Injection
Gonadorelin
A copy of the brain's own GnRH signal that keeps the testes producing testosterone and sperm, used alongside testosterone therapy and in fertility care. Prescribed and dosed by a licensed physician.
Starting at $159/mo
Men's healthFertilityTestosterone support
hCG
RxPrescription onlyInjected under the skin · Twice a week · 500 IU · Men's health · Fertility · Testosterone support
Starting at $249/mo
Human chorionic gonadotropin (hCG), a commercial pharmaceutical, supports testicular function in men on testosterone therapy by mimicking LH. Subcutaneous injection, 500 IU twice weekly; keeps sperm and testicular size intact while on external testosterone.
Choose your plan
Real prices from our pharmacy. Longer plans cost less per month and are billed up front. Pause or cancel anytime.
- Mimics LH so the testes stay active even on high-dose testosterone
- Preserves sperm production and testicular size during testosterone therapy
- Supports the option to stop TRT later or cycle it
Every plan includes
- Personalized, physician-guided plan
- Monthly, 3-month and 6-month plans
- Dispensed by a US-licensed compounding pharmacy
- Unlimited protocol adjustments and messaging
- Ongoing support and check-ins
- Pause or cancel anytime
- Reviewed by our in-house physicians
- Physician-guided care
- Ongoing, expert support
- 100% online
- Free, discreet shipping
What is hCG?
(ach-CEE-jee)
hCG (human chorionic gonadotropin) is a hormone made by pregnancy tissue and produced commercially as a pharmaceutical. It mimics LH (luteinizing hormone), telling the testes to make testosterone and sperm. When you take external testosterone, your pituitary stops signaling the testes, so they shrink and stop producing sperm. hCG replaces that signal, keeping the testes active. It is given as a subcutaneous injection, typically 500 IU twice weekly (0.25 mL of a 10,000 IU vial reconstituted with sterile water). The vial must be refrigerated after mixing and discarded after 60 days.
- How it is taken
- Injected under the skin
- How often
- Twice a week
- Dose range
- 500 IU
- Form
- Men's health · Fertility · Testosterone support
500 IU
twice weekly: the typical hCG dose used to maintain testicular function and sperm production on testosterone therapy
hCG is off-label when used with testosterone; it is an FDA-approved drug but used for a different indication. Your physician decides if it fits your goals.
How it works,
week by week.
Day 1
A US-licensed physician reviews your testosterone plan, fertility goals, labs, and starts you on hCG (usually 500 IU twice weekly). The kit includes vials, sterile water, syringes and alcohol pads.
Week 1
Subcutaneous injection twice weekly. You mix the 10,000 IU vial with 5 mL sterile water (making 500 IU per 0.25 mL), inject into the thigh or abdomen, and refrigerate the vial.
Month 1–2
hCG keeps LH signaling alive. Men on TRT report the testes staying fuller and maintaining their size. Your physician may check labs (testosterone, LH, FSH, semen parameters if fertility is the goal).
Month 3
Follow-up labs confirm testicular function is maintained. Your physician reviews testosterone levels, any side effects, and adjusts if needed.
Beyond
hCG runs alongside your testosterone plan as long as you want to preserve testicular function and fertility. Your physician reviews progress every 3–6 months.
What you may notice,
and when.
Testicular size maintained
the shrinkage of TRT is prevented
Sperm counts preserved
or stay much higher than on testosterone alone
Fertility option kept
natural conception remains possible
Easier off-ramp
recovery from TRT is faster and more complete
Individual results vary. Benefits reflect what Zepym Health members commonly report to their physician at check-ins; they are not the results of a clinical trial.
Safety first:
what to know before you start.
Important safety information and common side effects
hCG is generally well tolerated. The most common side effects are mild injection-site reactions (redness, itching, small lump) and, as testosterone rises, acne, mood swings or fluid retention. Rarely, hCG can overstimulate the testes (ovarian hyperstimulation syndrome does not occur in men, but testicular enlargement or pain can). hCG is not prescribed in men with prostate cancer, breast cancer, or a pituitary tumor. Tell your physician if you have a history of blood clots, heart disease, or uncontrolled high blood pressure. Seek care immediately for testicular pain, severe acne, chest pain, leg swelling, or mood changes that interfere with daily life. Tell your physician about every medication and any fertility or hormone treatment.
The research behind
hCG.
Human chorionic gonadotropin (hCG) is used alongside testosterone to keep the testicles working. The evidence is a small retrospective review; We found no randomized trial.
- Semen kept26 men
A retrospective review of 26 men with a mean age of 35.9 on testosterone replacement plus low-dose intramuscular hCG (500 IU every other day) for a mean of 6.2 months. Semen parameters were maintained during treatment, according to the authors.
Hsieh et al., J Urol 2013 - Why it is used40% azoospermia
The paper's background cites azoospermia in 40% of men on testosterone replacement, since testosterone suppresses the pituitary signal that drives sperm production. hCG stands in for that signal.
Hsieh et al., J Urol 2013 - Randomized trialsnone found
We found no randomized trial comparing testosterone with and without hCG for sperm or pregnancy outcomes. The evidence rests on retrospective series and mechanism.
Search of PubMed for hCG with testosterone
What the studies found
- Keeps semen parameters during testosterone therapy in a retrospective series of 26 men (mean follow-up 6.2 months; Hsieh et al., J Urol 2013).
- Raises testosterone less than SERMs do in pooled trials: about 134 ng/dL with hCG alone against about 153 to 158 ng/dL with SERM-based treatment (Hohl et al., Arch Endocrinol Metab 2025).
- Keeps the testes stimulated while testosterone is taken: hCG acts like LH and so maintains testicular testosterone production (mechanism; Hsieh et al., J Urol 2013).
The results are from a small retrospective review of hCG given with testosterone, not of hCG alone. Compounded hCG was not the product tested, and dosing in clinics varies.
What this does not say
- Semen outcomes in this review are short-term and in a small group.
- Pregnancy outcomes after long periods of combined treatment are not established.
- The reference is a single report from one urology group.
The research
behind it.
hCG preserves testicular volume and sperm production in men on exogenous testosterone, well-established in the andrology literature and widely used in TRT protocols for men concerned with fertility.
Men using hCG alongside testosterone report maintained testicular size and sperm counts that would otherwise drop to near-zero, and the option to recover quickly if therapy is stopped.
Testosterone beyond the gym:
what the trials show across body systemsSex drive, blood counts, bone, blood sugar and thinking: what the Testosterone Trials and T4DM found, and where the evidence stops.Read the researchTestosterone and the heart:
what TRAVERSE foundThe safety question most men ask first: heart events, fractures, prostate and blood counts, in the largest placebo-controlled trial of testosterone.Read the research
what the trials show across body systemsSex drive, blood counts, bone, blood sugar and thinking: what the Testosterone Trials and T4DM found, and where the evidence stops.Read the researchTestosterone and the heart:
what TRAVERSE foundThe safety question most men ask first: heart events, fractures, prostate and blood counts, in the largest placebo-controlled trial of testosterone.Read the research
Getting started
takes a few minutes.
- 1
Connect with a physician
Answer a few questions online and a US-licensed physician reviews your health, history and goals to make sure treatment is right for you. 100% online. No in-person visit required.
- 2
Get your discreet shipment
If approved, your treatment is compounded by a US-licensed, LegitScript-certified pharmacy, inspected for quality, and shipped discreetly to your door.
- 3
Receive continuous support
Start with one goal, then keep building over time. Unlimited physician messaging, easy refills and dose adjustments, all from the Zepym Health app.
Frequently asked questions
Contact supportHow do I use hCG - Men?
Injected under the skin, twice a week. The starting prescription is 0.25 mL (500 IU) each time. Your physician sets your own dose and it is printed on your label.
How much arrives in each shipment?
1 vial at the starting strength, shipped to your door from a licensed US pharmacy.
Why add hCG to testosterone therapy?
External testosterone suppresses your pituitary's signal to the testes, so they stop making sperm and shrink to about half their size. hCG mimics the signal the pituitary should be sending, keeping the testes active. Men on TRT who want to preserve fertility, maintain testicular size, or have the option to stop therapy later choose hCG.
How do I mix and inject hCG?
The 10,000 IU vial comes with sterile water. Add 5 mL water to the vial to make 2,000 IU/mL. Draw 0.25 mL (500 IU) into an insulin syringe and inject subcutaneously into the thigh or abdomen twice weekly. Refrigerate the vial after mixing; discard after 60 days. Your physician shows you; most men master it in one or two injections.
Can I use hCG instead of testosterone?
No. hCG stimulates the testes to make testosterone, but only if the pituitary is working normally. Men with truly low LH and FSH (central hypogonadism) may not respond. hCG is added TO testosterone therapy, not as a replacement.
What if I stop TRT?
Stopping TRT is often easier if you've been on hCG, because your testes never fully shut down. The pituitary's own signals can recover in weeks to months instead of the 6–12 months typical after TRT alone.
Can I take hCG with other medications?
Tell your physician about every medication. hCG is generally compatible with most drugs, but certain treatments (GnRH agonists, antiandrogens) interfere. Also tell your physician about any other hormone or fertility treatments.
hCG educational content reviewed by our physician
Scott Nass, MD Doctor of Medicine, board-certified in Family Medicine
Charles R. Drew University and David Geffen School of Medicine at UCLA. Family Medicine residency at Ventura County Medical Center.
More options
in this area.
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Anastrozole - Men
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9 capsules per month
Starting at $63/mo
Capsule
Anastrozole Capsules
Anastrozole, an aromatase inhibitor used in men to control estrogen levels during testosterone therapy. Prescribed and dosed by a licensed physician.
9 capsules per month
Starting at $63/mo
Tablet
Anastrozole Tablets
FDA-approved anastrozole tablets, an aromatase inhibitor used at low doses in men on testosterone therapy whose estradiol runs high. Prescribed by a licensed physician only after blood work.
5 tablets per month
Starting at $63/mo
References
- 1.Low-dose human chorionic gonadotropin maintains intratesticular testosterone in normal men with testosterone-induced gonadotropin suppression. J Clin Endocrinol Metab, 2005
- 2.Concomitant intramuscular human chorionic gonadotropin preserves spermatogenesis in men undergoing testosterone replacement therapy. J Urol, 2013
Prescription products require an online evaluation with a licensed medical professional who will determine if a prescription is appropriate. Products are compounded by a licensed pharmacy. The FDA has not reviewed or approved compounded products for any use for safety, efficacy, or quality. Compounded medications are not FDA-approved brand-name products.