Reviewed & approved by Dr. Nova Reyes · Last checked 2026-10-25. ← Back to Evidence Library
hCG (human chorionic gonadotropin): what the evidence says
At a glance
hCG is a prescription biologic. US labels (Novarel, Pregnyl) cover selected cases of hypogonadotropic hypogonadism in males, prepubertal undescended testes and ovulation induction. R5 FDA treats it as a biological product, so it cannot be compounded under the usual pharmacy exemptions. R3
What it is: the pregnancy hormone. In men it acts like LH and tells the testes to make testosterone and support sperm production. R2
What the evidence says: for weight loss (the "hCG diet"), controlled trials found it does not work beyond the diet itself, and the US label says so. R1, R5 For recovery after anabolic steroids ("PCT"), there are no randomized trials; two retrospective clinic studies, where hCG was always combined with clomiphene, suggest faster recovery of sperm and testicle size, while many men recover without treatment. R6, R7, R8
Biggest risks: the label lists breast growth in men, headache, mood changes, fluid retention, injection-site pain and allergic reactions including anaphylaxis; in fertility use, ovarian hyperstimulation, multiple births and blood clots. R5 Acne and breast tenderness were reported in men. R2
Rating
| Human Human (weight loss / "hCG diet") | Very limited (mixed results): a 24-trial meta-analysis found no benefit on weight, fat distribution or hunger beyond calorie restriction alone R1, and the US label states hCG is ineffective for obesity R5 |
| Human Human (recovery after anabolic steroids, "PCT") | Very limited: retrospective clinic cohorts (79 and 45 men on clomiphene + hCG) and an observational athlete cohort (18 men during AAS use); no randomized trials isolate hCG alone R6, R7, R8, R9 |
| Human Labeled uses (hypogonadotropic hypogonadism, cryptorchidism, ovulation induction) | Not rated here: FDA-approved prescription biologics (Pregnyl BLA 017692, Novarel BLA 017067, Ovidrel BLA 021149) R2, R5; pivotal approval trials are not reviewed on this page |
| Regulatory | FDA-approved prescription biologic (Pregnyl BLA 017692, Novarel BLA 017067, Ovidrel BLA 021149) R5 · Cannot be compounded under 503A/503B (FDA 2020 biologic transition rule) R3 · WADA 2026: prohibited at all times in males (S2.2.1, named) R4 |
| Established human dose | For labeled uses only, see the label. None for weight loss; PCT study regimens are in Study details |
Evidence verdict: Human (weight): Very limited (mixed results) · Human (post-steroid recovery): Very limited · Labeled uses: not rated Card verdict: Labeled uses (FDA-approved): not rated here · Post-steroid recovery: Very limited · Weight loss: Very limited (mixed results) Card note: Varies by use, see page
This page reports what studies used. It is not dosing advice.
Legend: HUMAN data · ANIMAL / LAB data · UNKNOWN · UNVERIFIED: not yet confirmed against a primary source
What is it?
hCG is a hormone made by the placenta. Medical hCG comes from urine or is made recombinantly. In men it substitutes for LH. R2
Does it work?
- Human Weight loss: a 1995 meta-analysis of 8 controlled and 16 uncontrolled trials found "no scientific evidence" that hCG helps weight loss, fat redistribution or hunger; most studies were poor quality. R1
- Human Men with congenital hypogonadotropic hypogonadism: hCG/hMG injections produced sperm in 83.3% of 18 men over 2 years in a nonrandomized comparison. R2
- Human Recovery after steroids (PCT): in a 79-man retrospective study of recreational bodybuilders who had used steroids for 6 months or less, hormones normalized in all groups by month 6. Treated men recovered sooner. At 12 months normal semen was seen in 87.5% on clomiphene + hCG, 69.2% on clomiphene alone and 58.6% with no treatment. Groups were not randomized. R6
- Human Men with infertility after long-term steroid use: in 45 men given clomiphene + hCG, only 1 of 18 initially azoospermic men with follow-up reached normal sperm counts at 6 months, and 5 still had no sperm. R7
- Human Use during high-dose steroid cycles (2004): in 18 male power athletes self-administering hCG during massive AAS cycles, spermatogenesis was maintained, but higher hCG doses correlated with a higher percentage of morphologically abnormal sperm (
r = 0.60, p < 0.01). R9 - Human Expert review (2026): most PCT data are observational; spontaneous recovery happens in most men within months, and academic guidance generally does not recommend PCT. R8
- Unknown hCG alone for PCT: no study isolated hCG's effect.
Is it safe?
- Caution In men on hCG/hMG, higher testosterone came with more acne and breast tenderness. R2
What the US label warns about (labeled uses): R5
- Caution Not effective for obesity; the label states there is no substantial evidence it adds weight loss beyond calorie restriction.
- Caution Contraindicated in precocious puberty, prostate cancer or other androgen-dependent tumors, prior allergy to hCG, and pregnancy.
- Caution In fertility use with menotropins: ovarian hyperstimulation syndrome, ovarian cyst rupture, multiple births and arterial blood clots.
- Caution Anaphylaxis has been reported with urine-derived hCG. It can trigger early puberty in boys treated for undescended testes. Use with caution in heart or kidney disease, epilepsy, migraine or asthma (fluid retention).
- Caution Listed side effects: headache, irritability, restlessness, depression, fatigue, swelling, breast growth in men and injection-site pain.
Gray-market "research use only" hCG (human chorionic gonadotropin): extra risks
Unknown contents. Products sold online as "research use only" or "not for human use" are not made under drug-quality rules, so identity, strength and sterility are unknown. This is a general caution; we have not found testing data for this product specifically. Unknown
Illegal "hCG diet" products. FDA has warned about over-the-counter hCG weight-loss products UNVERIFIED: not re-checked on fda.gov.
No legal compounding. As a biologic, hCG is outside the 503A/503B compounding exemptions. R3
What we don't know
- Unknown Randomized data for PCT, and any data on hCG alone
- Unknown Whether gray-market hCG matches labeled products
Is it legal?
Prescription biologic in the US; current labels for Novarel and Pregnyl are on DailyMed. R5 FDA: biological products "are not eligible for the exemptions for compounded drugs under sections 503A and 503B"; hCG transitioned on March 23, 2020. R3 EU, UK, Japan, China: UNVERIFIED not checked against EMA, MHRA, PMDA or NMPA. WADA: prohibited at all times (in and out of competition) in males under S2.2.1, "testosterone-stimulating peptides in males", which names chorionic gonadotrophin (CG); S2 substances are non-Specified R4.
Study details
These are doses researchers used, not recommendations.
R1 Human Human: Meta-analysis, hCG for obesity (Lijesen 1995)
| Study | People / model | Route | Dose used | Follow-up | Reported | Side effects / dropouts | Citation |
|---|---|---|---|---|---|---|---|
| Lijesen 1995 | 24 trials (8 controlled) | Injection (Simeons regimen) | Varies by trial | Varies | No evidence of benefit on weight, fat distribution, hunger | Not assessed | PMID 8527285 |
R2 Human Human: hCG/hMG vs gonadorelin pump in CHH men (Zhang 2019)
| Study | People / model | Route | Dose used | Follow-up | Reported | Side effects / dropouts | Citation |
|---|---|---|---|---|---|---|---|
| Zhang 2019 | 18 men on hCG/hMG | Injection | Amounts not in abstract | 24 months | Sperm in 83.3%; median onset 14 months | More acne and breast tenderness | PMID 30569789 |
R3 Regulatory
- FDA, Notice to Compounders: Changes that affect compounding as of March 23, 2020, and Compounding and the FDA: Questions and Answers ("Can biologics be compounded? No."). Text read via search extract Oct 24, 2026; full-page browser check pending.
R6–R7 Human Human: hCG in recovery after anabolic steroids
| Study | People / model | Route | Dose used | Follow-up | Reported | Side effects / dropouts | Citation |
|---|---|---|---|---|---|---|---|
| İbis 2026 (retrospective, 2 centres) | 79 men, ≤6 months of steroid use, normal pre-cycle tests | Oral clomiphene; hCG subcutaneous | No treatment vs clomiphene 25 mg/day vs clomiphene 25 mg/day + hCG 1,500 IU three times weekly | 12 months | Normozoospermia 87.5% (CC+hCG) vs 69.2% (CC) vs 58.6% (none); testis volume up ≥20% in 70.8% vs 6.9% | Not in abstract | PMID 41147237 |
| Ledesma 2023 (retrospective) | 45 infertile men with prior steroid use | Clomiphene + hCG | Amounts not in abstract; median 5 months | 6 months+ | Of 18 azoospermic men followed: 1 normozoospermic, 5 still azoospermic; 9 of 24 couples reporting had a pregnancy | Not in abstract | PMID 37769866 |
| Karila 2004 (observational athlete cohort) | 18 male power athletes abusing high-dose AAS + concomitant hCG | Parenteral | Self-administered hCG during AAS cycle | End of cycle, 1.5 mo, 6 mo | Mean sperm count 33×10⁶/mL at end of cycle vs 77×10⁶/mL at 6 mo post-cycle | Higher hCG dose correlated with higher % morphologically abnormal sperm (r=0.60, p<0.01) | PMID 15162244 |
R5 Label
- R5 Novarel label on DailyMed: Indications, Contraindications, Warnings, Precautions, Adverse Reactions. Read Oct 24, 2026.
Full reference list (PubMed entries verified Oct 24, 2026)
- R1 Lijesen GK, et al. Br J Clin Pharmacol. 1995;40(3):237-43. PMID 8527285
- R2 Zhang L, et al. Am J Mens Health. 2019;13(1):1557988318818280. PMID 30569789
- R3 FDA compounding notices (links in Study details).
- R4 WADA. World Anti-Doping Code International Standard: Prohibited List 2026 (in force Jan 1, 2026). https://www.wada-ama.org/sites/default/files/2025-09/2026list_en_final_clean_september_2025.pdf (text read Oct 24, 2026)
- R5 Novarel (chorionic gonadotropin) label, Ferring, DailyMed (published Sep 25, 2025). https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ac6918ff-9dc3-40d9-8619-54b26e4bdfc8 Pregnyl label: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=1e94155f-19be-4944-b197-be4edbb4faf9
- R6 İbis MA, et al. BJU Int. 2026;137(1):154-165. doi:10.1111/bju.70059. PMID 41147237
- R7 Ledesma BR, et al. Fertil Steril. 2023;120(6):1203-1209. doi:10.1016/j.fertnstert.2023.09.016. PMID 37769866
- R8 Smit DL, et al. Endocr Connect. 2026;15(9):e260319. doi:10.1530/EC-26-0319. PMID 42644333
- R9 Karila T, et al. Int J Sports Med. 2004;25(4):257-263. doi:10.1055/s-2004-819936. PMID 15162244
Disclaimer
This page summarizes published research for education and harm reduction; it is not medical advice or a recommendation to use hCG. Talk to a clinician you trust before using any drug, and report side effects to FDA MedWatch.
Approved for Adam Greene by Dr. Nova Reyes, 2026-10-25.