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Reviewed by MyPeptideMatch Editorial TeamLast reviewed February 2026Updated February 2026

HMG Dosing Protocol: 75 IU Vial — Male Fertility & Spermatogenesis Guide

HMG (human menopausal gonadotropin, FSH+LH) 75 IU vial dosing guide for male spermatogenesis induction, combined with HCG for hypogonadotropic infertility.

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Quickstart highlights

HMG (human menopausal gonadotropin, Menopur, Repronex) is a purified urinary gonadotropin preparation containing approximately equal proportions of FSH and LH activity (75 IU each).

  • Concentration: 75 IU/mL (75 IU vial + 1 mL bacteriostatic water); entire reconstituted vial = 1 injection.
  • Always combine with HCG for male spermatogenesis — FSH (HMG) + LH mimic (HCG) = complete induction.
  • Liu et al. 2009: median 7 months to sperm appearance with HCG+HMG in azoospermic hypogonadotropic men.
  • Inject 3x weekly SC; alternate sites for 3–6 month protocols.
  • Monitor semen analysis every 6–8 weeks and FSH/testosterone monthly.

Dosing table

For educational reference only. Your prescribing provider may adjust doses based on your clinical profile and response.

WeekDose (µg)UnitsFrequencyNotes
1-24——3x weekly (Mon/Wed/Fri) SC75 IU — 1 mL at 75 IU/mL; standard dose; combined with HCG 1500–2000 IU 2x/week for complete spermatogenesis induction
alt——3x weekly SC150 IU (2 vials reconstituted in 1 mL); higher dose for severe oligospermia under fertility specialist guidance

Reconstitution steps

  1. Draw 1 mL bacteriostatic water; inject slowly down the vial wall.
  2. Swirl gently until dissolved; do not shake.
  3. Final concentration: 75 IU/mL. At 75 IU/mL: 75 IU = 1 mL (entire reconstituted vial).
  4. Label with date; refrigerate at 2–8 °C. Use within 28 days.

Supplies needed

12wk-week plan

  • 36 vials
  • 36 syringes
  • 36 mL bac water
  • 36 alcohol swabs
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Protocol overview & cycle notes

Induce or restore spermatogenesis in hypogonadotropic hypogonadism by providing exogenous FSH (from HMG) to Sertoli cells alongside HCG-mediated LH stimulation of Leydig cell testosterone, enabling complete sperm maturation.

Cycle length: 24 weeks on.

Off-cycle: HMG fertility protocols typically continue 3–6 months until adequate semen parameters are achieved; duration determined by fertility specialist.

Storage & handling

Lyophilized: store below 25 °C or refrigerate. Reconstituted at 75 IU/mL: refrigerate 2–8 °C; use within 28 days.

Injection & tracking tips

  • Inject subcutaneously (abdomen, thigh, or upper arm); HMG is always administered SC — never IV.
  • HMG must always be combined with HCG for male spermatogenesis induction — FSH (from HMG) supports Sertoli cell spermatogenesis; LH (from HCG) supports Leydig cell testosterone production.
  • Alternate injection sites to prevent lipohypertrophy during extended 3–6 month fertility protocols.

Tracking

Logging helps you and your provider spot patterns and adjust dose or timing.

  • Semen analysis (sperm count, motility, morphology) at baseline and every 6–8 weeks.
  • Monitor serum FSH, LH, and testosterone monthly to guide dose adjustment.
  • Track estradiol every 6–8 weeks — FSH can increase aromatase in Sertoli cells, elevating estrogen.
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How this works & references

HMG (human menopausal gonadotropin, Menopur, Repronex) is a purified urinary gonadotropin preparation containing approximately equal proportions of FSH and LH activity (75 IU each). In men with hypogonadotropic hypogonadism (Kallmann syndrome, pituitary disease), endogenous LH and FSH are deficient — HCG alone can restore testosterone and partial spermatogenesis, but complete spermatogenesis requires FSH signaling to Sertoli cells via FSHR. The combination HCG (LH mimic) + HMG (FSH source) is the standard-of-care for fertility in hypogonadotropic males. Liu et al. (2009, Hum Reprod) demonstrated median time to sperm appearance was 7 months with HCG+HMG in azoospermic hypogonadotropic men.

Sources

  • Source: Liu PY et al. — Induction of spermatogenesis in HHG: HCG+HMG versus HCG alone. Hum Reprod. 2009;24(11):2910-21
  • Source: Bouloux PM et al. — HMG plus pulsatile GnRH for male fertility in Kallmann syndrome. J Clin Endocrinol Metab. 2003

Frequently asked questions

Why must HMG be combined with HCG for male fertility?
Spermatogenesis requires two separate gonadotropin signals: LH (or LH mimic from HCG) to stimulate Leydig cells to produce intratesticular testosterone; FSH to stimulate Sertoli cells to support sperm maturation (spermatid development and blood-testis barrier maintenance). HCG provides only LH-like activity; HMG provides FSH (and some additional LH). Without FSH, spermatogenesis is incomplete regardless of intratesticular testosterone levels.
How long does HMG + HCG therapy take to produce sperm?
Liu et al. (2009) reported median 7 months (range 3–24 months) to first sperm appearance in the ejaculate of azoospermic hypogonadotropic men. Complete spermatogenesis (from spermatogonium to mature sperm) takes approximately 74 days. Initial response is visible by 3 months; target sperm parameters typically require 6–18 months of continuous therapy.
Can HMG alone induce spermatogenesis without HCG?
No — HMG contains approximately equal FSH and LH activity per vial, but the LH content is insufficient to maintain the very high intratesticular testosterone levels required for spermatogenesis. HCG (longer half-life, higher affinity LH receptor binding) is required to maintain adequate Leydig cell stimulation. HMG alone may produce partial effects but combining with HCG produces superior and faster results.
Is HMG FDA-approved?
Yes — Menopur (menotropins, HMG) is FDA-approved for female ovulation induction and ART (assisted reproductive technology). In men, HMG is used off-label for hypogonadotropic hypogonadism and spermatogenesis induction. Repronex is an alternative FDA-approved HMG preparation.
Does prior testosterone/steroid use affect HMG therapy outcomes?
Yes — exogenous testosterone suppresses the HPG axis, atrophying Sertoli cells. Prolonged TRT significantly reduces Sertoli cell number and function. Liu et al. showed men with prior exogenous androgen use had significantly delayed and reduced response to HCG+HMG therapy versus treatment-naive hypogonadotropic men. A minimum 3–6 months off exogenous androgens before starting HCG+HMG is recommended.

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This content is for informational purposes only and does not constitute medical advice. Consult a licensed healthcare provider before starting any peptide therapy. Dosing and protocols may vary by formulation and prescriber.

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