FERTILITY
The Benefits Of Using HCG During Or After Testosterone Replacement Therapy (TRT)
SEPTEMBER 28, 2022 – BY DR. HAMAD SHAFQAT
Testosterone does a lot for your body than just acting as a “male sex hormone.” It plays a fundamental role in modulating different body functions ranging from cognitive ability and mood to muscle mass and production of sperm.
Low testosterone, also termed hypogonadism, is a common issue among men of different age groups, affecting around 4-5 million men in the United States. While testosterone replacement therapy (TRT) is an effective treatment for depleted testosterone levels, it is also known to influence fertility and testicular size.
HCG (Human Chorionic Gonadotropin) has become a popular adjunct to TRT for preserving fertility and testicular function while treating depleted testosterone levels!
What Happens When You Have Low Testosterone?
By the time you enter your 40s or 50s, your testosterone levels in the body start to decline. You may suffer the following symptoms of low testosterone levels:
- Testicle shrinkage
- Erectile dysfunction/impotence
- Decreased muscle strength and mass
- Lack of motivation
- Weaker and fewer spontaneous erections
- Reduced stamina
- Trouble concentrating
- Depression and sadness
- Reduce sperm count [1].
Testosterone replacement therapy is regarded as an efficient method to boost natural testosterone levels, but it negatively affects fertility, sperm count, and testicle size. Using HCG during or after TRT can help treat depleted testosterone while preserving fertility, sperm count, and other bodily functions.
What Is Human Chorionic Gonadotropin (HCG)?
Human Chorionic Gonadotropin (HCG) is a natural hormone that plays a vital role in maintaining pregnancy. It supports the ovarian corpus luteum to maintain pregnancy. So, it would be reasonable to question what HCG does in males?
In males, HCG serves as an analog of LH, meaning that it imitates the role of LH in males. In males, LH is responsible for the production and secretion of testosterone. Besides stimulating ovulation in women, HCG upregulates natural testosterone and sperm production from within the testes in men. In females, HCG has been FDA-approved to treat fertility concerns, and in males, HCG is used to treat hypogonadism (“low-T”) [2].
HCG is often used along with or after testosterone replacement therapy (TRT) to raise testosterone levels in hypogonadal males. HCG is used because TRT slows down the production of sperms and shrinks the size of Leydig cells in testicles. HCG therapy maintains intra-testicular testosterone levels to preserve sperm production. The result will be the restoration of sperm production and fertility and reduced testicle shrinkage [3].
How Do HCG Boost Testosterone Levels?
Do you know hypogonadism, aka low testosterone levels, can increase your risk of infertility?
During hormone replacement therapy (TRT), the production of gonadotropin-releasing hormone (GnRH) from the hypothalamus stimulates the pituitary gland to stop releasing LH. This reduction in LH results in far less testosterone secretion from the testicles, leading to the reduced size and volume of testicles. This condition is known as hypogonadism [4].
This is where HCG enters. When supplemented with TRT, HCG stimulates the testicles to continuously produce testosterone, thereby augmenting the amount of testosterone without any risk of hypogonadism or infertility. As a result of HCG, testicles grow in size over time.
What Does the Research Say?
According to a study conducted in 2019, HCG treatment was found to be effective and safe for men experiencing symptoms of hypogonadism. HCG augmented their testosterone levels above 300 ng/dL [5].
Another study reported that HCG raised testosterone levels in older men having partial hypogonadism compared to the placebo group [6].
HCG Can Also Boost Fertility in Men:
American Urological Association states that HCG is appropriate for hypogonadal males on TRT who desire to maintain fertility. How HCG whilst you’re on TRT maintains fertility has been well-documented in the literature.
HCG boosts testosterone levels by mimicking the function of LH, and since testosterone is required for the production of sperms, HCG has been used to boost fertility in males having a suboptimal sperm count and low testosterone.
HCG is particularly useful for males with hypogonadotropic hypogonadism (HH) – a condition characterized by the insufficient production of sex hormones. Substantial evidence has found that HCG increased sperm count in 25% of men with HH, thus helping them to conceive [7].
Another study reported that men who were on testosterone replacement therapy (TRT) along with HCG had their sperm count increased [8].
One study conducted in 2018 revealed that men with hypogonadism were able to preserve their fertility with HCG, which helped them restore sperm production [9].
Other Benefits Of HCG:
Apart from restoring sperm production and boosting testosterone levels, HCG has the following benefits:
- Maintaining your testicular size.
- Regulating testosterone production.
- Improving sexual function because male sexuality is highly associated with testosterone levels.
- Recovering from a medical condition or disease that lowers testosterone levels.
- Reversing the side effects of steroids in bodybuilders, such as infertility and gonad shrinkage.
- Helping in weight loss.
- Correcting undescended testicles.
How To Take HCG?
HCG should always be administered as an injectable medication because it provides more reliable delivery. It is important to note that HCG supplements or drops should NOT be used as a feasible substitute to medical-grade HCG. HCG injections are administered with a small insulin syringe in the lower stomach (into the fat tissue) or the fat pad of the outer glute.
Are There Any Side Effects Of HCG?
Generally, a majority of men can tolerate the HCG treatment well. Very few men experience its side effects. Common side effects of HCG include:
- Nausea
- Vomiting
- Skin rashes
- Headaches
- Pain, swelling, and redness on the injection site.
- Stomach pain
- Gynecomastia (breast enlargement in males).
HCG can cause severe allergic reactions in rare cases, such as anaphylactic reactions and mild skin rashes. Blood clotting is another rare consequence of taking HCG.
Bottomline:
Testosterone replacement therapy (TRT) is an effective option for boosting testosterone levels. HCG supplemented with TRT not only boosts intra-testicular testosterone but also preserves sperm count and boosts fertility. Some other benefits of HCG include weight loss, improved sexual desire, and maintaining testicle size.
References:
- Cohen J, Nassau DE, Patel P, Ramasamy R. Low Testosterone in Adolescents & Young Adults. Front Endocrinol (Lausanne) 2020;10:1–6. https://doi.org/10.3389/fendo.2019.00916.
- Wenker EP, Dupree JM, Langille GM, Kovac J, Ramasamy R, Lamb D, et al. The Use of HCG-Based Combination Therapy for Recovery of Spermatogenesis after Testosterone Use. J Sex Med 2015;12:1334–7. https://doi.org/10.1111/jsm.12890.
- Ramasamy R, Armstrong JM, Lipshultz LI. Preserving fertility in the hypogonadal patient: an update. Asian J Androl 2015;17:197–200. https://doi.org/10.4103/1008-682X.142772.
- Grech A, Breck J, Heidelbaugh J. Adverse effects of testosterone replacement therapy: An update on the evidence and controversy. Ther Adv Drug Saf 2014;5:190–200. https://doi.org/10.1177/2042098614548680.
- Madhusoodanan V, Patel P, Lima TFN, Gondokusumo J, Lo E, Thirumavalavan N, et al. Human Chorionic Gonadotropin monotherapy for the treatment of hypogonadal symptoms in men with total testosterone > 300 ng/dL. Int Braz J Urol 2019;45:1008–12. https://doi.org/10.1590/S1677-5538.IBJU.2019.0132.
- Liu PY, Wishart SM, Handelsman DJ. A double-blind, placebo-controlled, randomized clinical trial of recombinant human chorionic gonadotropin on muscle strength and physical function and activity in older men with partial age-related androgen deficiency. J Clin Endocrinol Metab 2002;87:3125–35. https://doi.org/10.1210/jcem.87.7.8630.
- Lin J, Mao J, Wang X, Ma W, Hao M, Wu X. Optimal treatment for spermatogenesis in male patients with hypogonadotropic hypogonadism. Medicine (Baltimore) 2019;98.
- Tung-Chin H, W. PA, Kathleen H, I. LL. Concomitant Intramuscular Human Chorionic Gonadotropin Preserves Spermatogenesis in Men Undergoing Testosterone Replacement Therapy. J Urol 2013;189:647–50. https://doi.org/10.1016/j.juro.2012.09.043.
- Lee JA, Ramasamy R. Indications for the use of human chorionic gonadotropic hormone for the management of infertility in hypogonadal men. Transl Androl Urol 2018;7:S348–52. https://doi.org/10.21037/tau.2018.04.11.