2018
This review established that HCG therapy can help restore or maintain sperm production (spermatogenesis) in men with hypogonadism (low testosterone because the testes under-produce), making it an essential tool for preserving fertility during testosterone therapy. It highlighted HCG's role in maintaining intratesticular testosterone levels (testosterone inside the testes).
Lee JA, Ramasamy R
2015
This study showed that HCG can reverse azoospermia (no sperm in semen) caused by testosterone therapy and keep testosterone inside the testes high. The research showed that combining HCG with SERMs (selective estrogen receptor modulators, drugs that block estrogen's action in some tissues) effectively maintains sperm production in men with hypogonadism.
Ramasamy R, Armstrong JM, Lipshultz LI
2021
This broad review found that combined HCG and FSH therapy promotes testicular growth in almost all patients, sperm production in approximately 80%, and pregnancy rates around 50% in men with hypogonadotropic hypogonadism (low sex hormones because the brain's signal is missing). Treatment lasting 12-24 months was typical for best results.
Boeri L, Capogrosso P, Salonia A
2025
This study showed that gonadotropin therapy with HCG and FSH successfully started sperm production in 82% of patients with prepubertal-onset hypogonadotropic hypogonadism (the condition starting before puberty). A larger testicular volume at the start was the best predictor of success.
Cho MC, Lee H, Kim SW
2026
In a study of over 9,500 men, 75% received HCG as part of their testosterone therapy protocol. The combination showed a favorable safety profile with significant improvements in quality of life, sexual function, energy levels, and performance in work and sport.
Clift AK, Johnson H, Huang DR, Morgentaler A
2023
FDA-labeled regimens of injections into a muscle for male hypogonadotropic hypogonadism (500-1,000 IU 3x/week x3 wk then 2x/week x3 wk) and for inducing spermatogenesis (starting sperm production) (4,000 IU 3x/week x6-9 mo, then 2,000 IU 3x/week x3 mo).
Organon (FDA label / DailyMed)
2005
Twenty-nine men with normal reproductive function received 200 mg testosterone enanthate weekly plus saline or 125, 250, or 500 IU hCG every other day for three weeks. Intratesticular testosterone (testosterone inside the testes) fell 25% below baseline at 125 IU, stayed within 7% of baseline at 250 IU, and rose 26% above baseline at 500 IU. This identified the every-other-day low-dose range that keeps testosterone in the testes up during testosterone use from outside the body.
Coviello AD, Matsumoto AM, Bremner WJ, Herbst KL, Amory JK, Anawalt BD, et al.
2013
Men on testosterone replacement who also took 500 IU hCG every other day kept their semen parameters (sperm measures) over more than one year of follow-up, with no cases of azoospermia (no sperm in semen). Testosterone therapy alone was reported to cause azoospermia in roughly 40%.
Hsieh TC, Pastuszak AW, Hwang K, Lipshultz LI
2025
Nineteen men at a Dutch harm-reduction clinic who kept using non-prescribed androgens (steroid-type hormones) were treated with hCG; mean total sperm count rose from 18.0 to 146.9 million and total motile sperm count (sperm that can swim) from 1.1 to 66.9 million. A minority remained oligospermic (low sperm count) or azoospermic (no sperm).
Smit DL, Verdegaal T, Bond P