Luteinizing hormone (LH) in the male is produced by the anterior pituitary in response to pulsatile secretion of gonadotropic releasing hormone (GnRH) from the hypothalamus. It acts on Leydig cells in the testicles promoting the production of testosterone. In men with hypogonadotropic hypogonadism (HH), or men with decreased LH secondary to exogenous testosterone use, the lack of LH results in severely decreased intratesticular testosterone levels. Without intratesticular testosterone spermatogenesis is impaired, and by replacing lost LH production with hCG, spermatogenesis can be restored by restoring adequate levels of intratesticular testosterone.

hCG has also found a prominent role in treating endocrine failure of the testicle in men with anabolic steroid induced hypogonadism. These men have lost the ability to produce their own testosterone and hCG has been indicated as a part of an algorithm to help recover endogenous testosterone production (6).

Finally, hCG has also been used to reduce some of the side effects of TRT, mainly preventing testicular atrophy and helping maintain response to TRT by “cycling off” TRT with a periodic replacement of therapy with hCG.

Citation: 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 Jul;7(Suppl 3):S348-S352. doi: 10.21037/tau.2018.04.11. PMID: 30159241; PMCID: PMC6087849.