hCG
A meta-analysis of hCG with the Simeons diet found no weight loss, fat redistribution or hunger effect beyond the diet itself. In men with hypogonadotropic hypogonadism, pooled gonadotropin therapy studies reported sperm production in 75% overall. Small trials found low-dose hCG kept intratesticular testosterone near normal during testosterone use. Adverse effect data were not sourced.
Add to Bio HackChecked 2026-11-09
- Status
- Prescription drug in the US, FDA-approved for ovulation induction in women and, in males, for hypogonadotropic hypogonadism and prepubertal cryptorchidism. It is not FDA-approved for weight loss, and over-the-counter hCG weight-loss products are not FDA-approved.
- Also called
- human chorionic gonadotropin, chorionic gonadotropin, Pregnyl, Novarel, Ovidrel, hCG diet, Simeons diet
- Taken for
- weight loss, hCG diet, fertility, sperm production, keeping testicular function on testosterone, raising testosterone
Strong several reviews agree · Moderate one review or consistent trials · Limited one or a few small studies · Untested no study in people, listed with what it rests on
Shown to help5
- ModerateShown to produce sperm in about 75% of men with hypogonadotropic hypogonadism, mostly with hCG combined with FSH.
- LimitedLimited evidence: hCG-combined therapy was linked to higher pregnancy rates in men with low sperm counts or after varicocele surgery, with wide intervals.
- LimitedOne small trial found testosterone alone cut testicular testosterone by 94%, while adding hCG kept it near baseline at 250 to 500 IU in healthy men.
- LimitedLimited evidence: in a review without controls, semen did not change in 26 men on testosterone plus hCG, and none lost sperm entirely.
- LimitedOne trial found testosterone rose from about 2.3 to 5.2 nmol/L on hCG, clomiphene or both in men with low testosterone, with no difference between groups.
What people take it for, and what was found
Shown to help5
Sperm production in hypogonadotropic hypogonadism
Shown to produce sperm in about 75% of men with hypogonadotropic hypogonadism, mostly with hCG combined with FSH.
The numbers and sources
- Effect
- The overall success rate for producing sperm was 75% (95% CI 69 to 81), with a mean sperm concentration of 5.92 million/mL (95% CI 4.72 to 7.13). Success was higher with hCG combined with FSH, and in men with lower baseline gonadotropins. Earlier testosterone therapy did not change the results. Studies of men with pre-pubertal onset had a lower success rate than mixed groups (68% vs 84%) [2].
- Population
- Men with hypogonadotropic hypogonadism and azoospermia, 44 gonadotropin studies [2].
- Sources
- [2]
- Caveats
- The pooled studies combine hCG with FSH preparations, so hCG alone is not isolated. The abstract does not say how many were controlled.
Pregnancy rates in male infertility
Limited evidence: hCG-combined therapy was linked to higher pregnancy rates in men with low sperm counts or after varicocele surgery, with wide intervals.
The numbers and sources
- Effect
- In men with oligospermia, 3 months of hCG-combined therapy was linked to higher pregnancy rates (OR 2.91, 95% CI 1.57 to 5.38). After varicocele surgery, hCG for 3 months was linked to higher pregnancy rates (OR 34.49, 95% CI 1.88 to 632.45). In men with severe testiculopathy there was no difference (OR 5.13, 95% CI 0.27 to 98.56) [4].
- Population
- 926 men in 7 RCTs [4].
- Sources
- [4]
- Caveats
- The search ended in December 2019. Intervals were wide, no pregnancy rate was reported for hypogonadotropic hypogonadism, and live births and adverse events were rarely reported [4].
Intratesticular testosterone during testosterone use
One small trial found testosterone alone cut testicular testosterone by 94%, while adding hCG kept it near baseline at 250 to 500 IU in healthy men.
The numbers and sources
- Effect
- Testosterone enanthate alone suppressed intratesticular testosterone by 94%. With hCG, it rose linearly with dose: 25% below baseline at 125 IU, 7% below at 250 IU and 26% above at 500 IU [5].
- Population
- 29 healthy men, randomized to 3 weeks of testosterone with placebo or one of three hCG doses [5].
- Sources
- [5]
- Caveats
- One small 3-week trial. It measured hormone levels in testicular fluid, not sperm or fertility.
Semen during testosterone therapy
Limited evidence: in a review without controls, semen did not change in 26 men on testosterone plus hCG, and none lost sperm entirely.
The numbers and sources
- Effect
- Semen parameters did not change over more than a year, and no man became azoospermic. Nine of 26 men contributed to a pregnancy during follow-up [6].
- Population
- 26 men with low testosterone, mean age 35.9, on testosterone plus hCG, mean follow-up 6.2 months [6].
- Sources
- [6]
- Caveats
- A retrospective review with no control group.
Raising testosterone in men with low testosterone
One trial found testosterone rose from about 2.3 to 5.2 nmol/L on hCG, clomiphene or both in men with low testosterone, with no difference between groups.
The numbers and sources
- Effect
- Testosterone rose from a mean of 2.31 nmol/L to 5.17 nmol/L by 3 months on hCG, clomiphene or both, with no significant difference between groups. Symptom scores rose most with the combination [7].
- Population
- 282 men with low testosterone seeking to keep fertility, randomized to three arms for 3 months [7].
- Sources
- [7]
- Caveats
- One short trial with no placebo arm.
Not shown to help2
Weight loss with the hCG diet
Not shown to cause weight loss, fat redistribution or less hunger with the hCG diet in people with obesity.
The numbers and sources
- Effect
- Of the 12 studies scoring 50 or more points for method quality, all controlled, one reported hCG as a useful adjunct. The authors found no evidence that hCG brought about weight loss or fat redistribution, reduced hunger or improved well-being [1].
- Population
- 8 controlled and 16 uncontrolled trials of hCG with the Simeons regimen in people with obesity [1].
- Sources
- [1]
- Caveats
- Method scores ranged from 16 to 73 of 100, and the meta-analysis is from 1995.
IVF pregnancy with intrauterine hCG before embryo transfer
Not shown to change live birth or pregnancy rates with intrauterine hCG before embryo transfer in people having IVF.
The numbers and sources
- Effect
- In an individual participant data meta-analysis, intrauterine hCG before embryo transfer did not change live birth rates (OR 0.99, 95% CI 0.83 to 1.19) or clinical pregnancy rates (OR 1.04, 95% CI 0.83 to 1.31) compared with placebo or no intervention [3].
- Population
- 2,244 people undergoing IVF in 7 RCTs with individual data, out of 28 RCTs located [3].
- Sources
- [3]
- Caveats
- The 21 trials without individual data all failed the review's trustworthiness checks, and those trials had shown higher pregnancy rates [3]. This is hCG placed in the uterus, not the injected trigger used for ovulation.
Doses studied
The intratesticular testosterone trial gave 200 mg testosterone enanthate weekly with saline or 125, 250 or 500 IU hCG every other day [5]. The retrospective series used 500 IU every other day [6]. The randomized trial in men with low testosterone used 5,000 IU twice weekly, compared with 50 mg clomiphene or both [7]. The weight loss meta-analysis abstract does not state doses [1].
Risks
Reported risks1
Adverse effects
The label lists headache, irritability, depression, fatigue, swelling and injection site reactions, breast growth in men and ovarian hyperstimulation in women. It gives no rates.
The numbers and sources
- How common
- How often is not known: the sources give no rate.
- Effect
- The Pregnyl label lists, for men and women, hypersensitivity reactions including rare anaphylaxis, irritability, restlessness, depression, headache, edema, fatigue, and bruising, pain, redness, swelling or itching at the injection site. In men, it states hCG may sporadically cause gynecomastia, that water and sodium retention is occasionally seen at high doses, and lists precocious puberty. In women, it lists ovarian hyperstimulation syndrome, which can become serious, and rare thromboembolism, usually with severe hyperstimulation [8].
- Population
- People treated with hCG for approved uses, as described in labeling [8].
- Sources
- [8]
- Caveats
- The label does not give how often each reaction occurs or compare it with placebo [8]. It does not describe use for weight loss or alongside testosterone.
Claims tested and not found
- That hCG causes weight loss on the Simeons diet. Controlled trials found no weight loss, fat redistribution or hunger effect from hCG [1].
- That hCG placed in the uterus before embryo transfer raises IVF live births. An individual participant data meta-analysis found no difference in live birth or clinical pregnancy [3].
Sources
- Lijesen G, Theeuwen I, Assendelft W, 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. British Journal of Clinical Pharmacology. 1995. https://doi.org/10.1111/j.1365-2125.1995.tb05779.x
- Rastrelli G, Corona G, Mannucci E, et al. Factors affecting spermatogenesis upon gonadotropin-replacement therapy: a meta-analytic study. Andrology. 2014. https://doi.org/10.1111/andr.262
- Zou H, Abdallah KS, Wirleitner B, et al. Intrauterine human chorionic gonadotropin administration before embryo transfer (IHABT): an individual participant data meta-analysis of randomized controlled trials. Human Reproduction Update. 2026. https://doi.org/10.1093/humupd/dmag009
- Shoaib H, Duffy J, Ahmed K. Use of Human Chorionic Gonadotropin (HCG) or HCG-Combined Treatments in Male Infertility: A Systematic Review. Cureus. 2025. https://doi.org/10.7759/cureus.94003
- Coviello AD, Matsumoto AM, Bremner WJ, et al. Low-Dose Human Chorionic Gonadotropin Maintains Intratesticular Testosterone in Normal Men with Testosterone-Induced Gonadotropin Suppression. The Journal of Clinical Endocrinology & Metabolism. 2005. https://doi.org/10.1210/jc.2004-0802
- Hsieh TC, Pastuszak AW, Hwang K, et al. Concomitant Intramuscular Human Chorionic Gonadotropin Preserves Spermatogenesis in Men Undergoing Testosterone Replacement Therapy. Journal of Urology. 2013. https://doi.org/10.1016/j.juro.2012.09.043
- Habous M, Giona S, Tealab A, et al. Clomiphene citrate and human chorionic gonadotropin are both effective in restoring testosterone in hypogonadism: a short-course randomized study. BJU International. 2018. https://doi.org/10.1111/bju.14401
- U.S. Food and Drug Administration. PREGNYL (chorionic gonadotropin for injection), prescribing information. 2025. DailyMed. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=1e94155f-19be-4944-b197-be4edbb4faf9