Human Chorionic Gonadotropin (HCG) is a naturally occurring hormone primarily produced by the placenta during pregnancy. Its therapeutic use as a prescription medication is widespread in fertility and endocrinology. The hormone shares significant structural similarity with Luteinizing Hormone (LH), allowing it to bind to the same receptors and effectively mimic LH’s function. HCG is used to stimulate hormone production in the ovaries and testes. Because the body’s response to HCG is highly variable, the specific dosage must always be prescribed, carefully monitored, and adjusted by a licensed physician.
HCG Dosing for Female Fertility Cycles
HCG’s primary role in female fertility treatment is to trigger the final maturation and release of an egg, often referred to as the “trigger shot.” This application is utilized during controlled ovarian stimulation protocols such as In Vitro Fertilization (IVF) or Intrauterine Insemination (IUI). The drug is administered once the developing follicles have reached an appropriate size, which is typically confirmed through ultrasound and measurement of estradiol levels.
The standard dosage range for this single-dose trigger is between 5,000 and 10,000 International Units (IU). The timing of this injection is extremely precise, as ovulation is expected to occur approximately 36 hours after administration. For an IVF cycle, egg retrieval is scheduled 34 to 36 hours after the injection, just before this expected ovulation window.
In addition to the single trigger dose, HCG may also be prescribed in smaller, multi-dose regimens for luteal phase support after egg retrieval or transfer. This secondary dosing helps the corpus luteum continue producing progesterone, a hormone necessary to prepare and maintain the uterine lining for a potential pregnancy.
HCG Protocols for Male Hypogonadism
In male patients, HCG therapy is used to treat hypogonadism by stimulating the Leydig cells within the testes to produce endogenous testosterone. This action is particularly valuable for men on Testosterone Replacement Therapy (TRT) who wish to maintain fertility. Exogenous testosterone can suppress the body’s natural signal to the testes, leading to reduced sperm production and testicular atrophy. HCG keeps the testes active while systemic testosterone levels are managed.
Typical dosing protocols involve administering HCG two to three times per week. The dosage per injection generally ranges from 500 IU to 1,500 IU, though some protocols may extend up to 2,500 IU per injection. For instance, a common low-dose regimen for men on concurrent TRT is 500 IU every other day to maintain intratesticular testosterone levels and prevent testicular shrinkage.
For men with hypogonadotropic hypogonadism who are not on TRT, HCG monotherapy is often initiated with doses in the 500 IU to 2,500 IU range, multiple times per week. These protocols are typically long-term and require regular blood monitoring to ensure that serum testosterone levels are normalized. If HCG alone does not achieve satisfactory results, Follicle-Stimulating Hormone (FSH) may be added to the regimen to directly support spermatogenesis.
Preparing and Injecting HCG
HCG is often supplied in a powdered form and requires reconstitution before injection. The powder must be mixed with a specific volume of sterile water, known as the diluent, which is typically provided with the medication. After gently injecting the diluent into the HCG vial, the vial should be swirled softly until the powder is fully dissolved. Avoid shaking the mixture vigorously, as this can damage the protein structure.
Once the medication is mixed, the unused portion must be stored in the refrigerator to maintain its stability and potency. The mixed solution has a limited lifespan, often remaining stable for about 30 to 60 days when properly refrigerated. The dose is then drawn from the vial using a sterile syringe at the time of injection.
HCG is administered either via a subcutaneous (SQ) or intramuscular (IM) route. Subcutaneous injections are given just under the skin into the fatty tissue, commonly in the lower abdomen or outer thigh, and are generally preferred for patient comfort and ease of self-administration. Both routes are considered clinically effective.
Safety Risks and Use Outside of Medical Supervision
The use of HCG injections carries specific risks, particularly for female patients undergoing ovarian stimulation. The most significant risk is Ovarian Hyperstimulation Syndrome (OHSS), a condition where the ovaries become excessively swollen and fluid leaks into the abdomen. OHSS is typically triggered by the HCG injection and can range from mild symptoms to severe complications such as blood clots, kidney problems, and severe fluid buildup.
Common side effects across all patients include localized pain, bruising, or a rash at the injection site, as well as general symptoms like headache, fatigue, and mood changes. Because HCG directly influences hormone levels, the risk of serious adverse events necessitates continuous medical supervision and blood monitoring.
HCG is a prescription-only medication approved for specific medical treatments. Its use for non-approved purposes, such as weight loss or bodybuilding post-cycle therapy (PCT), is dangerous. The FDA has warned consumers against using HCG for weight loss, noting that the associated 500-calorie-per-day diet is unsafe and can lead to electrolyte imbalances and cardiac issues. Self-dosing outside of a physician’s care bypasses necessary safety checks and increases the risk of serious harm.