulatory women after menotropin pretreatment; widely used as the final egg maturation trigger in IVF. |
Is HCG (human chorionic gonadotropin) legal in the United States?
FDA and compounding status
hCG is FDA approved as Pregnyl and Novarel (urinary derived chorionic gonadotropin) and Ovidrel (recombinant choriogonadotropin alfa). On March 23, 2020 these products transitioned from drug approvals to biologics license applications under the Biologics Price Competition and Innovation Act. FDA states that biological products are not eligible for the 503A or 503B compounding exemptions, so compounded hCG, which had been common in testosterone and weight loss clinics, became unlawful at that point. FDA has separately stated that over the counter hCG diet products are illegal and that hCG is not approved for weight loss. It is not on the FDA Category 2 list because it is an approved biologic rather than a bulk drug substance nomination.
WADA status
WADA prohibited. Athletes subject to anti-doping testing should treat this as prohibited at all times unless the current prohibited list says otherwise.
Regulatory timeline
- WADA
WADA publishes the 2027 Prohibited List
WADA published the 2027 Prohibited List on September 21, 2026, and it takes effect January 1, 2027. The S2 peptide hormone and growth factor classes are unchanged. BPC-157 is still named under S0, and MOTS-c is still named under S4.4 as an activator of AMP-activated protein kinase. WADA added a note that many peptides without approval for human use fall under S0 or another section, and that a peptide not named on the list may still be prohibited. GLP-1 receptor agonists such as semaglutide and tirzepatide are still not on the list.
- WADA
WADA 2026 Prohibited List takes effect
The 2026 WADA Prohibited List took effect on January 1, 2026 and continues to prohibit the S2 peptide hormone and growth factor classes (GHRH analogs, growth hormone secretagogues, GH fragments, IGF-1 and analogs, MGF, thymosin beta-4 and derivatives, hCG and GnRH-class releasing factors in males), myostatin inhibitors, insulin and the AMPK activator MOTS-c under S4, desmopressin under S5, and BPC-157 under S0. GLP-1 receptor agonists such as semaglutide and tirzepatide are not on the list.
- WADA
WADA 2025 Prohibited List keeps peptide hormones and growth factors banned at all times
The 2025 WADA Prohibited List took effect on January 1, 2025. Section S2 (peptide hormones, growth factors, related substances and mimetics) covers GHRH analogs such as CJC-1295, sermorelin, and tesamorelin, growth hormone secretagogues such as ipamorelin, GHRP-2, GHRP-6, hexarelin, and ibutamoren (MK-677), growth hormone fragments such as AOD-9604, growth factors including IGF-1 and its analogs, MGF, and thymosin beta-4 (TB-500), and chorionic gonadotropin and releasing factors such as gonadorelin and kisspeptin (prohibited in males). Myostatin inhibitors such as ACE-031 fall under S4, insulin under S4 metabolic modulators, desmopressin under S5, and BPC-157 remains an S0 non-approved substance.
Full tracker for HCG (human chorionic gonadotropin) or the category-wide tracker.
HCG (human chorionic gonadotropin) dose on the FDA label
Doses below are quoted from the FDA label for its approved uses, plus the doses used in the pivotal trials where noted. The prescriber sets the dose; PeptideAgent does not recommend doses or protocols.
FDA labels (Pregnyl and Novarel, DailyMed; intramuscular use only; the labels list regimens advocated by various authorities): prepubertal cryptorchidism not due to anatomic obstruction, for example 4,000 USP units three times weekly for 3 weeks or 5,000 units every second day for 4 injections; selected cases of hypogonadotropic hypogonadism in males, 500 to 1,000 units three times a week for 3 weeks followed by the same dose twice a week for 3 weeks, or 4,000 units three times weekly for 6 to 9 months followed by 2,000 units three times weekly for 3 more months; induction of ovulation, 5,000 to 10,000 units one day after the last dose of menotropins. Ovidrel (recombinant, subcutaneous): 250 mcg one day after the last dose of the follicle stimulating agent. Both urinary labels state that hCG has not been demonstrated to be effective adjunctive therapy for obesity.
Routes reported
| # | Route |
|---|---|
| 1 | Intramuscular injection (Pregnyl, Novarel labels) |
| 2 | Subcutaneous injection (Ovidrel prefilled syringe; also common off-label practice with urinary hCG) |
| 3 | Oral drops, pellets, and sprays sold for the hCG diet contain no meaningful hCG and are illegal per FDA |
What are the side effects and interactions of HCG (human chorionic gonadotropin)?
Side effects
| # | Reported side effect |
|---|---|
| 1 | Headache, irritability, restlessness, depression, fatigue |
| 2 | Edema and fluid retention |
| 3 | Gynecomastia and breast tenderness (via increased estradiol) |
| 4 | Precocious puberty when used in boys for cryptorchidism |
| 5 | Ovarian hyperstimulation syndrome and multiple pregnancy in women |
| 6 | Arterial and venous thromboembolism (rare) |
| 7 | Injection site pain and hypersensitivity reactions |
| 8 | Acne and rising estradiol in men on higher doses |
Interactions
| # | Interaction |
|---|---|
| 1 | Aromatase inhibitors and SERMs are sometimes co-prescribed to manage estradiol rise; combined use has not been studied in trials |
| 2 | Testosterone therapy: hCG is used concurrently to maintain intratesticular testosterone (retrospective data only) |
| 3 | Can cause false positive pregnancy tests and interfere with hCG based tumor marker assays for up to 10 days |
Contraindications
| # | Contraindication |
|---|---|
| 1 | Precocious puberty |
| 2 | Prostate cancer or other androgen dependent neoplasm |
| 3 | Prior hypersensitivity to hCG |
| 4 | Women: primary ovarian failure, uncontrolled thyroid or adrenal dysfunction, sex hormone dependent tumors, abnormal uterine bleeding of undetermined origin, ovarian cysts not due to polycystic ovary syndrome, pregnancy |
| 5 | Male athletes subject to WADA testing (prohibited under S2) |
How do people access HCG (human chorionic gonadotropin) legally?
Typical cost: Brand hCG (Pregnyl, Novarel) costs roughly 100 to 300 USD per 10,000 unit vial at retail pharmacies, which at 500 IU three times a week lasts about 6 to 7 weeks; Ovidrel prefilled syringes run roughly 150 to 250 USD each. Compounded hCG is no longer lawfully available. Prices verified on the last verified date.
Verified access options
Step 1
Prescription from a urologist, endocrinologist, or reproductive specialist filled at a retail or specialty pharmacy as Pregnyl, Novarel, or Ovidrel.
Step 2
Telehealth testosterone clinics can prescribe brand hCG but cannot lawfully supply compounded hCG.
Step 3
hCG diet products sold without a prescription are illegal and do not contain effective hCG.
Access paths are verified against public regulatory records and prescriber licensing. We never list unlicensed vendors.
Compare HCG (human chorionic gonadotropin)
What's actually offered, and what that means for you
Compounded HCG (human chorionic gonadotropin) is widely offered by clinics and telehealth prescribers. HCG (human chorionic gonadotropin) is FDA approved, but FDA deemed the applications for its approved products (Pregnyl, Novarel, and Ovidrel) biologics licenses in March 2020, and biologics cannot be compounded under 503A or 503B. Compounded versions have no lawful basis. [5] [8] [11]
Enforcement is uneven. FDA mostly acts through warning letters to compounders and online sellers and import alerts that let it detain shipments, rather than stopping every pharmacy. State pharmacy boards oversee pharmacies day to day, and their rules differ. [8] [12] [13] [14]
What changes for you
- No FDA review of the product: FDA does not check a compounded drug's safety, effectiveness, or quality before it is sold. [8]
- Identity, purity, sterility, and dose accuracy can vary from batch to batch. [8]
- Insurance rarely covers it, so you usually pay cash.
- For tested athletes, HCG (human chorionic gonadotropin) is prohibited at all times on the WADA list, whatever the source. [9]
What to check
No check makes a compounded version lawful. To be sure you get the approved product, check for:
- The approved product by name (Pregnyl, Novarel, or Ovidrel) on the pharmacy label, dispensed against your prescription. [5]
- The word "compounded" on the label or in the offer, which means it is not the approved product. [8] [11]
- A real evaluation by a licensed prescriber, not just an online form.
The approved options are Pregnyl, Novarel, and Ovidrel, by prescription. See hCG cost by channel.
Frequently asked questions
Does hCG work for weight loss?
No. A criteria-based meta-analysis of 24 trials found that of the 12 better quality controlled studies, only one favored hCG, and concluded there is no scientific evidence it causes weight loss, fat redistribution, reduced hunger, or a sense of well-being. The prescription label itself says hCG is not effective adjunctive therapy for obesity, and FDA calls hCG diet products illegal. Any weight lost on the hCG diet comes from its 500 calorie per day restriction. [4] [5] [7]
Does hCG preserve fertility on testosterone therapy?
The best available data say yes, but they are retrospective. In 26 men on testosterone who also received 500 IU hCG every other day, semen parameters did not decline over more than a year, none became azoospermic, and 9 contributed to a pregnancy. A dose ranging study in gonadotropin suppressed men showed hCG maintains intratesticular testosterone. No randomized trial has confirmed the fertility outcome. [1] [2]
What are the side effects of hCG?
In men: headache, irritability, fatigue, fluid retention, gynecomastia and breast tenderness from rising estradiol, acne, and injection site pain; in boys it can trigger early puberty. In women: ovarian hyperstimulation syndrome and multiple pregnancy. Rare thromboembolic events and allergic reactions are reported. It can cause false positive pregnancy tests for several days. [5] [6]
What is the hCG dose on the FDA label?
Pregnyl and Novarel are labeled for intramuscular injection. For hypogonadotropic hypogonadism in males the listed regimens include 500 to 1,000 units three times a week for 3 weeks then twice a week for 3 weeks, or 4,000 units three times a week for 6 to 9 months then 2,000 units three times a week for 3 months. Ovulation induction uses a single 5,000 to 10,000 unit dose one day after the last menotropins dose; Ovidrel is 250 mcg under the skin. Use alongside testosterone therapy is off label. [5] [6] [10]
How much does hCG cost?
Brand hCG costs roughly 100 to 300 USD per 10,000 unit vial, which lasts about 6 to 7 weeks at 500 IU three times weekly, and Ovidrel syringes are roughly 150 to 250 USD each. Compounded hCG, which used to be cheaper, is no longer lawfully available. Prices verified on the last verified date. [5] [8]
Is hCG banned by WADA?
Yes, for male athletes. Chorionic gonadotropin is named in section S2 of the WADA Prohibited List, prohibited in males at all times because it raises testosterone. It is not prohibited in females. Male athletes with a legitimate medical need must obtain a therapeutic use exemption. [9]
hCG vs gonadorelin: which should I use with TRT?
hCG has the evidence. It acts directly on the testes with a long half-life, so 2 to 3 injections a week maintain intratesticular testosterone, and retrospective data show preserved sperm production during testosterone therapy. Gonadorelin acts on the pituitary, lasts minutes, and only works when pumped in pulses; the weekly injection schedule clinics sell has never been studied. The practical problem is that only brand hCG is lawful now, while gonadorelin can be compounded cheaply. [1] [3] [8]
Decisions about starting, stopping, or combining any treatment belong with a licensed clinician who knows your history.
From the blog
- Peptides for men, ranked by human evidence
hCG, GLP-1 drugs, teriparatide, and tesamorelin have human trials and a lawful route. PT-141 is off-label for men, and kisspeptin and melanotan II have no lawful path. Ranking, legality, and WADA.
Sources
Numbered citations above point to these primary sources. PubMed entries link to the indexed abstract.
- [1]Hsieh TC et al. Concomitant intramuscular human chorionic gonadotropin preserves spermatogenesis in men undergoing testosterone replacement therapy. J Urol 2013PubMed 23260550, 2013
- [2]Amory JK et al. Serum 17-hydroxyprogesterone strongly correlates with intratesticular testosterone in gonadotropin-suppressed normal men receiving various dosages of human chorionic gonadotropin. Fertil Steril 2008PubMed 17462643, 2008
- [3]Buchter D et al. Pulsatile GnRH or human chorionic gonadotropin/human menopausal gonadotropin as effective treatment for men with hypogonadotropic hypogonadism: a review of 42 cases. Eur J Endocrinol 1998PubMed 9758439, 1998
- [4]Lijesen GK et al. The effect of human chorionic gonadotropin (HCG) in the treatment of obesity by means of the Simeons therapy: a criteria-based meta-analysis. Br J Clin Pharmacol 1995PubMed 8527285, 1995
- [5]FDA prescribing information for Pregnyl (chorionic gonadotropin) for injection, via DailyMedFDA, 2025
- [6]FDA prescribing information for Novarel (chorionic gonadotropin) for injection, via DailyMedFDA, 2025
- [7]FDA consumer update: Avoid dangerous HCG diet products (hCG is not approved for weight loss; over the counter hCG products are illegal)FDA, 2025
- [8]FDA: Compounding and the FDA, questions and answers (biological products are not eligible for the 503A or 503B compounding exemptions)FDA, 2026
- [9]WADA Prohibited List, section S2 peptide hormones, growth factors, related substances and mimeticsWADA, 2026
- [10]FDA prescribing information for Ovidrel (choriogonadotropin alfa injection), via DailyMedFDA, 2023
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