FERTILITY & HPG-AXIS RESEARCH · DEEP DIVE
hMG vs hCG: Gonadotropins Explained
Two gonadotropin preparations, two different jobs. hCG carries an LH-like signal; hMG carries FSH as well. Here is what that difference means and what the IVF meta-analyses found.
In 60 seconds
hCG acts like LH. hMG supplies FSH plus LH activity. Because follicle growth and the later stages of sperm production need FSH, clinics often use them together or in sequence.
- hCG = LH-like signal. hMG = FSH plus LH activity.
- FSH drives follicle growth and the later stages of sperm production.
- IVF meta-analyses found hMG at least comparable to recombinant FSH.
What it is
Two prescription gonadotropins: hCG from placental origin, hMG purified from the urine of post-menopausal women.
What researchers looked at
Live-birth, pregnancy and ovarian hyperstimulation rates in IVF/ICSI trials, and sperm outcomes in LH/FSH-deficient men.
What’s still unknown
How results transfer outside supervised clinical protocols; no trial used research-grade material.
Two hormones, two signals
LH (luteinising hormone) drives testosterone in the testes and triggers ovulation. FSH (follicle-stimulating hormone) grows ovarian follicles and supports sperm maturation in the Sertoli cells.
hCG binds the LH receptor, so it delivers an LH-type signal only. hMG (menotropin) carries both FSH and LH activity. That is the whole difference, and it explains how each is used.
What the IVF meta-analyses found
A 2008 meta-analysis compared hMG with recombinant FSH in IVF/ICSI cycles. Live-birth rates were significantly higher with hMG (odds ratio 1.20), while ovarian hyperstimulation syndrome rates did not differ significantly. Researchers proposed the LH activity as the reason.
A 2010 meta-analysis of five randomised trials comparing highly purified hMG with recombinant FSH found ongoing pregnancy and live-birth rates similar between the two. Different trial sets, slightly different conclusions — which is normal, and why clinicians read the whole body of evidence.
In men
In men whose pituitary does not make enough LH and FSH, protocols commonly start with hCG to restore testosterone and then add FSH activity. A pooled analysis found that most men who stayed without sperm after hCG alone produced sperm once FSH was added. A 2024 meta-analysis of gonadotropin treatment for pubertal induction in these males reviewed testicular growth and spermatogenesis outcomes.
The clinical route
If you are trying to conceive or think you may have a hormone problem, the right route is a fertility clinic or an endocrinologist. They test properly (semen analysis, LH, FSH, testosterone, oestradiol) and prescribe registered medicines under monitoring. Nothing here replaces that.
KEY TAKEAWAYS
- hCG = LH-like signal. hMG = FSH plus LH activity.
- FSH drives follicle growth and the later stages of sperm production.
- IVF meta-analyses found hMG at least comparable to recombinant FSH.
- Clinics often pair or sequence the two.
Sources · PubMed
- Efficacy and safety of human menopausal gonadotrophins versus recombinant FSH: a meta-analysis · Reprod Biomed Online 2008 · PMID 18252052
- Clinical efficacy of highly purified hMG versus recombinant FSH in IVF/ICSI cycles: a meta-analysis · Gynecol Obstet Invest 2010 · PMID 20389096
- A combined analysis of data to identify predictive factors for spermatogenesis in men with hypogonadotropic hypogonadism treated with recombinant human FSH and hCG · Fertil Steril 2009 · PMID 18930225
- Gonadotropins for pubertal induction in males with hypogonadotropic hypogonadism: systematic review and meta-analysis · Eur J Endocrinol 2024 · PMID 38128110
