hCG Therapy for Secondary Hypogonadism

Introduction to hCG Therapy

• The American College of Endocrinology recommends hCG as the first-line treatment for men with secondary hypogonadism who need testosterone restoration while preserving fertility potential, as it stimulates endogenous testosterone production without suppressing spermatogenesis 1
• The European Association of Urology suggests that hCG is preferred over testosterone therapy for any man with secondary hypogonadism who wishes to maintain fertility potential, as it preserves the hypothalamic-pituitary-testicular axis 2

Advantages of hCG Over Testosterone Therapy

• hCG therapy preserves fertility through maintained spermatogenesis, with no risk of erythrocytosis, and maintains testicular volume rather than causing testicular atrophy, according to the American Urological Association 2
• hCG therapy is also associated with lower cost compared to testosterone formulations, as stated by the Endocrine Society 2

Critical Contraindication

• Men with primary hypogonadism are absolutely contraindicated for hCG therapy, as they cannot respond to gonadotropin stimulation and require testosterone replacement, according to the National Comprehensive Cancer Network 3

Alternative to hCG: Clomiphene Citrate

• The European Association of Urology recommends clomiphene citrate as an alternative for stimulating endogenous production in secondary hypogonadism, particularly when fertility preservation is desired, with advantages including lower cost, oral administration, and no risk of erythrocytosis 2