Hormones & Fertility

HMG

The FSH shot that restarts sperm production when hCG alone cannot. Prescription fertility medicine, three shots a week for months.

Last updated October 30, 2026

UnderstandWhat it isApplyHow to use it

What it is

HMG is for a man who wants to have a child while on, or after, testosterone, and whose sperm count has not come back on hCG alone. It supplies the FSH signal that actually makes sperm, and it works in most men who stick with it for three to six months.

The HMG user is almost always a man on TRT, or coming off a long steroid run, whose partner wants to get pregnant and whose semen analysis came back near zero. hCG is the first step, because it restores testosterone inside the testicle; HMG is what you add when, after three or four months of hCG, the count is still flat. It supplies FSH, the hormone the testicle uses to make sperm, which hCG does not. Men with hypogonadotropic hypogonadism (a pituitary that never sent the signal) use it for the same reason. It is not a testosterone booster, a libido drug or a shortcut for someone without a fertility goal.

This is slow by design. A sperm takes about 74 days to mature, so the first semen analysis that could show anything is two to three months in, and most men need three to six months to reach a count that can get a partner pregnant. Clinical series put success at roughly 75 to 85 percent of men with no sperm who eventually produce them on hCG plus FSH. What you feel day to day is almost nothing beyond the hCG effects you already had; progress lives in the lab report, not in how you feel.

The standard is 75 IU subQ three times a week, raised to 150 IU if the count is not moving after two to three months, always alongside hCG (typically 1000 to 1500 IU two or three times a week; see that page). Run it continuously, not in cycles; stopping and starting resets the 74-day clock. One 75 IU vial is one dose, so three vials a week, and a six-month course is 70 to 80 vials, which is the cost reality of this medicine. Get a semen analysis every six to eight weeks and hormone labs (testosterone, estradiol, FSH, LH) monthly. The named mistake is quitting at week eight because nothing has happened yet.

This is prescription fertility medicine with decades of human use and clear trial data, which puts it in a different class from almost everything else on the site; we grade it 4 for animal and 4 for human evidence, and the clinical picture is settled. The FDA-approved product is sold under names like Menopur and is a standard part of fertility clinic protocols for both men and women; the US label is written for women, so use in men is off-label but routine. Nothing here is a guess.

If you have no fertility goal, there is no reason to run HMG; hCG or gonadorelin covers testicular upkeep on TRT. If you have not tried hCG alone for three to four months, do that first; many men recover without ever needing FSH. And because dosing is adjusted on bloodwork and semen results, running it without a doctor and a lab is throwing money at a problem you cannot see.

Best known for

Restarting sperm production alongside hCG

How it's taken

75 to 150 IU subQ, three times a week

How fast

First change on a semen analysis at 2 to 3 months

How long a cycle

3 to 6 months minimum (often longer). None; run continuously with labs

Pairs with

hCG, always; it does not work alone

What people use it for

Restarting sperm production

Most evidence

In men with no sperm because the pituitary signal is missing or suppressed, hCG plus HMG or FSH brings sperm back in roughly three out of four cases over several months. This is decades of clinical series, not a pilot study. The men who fail are usually the ones who stop early.

Sperm quality after TRT or steroids

Some evidence

For men whose count collapsed on testosterone, adding HMG to hCG improves count, movement and shape on follow-up analyses. The data here is smaller and more mixed than the pituitary-deficiency work, partly because how long someone was suppressed matters. Expect a longer road after years of use.

Pregnancy rates

Some evidence

The point of the exercise, and the hCG plus FSH combination produces natural pregnancies in a meaningful share of couples once sperm return. Numbers vary with the partner's age and fertility, so a single figure would mislead. A reproductive urologist can give you yours.

Testicle size and hormone output

Some evidence

FSH acts on the Sertoli cells that make up most of the testicle, so men on HMG typically see size return along with sperm. Testosterone itself comes from the hCG half of the pair, which is why HMG is not run alone.

How people use it

RouteSubQ

How often3 times a week

How long3 to 6 months minimum (often longer)

Ready to use it?Dosing and reconstitution guide

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Safety, in brief

Things people sometimes notice

Soreness, redness or a bruise at the injection site
Headache and tiredness in the first weeks
Mood swings or irritability as hormones shift
Breast tenderness, usually from the hCG half pushing estrogen up

The full picture — stop signs and who should talk to a doctor first — is on the dosing guide.

Sources

The labels and studies behind this page. Each link opens the original on PubMed, DailyMed or ClinicalTrials.gov.

Menopur (menotropins) prescribing informationDailyMed: Menopur (menotropins) · Label
Stimulation of spermatogenesis by gonadotropins in men with hypogonadotropic hypogonadismFinkel et al., N Engl J Med 1985 · Study
Efficacy of follitropin-alpha versus human menopausal gonadotropin for male patients with congenital hypogonadotropic hypogonadismOrtaç et al., Turk J Urol 2020 · Study
Clinician's guide to the management of azoospermia induced by exogenous testosterone or anabolic-androgenic steroidsHashimi et al., Asian J Androl 2025 · Review

This is education, not medical advice. Peptides affect everyone differently. Please talk with a doctor before starting anything, especially if you take other medicines or have a health condition.

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