Physician-led hCG and TRT care

hCG Therapy for Men on TRT in Jupiter, FL

Medically reviewed by Timothy W. Mackey, D.O., Medical Director, NovaGenix Health & Wellness · Florida License OS9185
Last reviewed: September 3, 2026

Testosterone replacement therapy works by supplying testosterone from outside the body. That relief comes with a trade-off: the brain reads the incoming supply as sufficient and stops signaling the testicles to produce their own. Testicular volume drops and sperm production falls.

hCG replaces the missing signal. For men on TRT who want to protect fertility and testicular function, it is prescribed alongside testosterone rather than after a problem appears. It requires a prescription, bloodwork, and a consultation with a physician.

No prescription is written before you speak with Dr. Mackey. NovaGenix offers telemedicine consultations to qualified patients in U.S. states where our clinicians are licensed to practice and where applicable telehealth laws allow. Eligibility and service availability are confirmed at intake based on your physical location.

Dr. Timothy Mackey reviewing hormone lab results with a male TRT patient at NovaGenix in Jupiter, Florida
Timothy W. Mackey, D.O., reviewing hormone lab results with a patient.
MDPhysician-led care
FLFlorida license OS9185
LABBloodwork required
RxLicensed U.S. pharmacy
Ongoing monitoring

Quick answers

Clear answers to the questions men most often ask before speaking with Dr. Mackey.

Does TRT affect fertility?

Yes. Testosterone therapy suppresses the signals that drive sperm production, and many men on testosterone-only protocols develop significantly reduced sperm counts. Suppressed is not the same as sterile — TRT is not a contraceptive.

What does hCG do for men on TRT?

hCG closely resembles luteinizing hormone, the signal the brain normally sends to the testicles. It can maintain testosterone production inside the testicle, help preserve testicular size, and support ongoing sperm production during testosterone therapy.

Can I buy hCG over the counter?

No. hCG requires a prescription in the United States. It cannot be legally purchased over the counter or without a physician's evaluation.

Is hCG approved for weight loss?

No. The FDA has not approved hCG for weight loss and states that current evidence does not support it as safe or effective for that purpose. NovaGenix does not prescribe hCG for weight loss.

Do I have to be an existing NovaGenix patient?

No. Dr. Mackey treats men starting fresh as well as men already on TRT with another clinic who want to add hCG to their protocol.

What's required before a prescription?

Bloodwork and a consultation with Dr. Mackey. NovaGenix offers telemedicine consultations to qualified patients in U.S. states where our clinicians are licensed to practice and where applicable telehealth laws allow. Eligibility and service availability are confirmed at intake based on your physical location.

How do I get hCG? Can I buy it over the counter?

hCG is prescription-only, and at NovaGenix Dr. Mackey reviews your history and bloodwork first. If hCG is appropriate, he writes the prescription after that visit. A licensed U.S. pharmacy then fills it and ships it to you, typically in 3 to 5 business days. It is not sold over the counter, and no prescription is written before you speak with him.

What is hCG?

Human chorionic gonadotropin is a hormone produced by the placenta during pregnancy, which is why it's what home pregnancy tests detect.

Its relevance to men has nothing to do with pregnancy — it's structural. hCG closely resembles luteinizing hormone (LH), the signal the brain normally sends to tell the testicles to produce testosterone and sperm. Because the two are similar enough to bind the same receptors, hCG can stand in for a signal that testosterone therapy switches off.

Why testosterone therapy suppresses fertility

The hormone-signaling pathway
BrainHypothalamus and pituitary coordinate the signal.
LH and FSHThese hormones carry the production signal.
TesticlesProduce intratesticular testosterone and sperm.
hCG acts directly at the testicleIt replaces an LH-like signal that TRT suppresses.

Your body regulates testosterone through a feedback loop between the brain and the testicles — the hypothalamic-pituitary-gonadal (HPG) axis. When the brain senses adequate testosterone in the bloodstream, it dials back the signaling hormones LH (luteinizing hormone) and FSH (follicle-stimulating hormone) that tell the testicles to produce testosterone and sperm.

Because testosterone replacement delivers that hormone from outside the body, the brain reads the signal as "we have plenty" and shuts down LH and FSH output. Two things follow:

  • Intratesticular testosterone falls dramatically. Sperm production doesn't run on blood testosterone — it runs on the concentrated testosterone inside the testicle, which normally sits at levels many times higher than what shows up on a lab draw. TRT alone can't replicate that.
  • Sperm counts decline. Many men on testosterone-only protocols develop significantly reduced sperm counts, and a meaningful percentage become azoospermic (no measurable sperm) within months. Testicular volume often shrinks as well.

Important: suppressed does not mean sterile. TRT is not a contraceptive, and men on testosterone therapy have absolutely conceived. Anyone not actively trying to father a child should continue using contraception.

For the full picture on sperm production, testicular function and recovery, see our guide to TRT and male fertility.

How hCG preserves testicular function on TRT

Human chorionic gonadotropin is structurally similar enough to LH that it binds the same receptors on the Leydig cells inside the testicle. In practical terms, hCG replaces the signal that testosterone therapy switched off.

What hCG can do

  • Maintain intratesticular testosterone at levels capable of supporting ongoing sperm production
  • Preserve testicular size and function rather than allowing atrophy
  • Keep the pathway "warm," which may shorten recovery time if you later stop TRT to conceive
  • Support the testicles' own steroid output, which some men notice in energy, libido, and overall response to treatment

Published research on men receiving testosterone alongside low-dose hCG has found that semen parameters can be maintained over extended treatment periods.

What hCG does not do

  • It is not a fertility guarantee. It improves the odds of maintaining sperm production; it does not ensure it.
  • It is not a weight-loss medication.
  • It does not eliminate the need for monitoring. hCG raises testicular testosterone production, which also increases conversion to estradiol.
  • It is not a substitute for banking sperm if you have near-term family plans.

A note on body composition

hCG stimulates the testicles' own testosterone production. Small studies in hypogonadal men have observed increases in lean body mass, and some men on TRT report secondary effects such as improved energy and training response.

These are not the reason hCG is prescribed. hCG is not a weight-loss medication, and NovaGenix does not prescribe it for weight loss.

Why hCG rather than something else

hCG is the only widely used option that directly replaces the LH signal at the testicle. Alternatives such as clomiphene and enclomiphene work upstream, at the brain — which means they depend on a pituitary that testosterone therapy has already suppressed.

For men on testosterone replacement therapy who are concerned about testicular function, fertility, or the effects of hormone suppression, concurrent hCG is the standard approach and an option worth raising at your consultation.

hCG, clomiphene, enclomiphene and gonadorelin

Clomiphene citrate (Clomid) and enclomiphene are selective estrogen receptor modulators. Both work upstream at the brain — blocking estrogen feedback so the pituitary releases more LH and FSH — rather than at the testicle directly, which is where hCG acts.

Clomid is a mixture of two isomers. Enclomiphene produces the intended effect; zuclomiphene is more estrogenic, clears far more slowly, and is associated with more mood and visual side effects. Enclomiphene isolates the isomer that does the work, and because patients generally tolerate it better, it is Dr. Mackey's primary choice among the SERMs. Enclomiphene is a compounded medication and is not FDA-approved.

Some men respond better to hCG, others to enclomiphene. A smaller number do better on clomiphene, or prefer how they feel on it — that happens, but it is the exception rather than the starting point. Which option fits depends on your labs, your goals, and how you respond, which is what the consultation and follow-up bloodwork are for.

Some clinics substitute gonadorelin. Its half-life is very short compared to hCG, which means dosing frequency has to be much higher to achieve a comparable effect. NovaGenix does not prescribe it.

Where it acts Requires intact pituitary FDA status Prescribed at NovaGenix
hCG Directly at the testicle No FDA-approved for hypogonadotropic hypogonadism in males Yes
Enclomiphene Brain (pituitary/hypothalamus) Yes Not FDA-approved; compounded Yes — primary SERM choice
Clomiphene (Clomid) Brain (pituitary/hypothalamus) Yes FDA-approved for female ovulation induction; off-label in men Case by case
Gonadorelin Brain (pituitary) Yes No

Concerned about fertility or testicular function on TRT? Submit the intake form and we'll call you to schedule a consultation with Dr. Mackey.

Request a consultation · Call 561-277-8260

Already on TRT and ready to start a family?

This is a very common scenario, and it's manageable.

Depending on your labs, age, duration of therapy, and your partner's fertility workup, options may include adding or increasing hCG, discontinuing testosterone under supervision while using hCG to restart the axis, or adding additional medications such as a SERM or FSH-containing therapy.

Recovery of sperm production after stopping testosterone is common but not immediate — for most men it takes several months to a year or more, and it isn't guaranteed for everyone.

The single most important step is not doing it alone. Stopping testosterone abruptly without a restart protocol tends to produce a rough crash in symptoms without accelerating fertility recovery.

Wanting children and wanting to treat low testosterone are not mutually exclusive goals. They simply require a physician who plans for both. If fertility matters to you — now or someday — say so at your first consultation so your protocol is built around it.

Already a patient somewhere else?

We're happy to work with you.

You do not need to be an established NovaGenix patient to be treated here. Dr. Mackey regularly sees men who are already on TRT with another clinic or physician and want to add hCG to their protocol — whether that's because fertility has become a concern, because testicular atrophy has set in, or because their current provider doesn't offer it.

You can bring your existing lab work with you. As long as it includes free and total testosterone, estradiol, PSA and hematocrit, and it's recent, Dr. Mackey can review it at your consultation. If you'd rather we run fresh labs, we can arrange that too.

Transferring care doesn't mean starting over. It means having a physician review where you are, what's working, and what your protocol is missing.

Request a consultation · Call 561-277-8260 · Text 561-277-8260

What hCG therapy looks like at NovaGenix

Dr. Mackey individualizes every protocol. A fertility-conscious approach generally involves:

Baseline evaluation before starting

Comprehensive hormone labs including LH and FSH, and — for men who intend to have children — a baseline semen analysis.

Treatment starts with low testosterone testing and a physician's review of your hormone panel.

Concurrent hCG dosing

hCG is administered subcutaneously alongside testosterone replacement, with the dose and frequency set by your labs, goals, and response.

Ongoing monitoring

hCG stimulates testicular testosterone production, which also increases aromatization to estradiol — so estradiol, hematocrit, and total and free testosterone are tracked and the protocol adjusted accordingly.

Follow-up visits can be completed through online TRT in Florida for eligible patients.

Sperm cryopreservation when appropriate

For men with near-term family plans or already-borderline semen parameters, banking sperm before starting therapy is the most reliable insurance available.

Who should not take hCG

hCG is not appropriate for everyone. It should not be administered to anyone with:

  • A known hypersensitivity to hCG or any of its ingredients
  • Precocious puberty
  • Active prostate cancer
  • Another androgen-dependent tumor

Some conditions are not automatic exclusions but do require careful evaluation before treatment — and in some cases, clearance from a specialist. These include a history of hormone-sensitive cancer, blood clots, thrombophilia, cardiovascular disease, or kidney disease.

This is part of why bloodwork and a consultation come before any prescription. Bring your full medical history to your consultation, including anything in the list above, so Dr. Mackey can determine whether hCG is a safe option for you.

Is hCG approved for weight loss?

No.

The hCG diet dates to the 1950s, when a British physician began pairing hCG injections with severe calorie restriction. It was never validated, and the restriction — not the hCG — accounted for the weight lost.

The FDA's position is unambiguous: hCG is not approved for weight loss, and current scientific evidence does not support the claim that it is safe and effective for weight loss or for the treatment of obesity. Approved uses are female fertility and select hormonal treatment in males.

Source: FDA — Questions and Answers on HCG Products for Weight Loss

NovaGenix does not prescribe hCG for weight loss, and our partnered pharmacies will not dispense it for that purpose.

If weight loss is what brought you here, there are FDA-approved medications that work, and Dr. Mackey prescribes them.

Medical weight loss · Semaglutide · Tirzepatide

hCG availability and sourcing

In 2020, the FDA changed compounding pharmacies' ability to manufacture and dispense hCG. Supply tightened, demand rose against it, and prices increased across the market. That shift is why some clinics stopped offering hCG altogether and substituted other medications.

NovaGenix maintains multiple sourcing options — brand-name FDA-approved hCG, and for patients who qualify and when clinically appropriate, a compounded version. That means the prescription can be fitted to the patient rather than the other way around.

What happens after you submit the form

1. We call you to schedule. No prescription is written before you speak with Dr. Mackey.

2. Bloodwork. Required before any prescription. We can arrange labs for you, or you can bring recent results that include the tests Dr. Mackey needs.

3. Consultation with Dr. Mackey. NovaGenix offers telemedicine consultations to qualified patients in U.S. states where our clinicians are licensed to practice and where applicable telehealth laws allow. Eligibility and service availability are confirmed at intake based on your physical location.

4. If hCG is appropriate, your prescription is filled by a licensed U.S. pharmacy and shipped to you.

5. Follow-up labs monitor your response and help guide any medically appropriate adjustment.

How does hCG bloodwork work?

If you need labs, Dr. Mackey writes the requisition and we send it to you and to LabCorp. You can book an appointment or walk into any LabCorp location. Results come back to our physician portal, Dr. Mackey reviews them with you, you receive copies, and they stay in your file.

What arrives with your hCG shipment?

Every shipment includes the hCG vial, bacteriostatic water, insulin syringes, alcohol swabs and mixing instructions. If you would rather be walked through it, a NovaGenix clinic manager will take you through the process step by step — our staff are reachable after hours, not only during clinic times.

What does hCG therapy cost?

hCG therapy starts at $199 per month. That covers the consultation with Dr. Mackey, the prescription, the medication, bacteriostatic water, insulin syringes, alcohol swabs, shipping, follow-up consultations and ongoing monitoring.

There is no startup fee, no cancellation fee and no hidden costs. To cancel, give 30 days' notice or settle the balance of your prescription.

A protocol that requires more medication than the standard adjunct dose costs more. Dr. Mackey explains the difference at your consultation before anything is prescribed. The price also depends on whether compounded or brand-name hCG is dispensed.

Bloodwork is separate. The panel is $125. If you already have recent labs from your own physician and they include the tests Dr. Mackey needs, we will use those instead.

Why NovaGenix

  • Direct access to Dr. Mackey. Questions and concerns go to the physician managing your protocol, not a chat queue or a rotating nurse line.
  • Physician-led. Dr. Mackey sees every patient. hCG is not dispensed on the basis of an online questionnaire.
  • Fertility planned for, not patched later. If fertility matters to you, that shapes the protocol from the first consultation rather than becoming a problem to solve after two years of testosterone-only therapy.
  • Monitoring included. Estradiol, hematocrit, and testosterone tracked on an ongoing basis, with the protocol adjusted to what your labs actually show.
  • Individualized, not standardized. No single protocol applied to everyone. Your history, your goals, your labs, adjusted as you go.
  • Local and telehealth. In-clinic in Jupiter. NovaGenix offers telemedicine consultations to qualified patients in U.S. states where our clinicians are licensed to practice and where applicable telehealth laws allow. Eligibility and service availability are confirmed at intake based on your physical location.
  • Transfers welcome. Already on TRT elsewhere? Bring your labs.
Timothy W. Mackey, D.O.

Meet Timothy W. Mackey, D.O.

NovaGenix's Medical Director provides individualized evaluation, lab review and ongoing physician monitoring for eligible patients.

View Dr. Mackey's credentials and clinical background →

Frequently asked questions

Does hCG prevent testicular shrinkage on TRT?

hCG helps preserve testicular size by replacing the LH signal that testosterone therapy suppresses. Response varies between individuals, and it works best when started alongside testosterone rather than after atrophy has developed.

Can I buy hCG without a prescription?

No. hCG is prescription-only in the United States and is not sold over the counter. Any product sold without a prescription is not hCG as prescribed.

Does hCG raise estrogen levels?

It can. hCG stimulates testosterone production inside the testicle, and some of that testosterone converts to estradiol. This is why estradiol is monitored and the protocol adjusted based on your labs.

How long does it take to recover fertility after stopping TRT?

For most men, several months to a year or more. Recovery is common but not immediate and not guaranteed for everyone. Stopping testosterone abruptly without a restart protocol tends to produce a rough symptom crash without speeding recovery.

Can I start hCG if I'm already on testosterone?

Yes. This is one of the most common reasons men come to us. Dr. Mackey will review your current protocol and labs and determine whether adding hCG is appropriate.

Do I have to be an existing NovaGenix patient?

No. Dr. Mackey treats men who are already on TRT with another clinic as well as men starting fresh. You can bring your existing lab work.

Is hCG covered by insurance?

NovaGenix is a direct self-pay practice, so treatment is not billed through insurance. hCG therapy starts at $199 and includes lab review, your consultation with Dr. Mackey, medication, supplies, shipping, follow-up visits and ongoing monitoring.

How much does hCG therapy cost, and what changes the price?

hCG therapy starts at $199 per month, covering the consultation, prescription, medication, supplies, shipping, follow-ups and monitoring. There is no startup fee and no cancellation fee. The price is higher for protocols requiring more medication, and depends on whether compounded or brand-name hCG is dispensed. Bloodwork is separate at $125, or you can use recent labs from your own physician.

Who should not take hCG?

hCG should not be given to anyone with a known hypersensitivity to hCG or its ingredients, precocious puberty, active prostate cancer, or another androgen-dependent tumor. A history of hormone-sensitive cancer, blood clots, thrombophilia, cardiovascular disease, or kidney disease is not always an absolute exclusion, but requires careful physician evaluation — and sometimes specialist clearance — before treatment.

Can I be treated if I don't live in Florida?

NovaGenix offers telemedicine consultations to qualified patients in U.S. states where our clinicians are licensed to practice and where applicable telehealth laws allow. Eligibility and service availability are confirmed at intake based on your physical location.

How long does it take to arrive?

Once Dr. Mackey writes the prescription, a licensed U.S. pharmacy fills it and ships it to you, typically within 3 to 5 business days. Some patients local to a pharmacy can collect the same day.

What is included in the shipment?

The hCG vial, bacteriostatic water, insulin syringes, alcohol swabs and mixing instructions. A NovaGenix clinic manager can walk you through the process step by step, including after hours.

Do I need bloodwork before starting?

Yes. Bloodwork is required before any prescription. If you have recent labs from your own physician that include the tests Dr. Mackey needs, we will use those. If not, he writes a requisition and you can book or walk into any LabCorp location. The panel is $125.

Schedule a consultation in Jupiter, FL

NovaGenix Health & Wellness 609 N Hepburn Ave Ste 106, Jupiter, FL 33458

Call or text: 561-277-8260 Hours: Monday–Friday, 9:00 am – 5:00 pm

Request a consultation — HIPAA-compliant intake form. We'll call you to schedule.

From I-95, take exit 87A and follow W Indiantown Road east to Center Street, then north to N Hepburn Avenue.

Talk with Dr. Mackey about hCG and TRT

Bring recent labs if you have them, or NovaGenix can help arrange the required testing. No prescription is written without a physician consultation.

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