HCG (Human Chorionic Gonadotropin): Uses, Dosage, Side Effects & Precautions

At a Glance

What is HCG?

HCG is a hormone produced by the placenta during pregnancy. As a medicine, it is used in fertility treatment, in hypogonadotropic hypogonadism in men (low testosterone caused by a pituitary deficiency), and in selected boys with undescended testes. HCG is widely promoted online for weight loss and bodybuilding, but it is not approved or proven for either use.

How HCG Works

HCG acts almost identically to LH, the hormone that triggers ovulation. In women, it can substitute for the mid-cycle LH surge, which prompts the release of a mature egg. It also supports the ovary’s progesterone production. In men, it stimulates the testes to produce androgens such as testosterone.

When HCG Is Used

• Fertility treatment: Urinary HCG is used to induce ovulation and pregnancy in infertile women whose ovulation problem is not due to primary ovarian failure and who have been pretreated with human menopausal gonadotropins. Recombinant HCG is used to trigger final egg maturation and ovulation in women who have had follicle-stimulating treatment, including in assisted reproduction cycles. The fertility specialist decides which product and plan suit you.

• Hypogonadotropic hypogonadism in men: Used in selected cases where low testosterone is due to a pituitary deficiency. It is not a general treatment for low testosterone.

• Prepubertal cryptorchidism: Used in selected boys with undescended testes not caused by a physical blockage. The response is often temporary, and therapy is usually started between ages 4 and 9. HCG is not appropriate for every cause of undescended testes.

• Weight loss (not approved): According to the US prescribing information, HCG has not been demonstrated to be effective adjunctive therapy for obesity. There is no substantial evidence that it increases weight loss beyond that from calorie restriction, improves fat distribution, or reduces the hunger and discomfort of low-calorie diets. HCG diets are not recommended.

Dosage and How to Take It

Dosing varies by product, indication, age, weight and the specialist’s plan. Urinary HCG is measured in units (USP units/IU) and recombinant HCG in micrograms (mcg). These are different measures, so a dose in one cannot be swapped for the other (250 mcg of recombinant HCG is not the same as 250 units of urinary HCG). The regimens below are examples from US prescribing information, not universal doses. Never calculate, change or self-inject HCG without medical supervision.

Urinary HCG (for example Novarel, given by intramuscular injection only)

• Ovulation induction: 5,000 to 10,000 USP units given one day after the last dose of menotropins. This is a specific labelled regimen for urinary HCG, not a general HCG dose.

• Hypogonadotropic hypogonadism in men: One labelled example is 500 to 1,000 units three times a week for three weeks, followed by the same dose twice a week for three weeks. Other regimens are used, and treatment is individualized.

• Prepubertal cryptorchidism (selected boys): The label lists several regimens (one example is 4,000 USP units three times weekly for three weeks). The child’s doctor chooses the product and regimen. Safety and effectiveness in children below 4 years have not been established.

Recombinant HCG (choriogonadotropin alfa, subcutaneous injection only)

• Ovulation trigger: A single 250 mcg injection, with timing set by the fertility specialist after follicle-stimulating treatment. The maximum dose is 250 mcg. This applies to recombinant choriogonadotropin alfa products and not to urinary HCG.

Weight loss or bodybuilding

There is no approved dose, because HCG is not an approved treatment for either.

Take this medicine only as advised by your doctor or healthcare professional. Do not start, stop, or change the dose on your own.

Side Effects

Common side effects include:

• Headache, irritability, restlessness, depression and fatigue

• Swelling (edema)

• Pain at the injection site

• Breast enlargement (gynecomastia) in males

Serious side effects need prompt medical attention:

• Ovarian hyperstimulation syndrome (OHSS): sudden ovarian enlargement, abdominal pain or swelling from fluid build-up, and breathlessness.

• Ovarian cyst problems: enlargement of existing ovarian cysts, or rupture of a cyst with bleeding into the abdomen (hemoperitoneum).

• Multiple births and blood clots (arterial thromboembolism) in fertility treatment.

• Allergic reactions, including rash, swelling, breathing difficulty and anaphylaxis.

• Early puberty in boys treated for undescended testes. Treatment should stop if signs of puberty appear.

Precautions and Monitoring

• Do not use HCG during pregnancy, or if you have precocious puberty, prostate cancer or another androgen-dependent tumor, or have had an allergic reaction to HCG. Other contraindications depend on the product. For example, recombinant HCG is contraindicated in primary ovarian failure, and its label lists further conditions.

• Fertility treatment needs specialist supervision. It can increase the risk of OHSS, ovarian enlargement, fluid accumulation, multiple pregnancy and blood clots, so careful ultrasound and laboratory monitoring is needed.

• HCG can cause fluid retention, so the urinary HCG label advises caution in heart or kidney disease, epilepsy, migraine or asthma.

• Laboratory tests: The urinary HCG label notes that HCG can cross-react in some gonadotropin blood tests, especially LH, so tell the lab and your doctor that you take it. For other products, follow the product information.

Drug Interactions

The US prescribing information for urinary HCG lists no specific drug-drug interactions. HCG is often used together with other fertility medicines, such as menotropins or FSH. This is an intentional combination planned and monitored by a specialist, not a harmful interaction in itself. Tell your doctor and pharmacist about all medicines, supplements and hormones you take.

Pregnancy and Breastfeeding

HCG is not indicated for use during pregnancy. In fertility treatment, it is used to help achieve pregnancy and not as treatment during an established pregnancy. The urinary HCG label lists pregnancy as a contraindication, based on animal findings whose relevance to humans has not been determined. Do not start, stop or continue HCG during pregnancy without medical advice, and tell your doctor immediately if you are or may be pregnant. It is not known whether urinary HCG passes into breast milk, so caution is advised while breastfeeding. Discuss this with your doctor.

Brands, Strengths and Approximate Price in India

Examples of HCG products marketed in India may include Pregnyl, Hucog HP and Ovitrelle (the market name in India for recombinant HCG, sold as Ovidrel in the US). This is not an exhaustive list, and availability can change.

Approximate price in India (based on online pharmacy listings): ₹440–₹560 per 5,000 IU urinary HCG injection, and about ₹2,060–₹2,070 for one recombinant HCG 250 mcg injection.

The urinary and recombinant products use different units and are not directly comparable by strength or price. Prices are printed MRPs, not discounted selling prices, and can change with brand, pack size, pharmacy and location.

How HealthPil Can Help

Medicines should be started, adjusted, or stopped only under the guidance of a qualified healthcare professional. If you have questions about this medicine, its side effects, or your treatment plan, you can consult a doctor through HealthPil, including fertility specialists for personalized care.