Influence of multiple injections of HCG on urine and blood hormone levels

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Nelson Vergel

Influence of multiple injections of human chorionic gonadotropin (hCG)on urine and serum endogenous steroids concentrations


Since it is established that human chorionic gonadotropin (hCG) affects testosterone production andrelease in the human body, the use of this hormone as a performance enhancing drug has been prohibitedby the World Anti-Doping Agency. Nowadays, the only validated biomarker of a hCG doping is its directquantification in urine. However, this specific parameter is subjected to large inter-individual variabilityand its determination is directly dependent on the reliability of hCG immunoassays used. In order tocounteract these weaknesses, new biomarkers need to be evidenced.To address this issue, a pilot clinical study was performed on 10 volunteers submitted to 3 subsequenthCG injections. Blood and urine samples were collected during two weeks in order to follow thephysiological effects on related compounds such as the steroid profile or hormones involved in thehypothalamo-pituitary axis.The hCG pharmacokinetic observed in all subjects was, as expected, prone to important interindividualvariations. Using ROC plots, level of testosterone and testosterone on luteinizing hormoneratio in both blood and urine were found to be the most relevant biomarker of a hCG abuse, regardless ofinter-individual variations.In conclusion, this study showed the crucial importance of reliable quantification methods to assesslow differences in hormonal patterns. In regard to these results and to anti-doping requirements andconstraints, blood together with urine matrix should be included in the anti-doping testing program.Together with a longitudinal follow-up approach it could constitute a new strategy to detect a hCG abuse,applicable to further forms of steroid or other forbidden drug manipulation.

NOTE: Paper is attached.

They used 2000 IU at 0, 48 and 96 hours. Testosterone/Estradiol ratio did not change much. Testosterone, E2 and other steroid hormones decreased to baseline 12 days after the first injection.


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