Both are fertility hormones extracted from human urine, both are injected, and both carry the word gonadotropin. They are not interchangeable. hCG (human chorionic gonadotropin) is one hormone that behaves like luteinizing hormone. hMG (human menopausal gonadotropin, generic name menotropins) is a mixture that carries follicle-stimulating hormone as well. In fertility treatment the second is usually given first and the first is given last.
This page sets the two side by side from their US labels and the published evidence, with dates. hCG's own records are on hCG side effects, hCG for men and the hCG dosage page; hCG's comparison with the oral alternative is on hCG vs Clomid. Nothing here is a recommendation; treatment choices belong with a reproductive specialist.
The two products, label against label
| hCG | hMG (menotropins) | |
|---|---|---|
| Source | Urine of pregnant women (urinary products); Ovidrel is recombinant | Urine of postmenopausal women |
| Hormone activity | LH-like (acts on the LH receptor) | FSH and LH, 75 IU of each per Menopur vial |
| US products marketed | Pregnyl (Organon), Novarel (Ferring), generic chorionic gonadotropin (Fresenius Kabi, Ferring); Ovidrel (EMD Serono) | Menopur (Ferring) only |
| Discontinued US brands | Several generic urinary hCG applications | Pergonal (1975), Humegon (1994), Repronex (1999) |
| Route | Intramuscular (urinary); subcutaneous (Ovidrel) | Subcutaneous |
| US approved uses | Ovulation induction after menotropins pretreatment; selected male hypogonadotropic hypogonadism; prepubertal cryptorchidism | Multiple-follicle development in ovulatory women in IVF/ICSI |
| Label obesity statement | "HCG has not been demonstrated to be effective adjunctive therapy in the treatment of obesity" | None |
Sources: Pregnyl label (effective 2 December 2025), Novarel label (27 August 2025), Menopur label (31 May 2018), and the Drugs@FDA application list for both ingredients, all read through openFDA on 2 November 2026.
Two details from the labels explain how the products relate. The hCG labels describe the woman being treated as "appropriately pretreated with human menotropins" — hCG is the step after hMG. And the Menopur label states that "Human Chorionic Gonadotropin (hCG) is detected in MENOPUR": the mixture is not free of the other hormone.
Why fertility treatment uses them in sequence
In an ovarian stimulation cycle, the FSH in hMG drives several follicles to grow over days of daily injections (Menopur's pivotal IVF trial allowed up to 20 days of stimulation). When ultrasound and blood estradiol show the follicles are mature, a single dose of hCG stands in for the natural LH surge and triggers final egg maturation and release. The Menopur label puts the safety logic in one line: if the ovaries are abnormally enlarged on the last day of stimulation, "hCG should not be administered" because it raises the chance of ovarian hyperstimulation syndrome (OHSS).
In men with hypogonadotropic hypogonadism — testes that do not receive pituitary signals — the roles are similar. hCG stimulates the testes' Leydig cells to produce testosterone; an FSH source such as hMG supports sperm production in the tubules. The US hCG labels approve hCG for "selected cases" of the condition. The current Menopur label does not include a male indication.
Side effects, as each label records them
| hCG (Pregnyl, Novarel) | hMG (Menopur) | |
|---|---|---|
| Trial rates on the label | None — older labels list reactions without frequencies | IVF trials, 434 women: abdominal pain 6.7%, OHSS 6.2%, headache 6.2%, injection-site pain or reaction 3.9%, abdominal cramps 3.0%, abdomen enlarged 2.3%, injection-site inflammation 2.3% |
| Both sexes | Headache, irritability, restlessness, depression, fatigue, oedema, injection-site pain; hypersensitivity including anaphylaxis | — |
| Women | OHSS, ovarian cysts and rupture, multiple births, arterial thromboembolism (with gonadotropin stimulation) | OHSS, ovarian enlargement and torsion, multiple births, ectopic pregnancy, miscarriage, thromboembolism, lung complications |
| Men | Gynaecomastia; water and sodium retention at high doses | Not approved for men in the US |
| Children | Precocious puberty (cryptorchidism use) | Not approved for children |
From the labels cited above. The OHSS figure is the one comparable number, and it belongs to the whole stimulation cycle rather than to one product: the Pregnyl label notes that OHSS develops after gonadotropin treatment stops and peaks seven to ten days later.
What the 2026 Cochrane update found about hMG
The question fertility clinics actually argue about is not hMG against hCG but hMG against recombinant FSH, the laboratory-made alternative for the stimulation phase. Cochrane updated its review on 14 July 2026 (Berkhout, Kostova and van Wely, CD005354): 59 randomised trials, 18,119 women in IVF or ICSI, with potentially untrustworthy trials screened out.
| Outcome, recombinant FSH vs hMG / HP-hMG | Odds ratio (95% CI) | Trials, women | Certainty |
|---|---|---|---|
| Live birth | 0.83 (0.73 to 0.95) | 15, 4,793 | Moderate |
| Clinical pregnancy | 0.87 (0.76 to 0.98) | 15, 4,839 | Moderate |
| OHSS | 1.42 (1.12 to 1.80) | 37, 9,813 | Moderate |
The review concluded that live birth and clinical pregnancy are "probably lower" with recombinant FSH than with hMG, and OHSS "probably higher". It also noted that many included trials were sponsored by the pharmaceutical industry. An odds ratio of 0.83 is a modest difference, not a verdict on any individual cycle. The 2026 version updates a review first published in 2011 and adds 25 new studies.
What the men's record shows
For men, the two hormones are studied together rather than against each other. The largest pooled analysis we found, Rastrelli and colleagues in Andrology (2014), combined 44 studies of gonadotropin therapy in men with hypogonadotropic hypogonadism and no sperm:
- sperm appeared in the ejaculate in 75% (95% CI 69–81%), with a mean concentration of 5.9 million/mL;
- success was lower when the condition began before puberty (68%) than in mixed populations (84%);
- a higher success rate was seen in men "using both human chorionic gonadotropin and FSH", and no difference was found between FSH preparations — urinary hMG and recombinant FSH performed alike;
- previous testosterone therapy did not affect the result.
When gonadotropins alone do not produce enough sperm, a 2018 meta-analysis of 20 studies found assisted reproduction gave this group pregnancy rates comparable to other causes of infertility (388 pregnancies among 709 patients). The alternatives that act upstream of the testes are compared on enclomiphene vs hCG and gonadorelin vs hCG.
What is not established
- No head-to-head trial of hCG against hMG exists for any approved use, because they do different jobs. Search results that frame them as rivals are comparing a trigger with a stimulant.
- The hCG labels carry no modern adverse-event rates. Their reaction lists come from decades of use, not from trial tables, so the hCG column above cannot be set against Menopur's percentages.
- Neither is approved for weight loss, and the hCG labels say so in capitals. The diet use is covered on the hCG diet.
- Research-market vials sold as "HCG" or "HMG" are outside every label above; nothing on this page describes them.
Sources
- Pregnyl (chorionic gonadotropin) label, Organon, effective 2 December 2025; Novarel label, Ferring, 27 August 2025; Menopur (menotropins) label, Ferring, 31 May 2018 — openFDA label API, read 2 November 2026.
- Drugs@FDA applications for chorionic gonadotropin (BLA 017692, 017016, 017067, 021149 and discontinued applications) and menotropins (BLA 021663 Menopur; 017646 Pergonal, 020328 Humegon, 021047 Repronex — discontinued), via openFDA, read 2 November 2026.
- Berkhout RP, Kostova EB, van Wely M. Recombinant FSH versus other recombinant or urinary gonadotropins for ovarian stimulation in ART cycles. Cochrane Database Syst Rev, 14 July 2026, CD005354.pub3. PMID 42445958.
- Rastrelli G, Corona G, Mannucci E, Maggi M. Factors affecting spermatogenesis upon gonadotropin-replacement therapy: a meta-analytic study. Andrology 2014;2(6):794–808. PMID 25271205.
- Gao Y et al. Assisted reproductive techniques with congenital hypogonadotropic hypogonadism patients: a systematic review and meta-analysis. BMC Endocr Disord 2018;18:85. PMID 30453944.