Peptide education
Human chorionic gonadotropin
hCG · Chorionic gonadotropin · Choriogonadotropin alfa
Human chorionic gonadotropin, or hCG, is a hormone made during pregnancy. Prescription hCG medicines can act on the same receptor as luteinizing hormone and have selected reproductive and endocrine uses.
hCG has specific uses in fertility care and selected hormone disorders. It is not approved for weight loss. Ovarian hyperstimulation and multiple pregnancy are important risks in fertility treatment, which requires monitoring.
Overview
Quick answer
Pregnyl is a urine-derived product labeled in USP units for intramuscular injection. Ovidrel is a recombinant product labeled in micrograms for subcutaneous injection. Their indications, doses, and directions are not interchangeable by a simple unit conversion.
Why is hCG used in fertility care?
After follicles have developed with gonadotropin treatment, a specific hCG product may be used to trigger final maturation or ovulation in eligible patients.
Can hCG be used for every cause of low testosterone?
No. The Pregnyl label identifies selected cases of male hypogonadotropic hypogonadism, not all causes of low testosterone.
Did trials prove urinary and recombinant hCG are identical?
A review of seven randomized trials found no conclusive difference in ongoing pregnancy or live birth in the studied IVF and ICSI settings. That result does not prove identical effects for all outcomes or uses.
Does hCG cause weight loss?
FDA says hCG is not approved for weight loss and has not been shown effective for it. Some very low-calorie diets marketed with hCG carry their own risks.
Evidence
Evidence snapshot
The ongoing-pregnancy or live-birth comparison did not show a conclusive difference between recombinant and urinary hCG.
Testosterone rose in each study group, but fertility preservation was not an outcome established by the study.
Pregnyl and Ovidrel have different formulations, routes, and labeled uses.
Fertility treatment can cause a serious syndrome and requires ovarian monitoring.
Claims
Common claims vs evidence
| Claim | Human evidence | Verdict |
|---|---|---|
| hCG is an effective weight-loss drug. | FDA states that prescription hCG is not approved for weight loss and has not been shown effective for that use. | Weight-loss marketing is not evidence of an approved or demonstrated benefit. |
| A rise in testosterone proves fertility was preserved. | A short randomized study reported testosterone changes in men wishing to preserve fertility; it did not establish sperm or pregnancy outcomes. | Hormone measurements and fertility outcomes are different endpoints. PMID 29772111: Clomiphene citrate and human chorionic gonadotropin are both effective in restoring testosterone in hypogonadism: a short-course randomized studyPMID 29772111: Clomiphene citrate and human chorionic gonadotropin are both effective in restoring testosterone in hypogonadism: a short-course randomized study (2) |
| Recombinant and urinary hCG have proven equal effects in every setting. | A review found no conclusive difference in ongoing pregnancy or live birth across seven IVF and ICSI trials; the confidence interval allowed for differences in either direction. | The comparison is limited to the studied population and outcome, and does not make the products interchangeable. |
Bottom line
Main takeaway
hCG is a prescription hormone for particular reproductive or endocrine situations, not an approved weight-loss drug.
Fertility care requires assessment of ovarian response and attention to hyperstimulation and multiple-pregnancy risks.
A change in testosterone, ovulation, ongoing pregnancy, live birth, and adverse events answer different questions.
Identity
What it is
hCG is a glycoprotein with alpha and beta subunits; prescription products include urine-derived and recombinant preparations.
Pregnyl's label includes selected male hypogonadotropic hypogonadism, non-obstructive prepubertal cryptorchidism, and selected anovulatory infertility after gonadotropin treatment.
Ovidrel is labeled for selected patients undergoing assisted reproduction or ovulation induction after appropriate follicular development.
Use context
Routes, doses, and cycle patterns
Pregnyl and Ovidrel have different labeled uses and routes. The male hormone-response study used a separate subcutaneous regimen and population.
Human studies and product labels
Pregnyl, ovulation induction
- Purpose
- Selected anovulatory infertility after appropriate gonadotropin treatment
- Context
- U.S. prescription label
- Route
- Intramuscular
- Amount
- 5,000 to 10,000 USP units
- Frequency
- One dose, one day after the last gonadotropin dose
The label excludes primary ovarian failure and calls for clinical monitoring of ovarian response.
Ovidrel, assisted reproduction or ovulation induction
- Purpose
- Final follicular maturation in eligible patients
- Context
- U.S. prescription label
- Route
- Subcutaneous
- Amount
- 250 mcg in one prefilled syringe
- Frequency
- One dose, one day after the last follicle-stimulating agent
The label requires adequate follicular development and says to withhold the injection when ovarian response is excessive.
Pregnyl, selected male hypogonadotropic hypogonadism
- Purpose
- One of the dosing examples in the U.S. label
- Context
- U.S. prescription label
- Route
- Intramuscular
- Amount
- 500 to 1,000 USP units per injection
- Frequency
- Three times weekly for three weeks, then twice weekly for three weeks
The label lists more than one regimen and says the choice depends on the patient and indication.
Pregnyl, prepubertal cryptorchidism
- Purpose
- Selected cases not caused by anatomical obstruction
- Context
- U.S. prescription label
- Route
- Intramuscular
- Amount
- 500 USP units per injection in one listed regimen
- Frequency
- Three times weekly for four to six weeks
The label generally describes treatment between ages four and nine and lists alternative regimens. Testicular descent is often temporary.
Male hypogonadism trial
- Purpose
- Testosterone and symptom response in men who wished to preserve fertility
- Context
- Published study regimen
- Route
- Subcutaneous
- Amount
- 5,000 IU per injection in the hCG group
- Frequency
- Twice weekly
- Duration
- Outcomes measured over three months
The study excluded men with hypogonadotropic hypogonadism and primary testicular failure. It assessed hormones and symptoms rather than fertility outcomes; the abstract does not identify the hCG product.
What varies
- A dose labeled in micrograms for recombinant Ovidrel should not be substituted for a USP-unit dose of Pregnyl without the applicable product instructions and clinical oversight.
Research
Research evidence
Human studies address several distinct questions, from assisted-reproduction outcomes to short-term hormone response. Their populations and outcomes should not be combined.
| Study / evidence area | Population | Design | Product context | Main outcome | Limitations | Weight |
|---|---|---|---|---|---|---|
| Recombinant versus urinary hCG review | 1,136 participants in seven randomized IVF or ICSI trials reporting ongoing pregnancy or live birth | Systematic review and meta-analysis | Recombinant compared with urine-derived hCG for final oocyte maturation | Odds ratio 1.15, with a 95% confidence interval of 0.89 to 1.49 | The interval includes possible benefit or harm; results are specific to these assisted-reproduction settings | Moderate-quality evidence for this outcome as rated by the review |
| Short-course male hypogonadism comparison PMID 29772111: Clomiphene citrate and human chorionic gonadotropin are both effective in restoring testosterone in hypogonadism: a short-course randomized studyPMID 29772111: Clomiphene citrate and human chorionic gonadotropin are both effective in restoring testosterone in hypogonadism: a short-course randomized study (2) | Men with late-onset testosterone deficiency who wished to preserve fertility; primary testicular failure and hypogonadotropic hypogonadism were excluded | Three-arm randomized comparison over three months | Subcutaneous hCG injections, oral clomiphene, or both | Testosterone increased in all three groups | Unblinded, with no placebo group and incomplete follow-up; the abstract gives inconsistent total and group counts and does not identify the product or report fertility outcomes | Short-term hormone and symptom evidence |
Cautions
Safety and unknowns
- Ovarian hyperstimulation syndrome can become serious. Severe pelvic pain, abdominal swelling, vomiting, rapid weight gain, or breathing difficulty after fertility treatment warrants prompt medical assessment.
- Multiple pregnancy and thromboembolic events are risks in fertility care. Allergic reactions, including anaphylaxis, have been reported.
- In boys treated for cryptorchidism, hCG can induce early puberty. Fluid retention and gynecomastia are also described in the Pregnyl label.
- Pregnyl is contraindicated after hypersensitivity to human gonadotropins or its ingredients, with high FSH indicating primary gonadal failure in women, or with uncontrolled thyroid, adrenal, or pituitary disorders.
- Pregnyl is also contraindicated with tumors of the hypothalamus or pituitary, ovarian or uterine tumors in females, breast tumors, or prostate tumors in males. Unexplained vaginal bleeding and reproductive malformations or uterine fibroids incompatible with pregnancy are contraindications. The label says Pregnyl is not indicated during pregnancy.
- Ovidrel is contraindicated during pregnancy and in patients with prior hypersensitivity to hCG or its ingredients, primary ovarian failure, uncontrolled thyroid or adrenal dysfunction, or an uncontrolled intracranial lesion such as a pituitary tumor.
- Ovidrel is also contraindicated with unexplained uterine bleeding, ovarian cysts or enlargement of undetermined origin, or sex hormone-dependent tumors of reproductive organs and accessory structures.
Product quality
Product identity and quality
Prescription urine-derived and recombinant hCG products have distinct labels; a research-market vial is not established to be equivalent.
Product and route
Pregnyl is labeled for intramuscular use, while the Ovidrel prefilled syringe is labeled for subcutaneous use.
Strength and units
Pregnyl label examples use USP units; Ovidrel's prefilled dose is expressed in micrograms.
Mechanism
How it is proposed to work
hCG can act like luteinizing hormone at its receptor, prompting final follicular maturation or testicular androgen production in the appropriate setting.
In fertility treatment, the clinical response depends on prior stimulation, follicle development, and monitoring rather than the trigger injection alone.
FAQ
Common questions
Is hCG an approved weight-loss medication?
No. The FDA says hCG is not approved for weight loss and has not been shown effective for that purpose.
Details
Technical details
Sources
References
- 1.
DailyMed. Pregnyl prescribing information
Urine-derived hCG, intramuscular use, indications, dosing examples, and risks.
- 2.
DailyMed. Ovidrel prescribing information
Recombinant choriogonadotropin alfa, subcutaneous dosing, and fertility-treatment risks.
- 3.
doi:10.1002/14651858.CD003719.pub4
Randomized-trial review of reproductive outcomes after different trigger preparations.
- 4.
doi:10.1111/bju.14401 PMID:29772111
Three-month randomized comparison in men seeking to preserve fertility; the abstract does not report fertility outcomes.
- 5.
BJU International. Clomiphene citrate and human chorionic gonadotropin are both effective in restoring testosterone in hypogonadism: a short-course randomized study
doi:10.1111/bju.14401 PMID:29772111
Full study methods and results, including injection route, eligibility, and follow-up; publisher access may be required.
- 6.
FDA. Questions and answers on HCG products for weight loss
FDA position on hCG weight-loss claims and unapproved over-the-counter products.