HCG Therapy Management at 600 IU Three Times Weekly
For male hypogonadotropic hypogonadism treated with 600 IU hCG administered Monday, Wednesday, and Friday (1,800 IU total weekly), this dosing regimen falls within evidence-based recommendations and should effectively maintain testosterone production while minimizing receptor desensitization risk, provided monitoring confirms adequate testosterone response. 1
Dosing Appropriateness
Your current regimen of 600 IU three times weekly aligns well with established guidelines:
The Endocrine Society recommends 500-2,500 IU administered 2-3 times weekly for male hypogonadotropic hypogonadism as initial therapy. 1 Your 600 IU dose falls within this therapeutic range.
Research demonstrates that even lower frequency dosing (1,500 IU every 6 days) successfully induces pubertal development and progressive testicular growth over 12 months without evidence of desensitization. 2 Your more frequent 600 IU dosing provides more consistent hormonal stimulation.
The three-times-weekly schedule provides regular receptor stimulation without the prolonged high-dose exposure that causes desensitization. 2
Receptor Desensitization Risk Assessment
Your 600 IU dose carries minimal desensitization risk based on the following evidence:
Receptor downregulation occurs primarily with massive single doses (75 IU in rats caused 90-95% receptor loss). 3 Your 600 IU human dose is substantially lower relative to body mass.
Studies using 1,500 IU every 6 days showed progressive testosterone increases over 12 months (from 11.2 ng/dL baseline to 415.6 ng/dL at 12 months), indicating maintained receptor responsiveness despite chronic administration. 2
The key mechanism of desensitization involves sustained high circulating hCG levels overwhelming receptors. 3 Your moderate dose allows receptor recovery between administrations.
Critical Monitoring Requirements
To ensure your regimen remains effective and detect any early desensitization:
Monitor serum testosterone levels before adding FSH therapy, as recommended by the American Urological Association. 1 Check testosterone at baseline, then 4-8 weeks after starting therapy, and periodically thereafter.
Assess clinical response including testicular volume increases, virilization signs, and symptom improvement. 2
If testosterone response plateaus or declines despite continued therapy, this may indicate receptor desensitization requiring dose adjustment or treatment modification. 3
Optimization Strategies
To maximize efficacy while preventing desensitization:
Maintain your current three-times-weekly schedule rather than consolidating into larger, less frequent doses. More frequent smaller doses provide consistent stimulation without overwhelming receptors. 2, 3
Avoid concurrent or planned exogenous testosterone therapy, as the Endocrine Society warns this suppresses gonadotropin secretion and negates hCG benefits. 1
If inadequate testosterone response occurs after 3-6 months of optimized hCG therapy, consider adding FSH analogues rather than increasing hCG dose excessively. 1
Common Pitfalls to Avoid
Do not increase to massive doses (>2,500 IU per injection) attempting to accelerate response, as this increases desensitization risk without proportional benefit. 3
Do not switch to once-weekly dosing with higher individual doses (e.g., 1,800 IU once weekly), as this creates greater peak-trough variation and higher peak receptor exposure. 2
Recognize that testosterone response is progressive over months, not immediate—the study showed continued increases from month 4 (198 ng/dL peak) to month 12 (415 ng/dL peak). 2
Your 600 IU Monday-Wednesday-Friday regimen represents a physiologically sound approach that balances adequate stimulation with receptor preservation, supported by both guideline recommendations and long-term efficacy data.