TRT vs hCG — what's the difference?
TRT delivers exogenous testosterone and suppresses the testicular axis. hCG mimics LH and stimulates intratesticular testosterone and spermatogenesis. They are sometimes combined to preserve testicular function on TRT.
Full answer
TRT delivers exogenous testosterone, which suppresses LH/FSH and reduces intratesticular testosterone and sperm production. hCG mimics LH at the testicular level, stimulating intratesticular testosterone and spermatogenesis. Some men on TRT add hCG to preserve testicular volume and fertility-axis function. Standalone hCG (without TRT) can raise testosterone in men with intact testicular function and is reviewed in selected fertility-preserving contexts. All combinations are synchronous-video reviewed.
Educational. Not a substitute for individualized provider review.
- Testosterone Optimization pathway — Primary source · oMeds
- Reviewed by Dr. Laura Purdy, MD, MBA · Clinical Director, oMeds · Last reviewed 2026-06-03