I'm confused about how to inject HCG. My prescription says to inject it intramuscular, but everything I read on this site, says it should be injected subcutaneous. Which do you guys recommend and why?
madman
Super Moderator
Do whichever method suits you best.
One of the leading fertility experts commonly uses/prescribes subcutaneous injections.
Do I need to come off TRT to use HCG for fertility?
Good Morning everyone, I current receive TRT treatment and then do HCG sub Q 500iu twice weekly I’m addition to testosterone and anastrozole and cabergoline. If I wanted to get my wife pregnant, would I have to come off of TRT or does the HCG keep me fertile while being on TRT? Thanks for the help.
www.excelmale.com
Low-dose hCG can prevent sterility in men prescribed testosterone (2019)
If the man desires a future pregnancy, the clinician should prescribe hCG concurrent with testosterone therapy, typically at 500 U subcutaneous three times per week or 1,500 U once weekly if the patient wishes only to prevent testicular atrophy. The patient should cycle off of testosterone twice yearly, at a rate of 3,000 U three times per week for 4 weeks, adding 25 mg daily clomiphene therapy during that period, Lipshultz said. However, for men desiring a pregnancy, 3,000 U hCG three times per week should be prescribed in addition to clomiphene therapy. Clinicians should check the patient’s follicle-stimulating hormone (FSH) level and conduct a semen analysis after 4 months for men desiring pregnancy; if the FSH level is not sufficiently elevated, the clinician should discontinue clomiphene and instead introduce FSH concurrent with the hCG, he said.
Thank you. From everything I have read, it sounds like subcutaneous injections are absorbed slower than in the muscle. I was wondering if that would provide a slower, more stable delivery verses in the muscle. Curious what other guys here are doing.Do whichever method suits you best.
One of the leading fertility experts commonly uses/prescribes subcutaneous injections.
Do I need to come off TRT to use HCG for fertility?
Good Morning everyone, I current receive TRT treatment and then do HCG sub Q 500iu twice weekly I’m addition to testosterone and anastrozole and cabergoline. If I wanted to get my wife pregnant, would I have to come off of TRT or does the HCG keep me fertile while being on TRT? Thanks for the help.
Low-dose hCG can prevent sterility in men prescribed testosterone (2019)
If the man desires a future pregnancy, the clinician should prescribe hCG concurrent with testosterone therapy, typically at 500 U subcutaneous three times per week or 1,500 U once weekly if the patient wishes only to prevent testicular atrophy. The patient should cycle off of testosterone twice yearly, at a rate of 3,000 U three times per week for 4 weeks, adding 25 mg daily clomiphene therapy during that period, Lipshultz said. However, for men desiring a pregnancy, 3,000 U hCG three times per week should be prescribed in addition to clomiphene therapy. Clinicians should check the patient’s follicle-stimulating hormone (FSH) level and conduct a semen analysis after 4 months for men desiring pregnancy; if the FSH level is not sufficiently elevated, the clinician should discontinue clomiphene and instead introduce FSH concurrent with the hCG, he said.
madman
Super Moderator
*Results: Compared with IM administration of hCG, peak serum drug concentration was significantly delayed (P = 0.01) and serum half-life was prolonged (P = 0.01) after SC injection; however, T, LH, and FSH responses were identical.
Pharmacodynamics and pharmacokinetics after subcutaneous and intramuscular injection of human chorionic gonadotropin
Objective: The pharmacokinetics and efficiency of human chorionic gonadotropin (hCG) after subcutaneous (SC) injection was to clarify in comparison with the intramuscular (IM) mode of administration.
Design: In a prospective study, the pharmacokinetics of hCG and the response of serum testosterone (T), luteinizing hormone (LH), and follicle-stimulating hormone (FSH) after an IM and SC injection of 5,000 IU hCG were evaluated up to 144 hours in two randomized groups.
Setting: The study was carried out in a clinical dermatology department providing tertiary care.
Participants: Twenty-four healthy male volunteers with a mean age of 22.7 ± 4.3 years were divided into two groups. Interventions: Human chorionic gonadotropin (5,000 IU) was injected IM or SC.
Main Outcome Measure: Serum concentration of, β-hCG, T, LH, and FSH were evaluated after IM and SC administration of hCG. Differences between the two groups were determined by t-test.
Results: Compared with IM administration of hCG, peak serum drug concentration was significantly delayed (P = 0.01) and serum half-life was prolonged (P = 0.01) after SC injection; however, T, LH, and FSH responses were identical.
Conclusions: Subcutaneous application of 5,000 IU hCG is as effective as IM administration in terms of steroidogenesis.
Male hypogonadotropic hypogonadism can be treated by gonadotropin substitution. Application is possible by parenteral access only. Until now, gonadotropins were administered exclusively by intramuscular (IM) injection. The therapeutic schedule most frequently used provides for the administration of the preparation three times weekly. Because the IM injections can be performed by the physician or the medical professional staff only, the patient is expected to visit a private practice or a hospital regularly to receive treatment. Apart from the discomfort caused by IM injections, the time that is taken by this type of application often leads to unsatisfactory compliance because treatment frequently extends over several months until both pubertal maturation and relatively normal fertility are achieved. To simplify treatment and to improve patient compliance during long-term gonadotropin therapy, the subcutaneous (SC) route of administration, allowing self-administration by the patient, had previously been chosen by our group in the treatment of hypogonadotropic males.
To date, no detailed data are available concerning the pharmacokinetics and pharmacodynamics of human chorionic gonadotropin (hCG) after SC application and its effects on the hypothalamopituitary-gonadal axis. Changes in endogenous gonadotropin secretion during hCG therapy could not be studied until highly specific radioimmunological methods using monoclonal antibodies were developed because all other test systems for the determination of luteinizing hormone (LH) had high cross-reactivity with hCG.
Our study was designed to compare the pharmacokinetics and pharmacodynamics of hCG after IM and SC injection on healthy test persons. For both modes of administration, the efficacy regarding the steroidogenic response was investigated by measuring the increase in serum testosterone (T). The effect of the exogenous gonadotropin on the hypothalamopituitary-gonadal axis was investigated by determining the endogenous LH and follicle-stimulating hormone (FSH) serum levels.
RESULTS
Serum β-hCG
Before the injection, fJ-hCG serum concentration was at the lower detection limit in all volunteers. After IM injection, 406.97 ± 60.19 mU/mL was found after 6 hours; thereafter, serum hCG declined slowly with a half-life of 31 ± 3 hours (Fig. 1). After SC injection, the highest value of 187.47 ± 55.9 mU/mL was reached after 16 hours, and the half-life was extended to 38 ± 3 hours (Fig. 1). The area under the curve (AUC) was 19,777 mU/mL X hours in group 1 and 12,586 mU/mL X hours in group 2.
Serum T
Before hCG injection, the T values were similar in both groups. The highest serum concentration was reached 72 hours after IM injection as well as after SC injection. Serum T peak value showed no significant difference after the two modes of administration (Fig. 1). The stimulation index (T maximum/basal T) was 1.89 in group 1 and 1.83 in group 2. The AUC was 1,896 ng/mL X hours in group 1 and 1,848 ng/mL X hours in group 2.
Serum LH and FSH
There was also no significant difference between the two groups regarding the absolute values of LH and FSH before hCG injection or during the whole period of investigation. Serum LH dropped rapidly during the 1st 24 hours after hCG injection. During the following 120 hours, the serum level decreased only slightly, and the lowest value was determined after 144 hours, i.e., at the end of the controlled period (Fig. 1). Serum FSH declined more slowly till the end of the investigation, 144 hours after hCG injection (Fig. 1). No side effects were observed at the injection site after SC or IM injection of hCG.
DISCUSSION
The pharmacokinetics of hCG and the testicular steroidogenic response after IM and intravenous injection in normal men are well known from the investigations of other authors. For the IM mode of administration, our results are similar to those reported previously. 5-7 In our study, the peak of hCG serum level was reached 6 hours after IM injection of 5,000 IU hCG, and the serum half-life was 31 ± 3 hours. Other investigators found the peak of hCG in serum (or plasma) after 5,000 to 10,000 IU hCG between 6 and 8 hours, and the half-life was determined to range from 24 to 32 hours. The pharmacokinetics of hCG after SC injection is described for the first time in the present study. Compared with IM administration, the peak hCG serum level was delayed after SC administration, and the magnitude was reduced. The half-life was extended, which indicates a slower diffusion of the SC-administered hCG into circulation.
*The testicular steroidogenic response, however, was similar after IM and SC injection of 5,000 IU hCG. The peak of serum Twas reached after 72 hours, and the stimulation index was 1.89 and 1.83, respectively after IM and SC administration.
The results of this study are of great clinical significance. In spite of the different pharmacokinetic results after IM and SC application of a single bolus injection of 5,000 IU hCG, both routes of application showed equal effectiveness in terms of steroidogenesis. Thus, long-term treatment can be carried out easily because the SC injection can be done by the patient himself.
Figure 1 Serum concentration (mean ± SD) of hCG, T, LH, and FSH before and after IM and SC injection of 5,000 IU hCG.
Pharmacodynamics and pharmacokinetics after subcutaneous and intramuscular injection of human chorionic gonadotropin
Objective: The pharmacokinetics and efficiency of human chorionic gonadotropin (hCG) after subcutaneous (SC) injection was to clarify in comparison with the intramuscular (IM) mode of administration.
Design: In a prospective study, the pharmacokinetics of hCG and the response of serum testosterone (T), luteinizing hormone (LH), and follicle-stimulating hormone (FSH) after an IM and SC injection of 5,000 IU hCG were evaluated up to 144 hours in two randomized groups.
Setting: The study was carried out in a clinical dermatology department providing tertiary care.
Participants: Twenty-four healthy male volunteers with a mean age of 22.7 ± 4.3 years were divided into two groups. Interventions: Human chorionic gonadotropin (5,000 IU) was injected IM or SC.
Main Outcome Measure: Serum concentration of, β-hCG, T, LH, and FSH were evaluated after IM and SC administration of hCG. Differences between the two groups were determined by t-test.
Results: Compared with IM administration of hCG, peak serum drug concentration was significantly delayed (P = 0.01) and serum half-life was prolonged (P = 0.01) after SC injection; however, T, LH, and FSH responses were identical.
Conclusions: Subcutaneous application of 5,000 IU hCG is as effective as IM administration in terms of steroidogenesis.
Male hypogonadotropic hypogonadism can be treated by gonadotropin substitution. Application is possible by parenteral access only. Until now, gonadotropins were administered exclusively by intramuscular (IM) injection. The therapeutic schedule most frequently used provides for the administration of the preparation three times weekly. Because the IM injections can be performed by the physician or the medical professional staff only, the patient is expected to visit a private practice or a hospital regularly to receive treatment. Apart from the discomfort caused by IM injections, the time that is taken by this type of application often leads to unsatisfactory compliance because treatment frequently extends over several months until both pubertal maturation and relatively normal fertility are achieved. To simplify treatment and to improve patient compliance during long-term gonadotropin therapy, the subcutaneous (SC) route of administration, allowing self-administration by the patient, had previously been chosen by our group in the treatment of hypogonadotropic males.
To date, no detailed data are available concerning the pharmacokinetics and pharmacodynamics of human chorionic gonadotropin (hCG) after SC application and its effects on the hypothalamopituitary-gonadal axis. Changes in endogenous gonadotropin secretion during hCG therapy could not be studied until highly specific radioimmunological methods using monoclonal antibodies were developed because all other test systems for the determination of luteinizing hormone (LH) had high cross-reactivity with hCG.
Our study was designed to compare the pharmacokinetics and pharmacodynamics of hCG after IM and SC injection on healthy test persons. For both modes of administration, the efficacy regarding the steroidogenic response was investigated by measuring the increase in serum testosterone (T). The effect of the exogenous gonadotropin on the hypothalamopituitary-gonadal axis was investigated by determining the endogenous LH and follicle-stimulating hormone (FSH) serum levels.
RESULTS
Serum β-hCG
Before the injection, fJ-hCG serum concentration was at the lower detection limit in all volunteers. After IM injection, 406.97 ± 60.19 mU/mL was found after 6 hours; thereafter, serum hCG declined slowly with a half-life of 31 ± 3 hours (Fig. 1). After SC injection, the highest value of 187.47 ± 55.9 mU/mL was reached after 16 hours, and the half-life was extended to 38 ± 3 hours (Fig. 1). The area under the curve (AUC) was 19,777 mU/mL X hours in group 1 and 12,586 mU/mL X hours in group 2.
Serum T
Before hCG injection, the T values were similar in both groups. The highest serum concentration was reached 72 hours after IM injection as well as after SC injection. Serum T peak value showed no significant difference after the two modes of administration (Fig. 1). The stimulation index (T maximum/basal T) was 1.89 in group 1 and 1.83 in group 2. The AUC was 1,896 ng/mL X hours in group 1 and 1,848 ng/mL X hours in group 2.
Serum LH and FSH
There was also no significant difference between the two groups regarding the absolute values of LH and FSH before hCG injection or during the whole period of investigation. Serum LH dropped rapidly during the 1st 24 hours after hCG injection. During the following 120 hours, the serum level decreased only slightly, and the lowest value was determined after 144 hours, i.e., at the end of the controlled period (Fig. 1). Serum FSH declined more slowly till the end of the investigation, 144 hours after hCG injection (Fig. 1). No side effects were observed at the injection site after SC or IM injection of hCG.
DISCUSSION
The pharmacokinetics of hCG and the testicular steroidogenic response after IM and intravenous injection in normal men are well known from the investigations of other authors. For the IM mode of administration, our results are similar to those reported previously. 5-7 In our study, the peak of hCG serum level was reached 6 hours after IM injection of 5,000 IU hCG, and the serum half-life was 31 ± 3 hours. Other investigators found the peak of hCG in serum (or plasma) after 5,000 to 10,000 IU hCG between 6 and 8 hours, and the half-life was determined to range from 24 to 32 hours. The pharmacokinetics of hCG after SC injection is described for the first time in the present study. Compared with IM administration, the peak hCG serum level was delayed after SC administration, and the magnitude was reduced. The half-life was extended, which indicates a slower diffusion of the SC-administered hCG into circulation.
*The testicular steroidogenic response, however, was similar after IM and SC injection of 5,000 IU hCG. The peak of serum Twas reached after 72 hours, and the stimulation index was 1.89 and 1.83, respectively after IM and SC administration.
The results of this study are of great clinical significance. In spite of the different pharmacokinetic results after IM and SC application of a single bolus injection of 5,000 IU hCG, both routes of application showed equal effectiveness in terms of steroidogenesis. Thus, long-term treatment can be carried out easily because the SC injection can be done by the patient himself.
Figure 1 Serum concentration (mean ± SD) of hCG, T, LH, and FSH before and after IM and SC injection of 5,000 IU hCG.
It looks like the responses are similar. Thanks!
Nelson Vergel
Founder, ExcelMale.com
HCG Use in Men on TRT or as Monotherapy: Over 200 Questions and Answers
I collected questions and answers posted on ExcelMale.com in the last 10 years about the use of human chorionic gonadotropin in men who want to prevent loss of testicular size and fertility while on testosterone replacement therapy or that want to use hCG alone as a way to boost their...
www.excelmale.com
Nelson Vergel
Founder, ExcelMale.com
ivkonst2017
Active Member
I see no any reason to inject HCG IM, unlike testosterone HCG is a water solution and is perfecy absorbed in fat tissue
Phil Goodman
Active Member
From what I have been able to find(and it’s shown in this thread) it looks like IM administration of HCG results in not only obtaining higher levels in the body but also maintaining higher levels. So why does SQ seem to be the mainstream method? Is there something I’m missing here?
I agree. Seems like there are differing opinions on this. My prescription states to inject it IM, but others say it's better SQ.
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