Meta Information
ID:hcg
Name:
Schema Version:2.4_uniform_evidence_2026_06_18
Created
2026-05-21T22:30:00Z
Model
phase-a-upgrade-claude-sonnet-4.6
Interactions
Target id:
/condition/hormone-sensitive-cancer
Target name:
Hormone-Sensitive Cancers (Prostate, Breast)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
hCG stimulates testosterone and estrogen production, which can promote the growth of hormone-dependent tumors like prostate or breast cancer.
Actionable advice:
This should be strictly avoided with a current or past diagnosis of a hormone-sensitive cancer.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Exact phrase from label:
Tumors of the hypothalamus or pituitary gland and ovary, breast, or uterus
Label source:
FDA label: Chorionic gonadotropin (Pregnyl)
Action type:
avoid
Target id:
/condition/pregnancy
Target name:
Pregnancy
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Exogenous hCG is classified as Pregnancy Category X; it offers no benefit during an established pregnancy and may cause fetal harm.
Actionable advice:
This should not be used during pregnancy.
Validation status:
anecdotal
Evidence tier:
tier_d
Evidence basis:
anecdotal_summary
Evidence anchors:
Source url:
Exact phrase from label:
If you think you have become pregnant, contact your care team at once.
Label source:
Anecdotal: Cleveland Clinic
Action type:
avoid
Target id:
/intervention/testosterone
Target name:
Testosterone Replacement Therapy (TRT)
Severity:
major
Interaction type:
synergistic
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
hCG mimics Luteinizing Hormone (LH) to directly stimulate the testes, preventing the testicular atrophy and loss of fertility commonly caused by exogenous testosterone.
Actionable advice:
This should be used as prescribed alongside TRT to maintain testicular function and fertility.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
5.9 Potential for Adverse Effects on Spermatogenesis At large doses of exogenous androgens, including testosterone topical solution, spermatogenesis may be suppressed through feedback inhibition of pituitary follicle-stimulating hormone (FSH) which could possibly lead to adverse effects on semen parameters including sperm count.
Label source:
Action type:
informational_none
Target id:
/biomarker/lh
Target name:
Luteinizing Hormone (LH) Blood Test
Severity:
major
Interaction type:
assay_interference
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
hCG is structurally similar to LH and will cross-react with most laboratory immunoassays, causing a falsely high or uninterpretable LH level.
Actionable advice:
The lab and a doctor should be informed about hCG use when getting an LH test, as the result will not reflect natural pituitary output.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Exact phrase from label:
the mid-cycle LH surge triggers ovulation. hCG can substitute for LH
Label source:
FDA label: Chorionic gonadotropin (Pregnyl)
Action type:
monitor
Target id:
/procedure/urine-pregnancy-test
Target name:
Urine Pregnancy Test
Severity:
major
Interaction type:
assay_interference
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Urine pregnancy tests work by detecting hCG. Exogenous administration of hCG will result in a false positive test.
Actionable advice:
Urine pregnancy tests should not be relied upon while using hCG; a blood test should be used for confirmation if pregnancy is suspected.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Exact phrase from label:
Human chorionic gonadotropins can crossreact in the radioimmunoassay of gonadotropins
Label source:
FDA label: Chorionic gonadotropin (Pregnyl)
Action type:
informational_none
Target id:
/biomarker/estradiol
Target name:
Estradiol (E2)
Severity:
major
Interaction type:
requirement
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
The testosterone produced via hCG stimulation can be converted to estradiol by the aromatase enzyme; levels must be monitored to prevent side effects from high estrogen.
Actionable advice:
Regularly monitor estradiol levels to manage potential estrogenic side effects like water retention or gynecomastia.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Exact phrase from label:
Safe and effective induction of ovulation with use of PREGNYL requires monitoring of ovarian
Label source:
FDA label: Chorionic gonadotropin (Pregnyl)
Action type:
monitor
Target id:
/biomarker/total-testosterone
Target name:
Total Testosterone
Severity:
major
Interaction type:
requirement
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
hCG directly stimulates testosterone production, and levels must be monitored to ensure the dose is therapeutic and not excessive.
Actionable advice:
Regularly monitor total and free testosterone levels to guide appropriate dosing.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
hCG can substitute for LH
Label source:
FDA label: Chorionic gonadotropin (Pregnyl)
Action type:
monitor
Target id:
/class/gnrh-analogs
Target name:
GnRH Analogs (e.g., Leuprolide)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
GnRH analogs suppress natural gonadotropin production, while hCG acts as a gonadotropin substitute; their concurrent use is pharmacologically contradictory.
Actionable advice:
These should not be used together unless specifically directed by an endocrinologist for a specialized protocol (e.g., IVF).
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
In the absence of an endogenous LH surge, hCG is given when monitoring of the patient
Label source:
FDA label: Chorionic gonadotropin (Pregnyl)
Action type:
avoid
Target id:
/condition/heart-failure
Target name:
Heart Failure
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
hCG can cause sodium and fluid retention, potentially worsening edema and exacerbating heart failure.
Actionable advice:
This is best used with extreme caution and under close medical supervision in those with heart failure.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Exact phrase from label:
Use hCG with caution in patients with cardiac or renal disease, hypertension, epilepsy, migraine, or
Label source:
FDA label: Chorionic gonadotropin (Pregnyl)
Action type:
informational_none
Target id:
/condition/renal-impairment
Target name:
Renal Impairment
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
hCG can cause fluid retention, which may strain compromised kidneys and worsen renal impairment.
Actionable advice:
This is best used with caution, and it is a good idea to monitor for fluid retention in those with kidney disease.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Exact phrase from label:
Use hCG with caution in patients with cardiac or renal disease, hypertension, epilepsy, migraine, or
Label source:
FDA label: Chorionic gonadotropin (Pregnyl)
Action type:
monitor
Target id:
/class/anticoagulants-antiplatelets
Target name:
Anticoagulants and Antiplatelets
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
hCG may increase the risk of thromboembolic events (blood clots), potentially altering the required dosage or increasing the risk profile of anticoagulant medications.
Actionable advice:
This is best used with caution, and it is important to discuss it with a doctor, as closer monitoring of clotting factors may be required.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
of Events a b Major Bleeding 8 33 28 3.35 (ND) ND c ND 4.00 (ND) d b Minor Bleeding 39 103 133 3.21 (ND) ND c ND 2.55 (ND) e b Composite Endpoints 241 203 181 0.81 (0.69-0.95) 0.03 c 0.001 0.71 (0.60-0.83) b Reinfarction 117 90 69 0.56 (0.41-0.78) <0.001 c 0.03 0.74 (0.55-0.98) b Thromboembolic Stroke 32 17 17 0.52 (0.28-0.98) 0.03 c 0.03 0.52 (0.28-0.97) Death 92 96 95 0.82 a Major bleeding episodes were defined as nonfatal cerebral hemorrhage or bleeding necessitating surgical intervention or blood transfusion.
Label source:
Action type:
monitor
Target id:
/condition/seizure-disorder
Target name:
Seizure Disorder / Epilepsy
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Fluid and electrolyte changes induced by hCG may lower the seizure threshold in susceptible individuals.
Actionable advice:
This is best used with caution and under medical supervision in those with a history of seizures.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Exact phrase from label:
Use hCG with caution in patients with cardiac or renal disease, hypertension, epilepsy, migraine, or
Label source:
FDA label: Chorionic gonadotropin (Pregnyl)
Action type:
informational_none
Target id:
/biomarker/complete-blood-count
Target name:
Complete Blood Count (CBC)
Severity:
moderate
Interaction type:
requirement
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
hCG increases androgens, which can stimulate red blood cell production. Monitoring hematocrit is necessary to screen for polycythemia (thickened blood).
Actionable advice:
CBC, specifically hematocrit and hemoglobin, should be monitored every 3-6 months.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Exact phrase from label:
testosterone increases hematocrit through stimulation of erythropoiesis
Label source:
Primary literature: https://journals.physiology.org/doi/abs/10.1152/ajpendo.00184.2014
Action type:
monitor
Target id:
/biomarker/prostate-specific-antigen
Target name:
Prostate Specific Antigen (PSA)
Severity:
moderate
Interaction type:
requirement
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
The increase in testosterone from hCG can stimulate prostate tissue. Regular PSA monitoring is a standard precaution for men on any androgen-boosting therapy.
Actionable advice:
PSA levels are best monitored at baseline and periodically as recommended by a physician.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Induction of androgen secretion by hCG may cause fluid retention. Use hCG with caution in patients with cardiac or renal disease, hypertension, epilepsy, migraine, or asthma
Label source:
FDA label: Chorionic gonadotropin (Pregnyl)
Action type:
monitor
Target id:
/intervention/enclomiphene
Target name:
Enclomiphene / Clomiphene
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Enclomiphene stimulates the pituitary to produce LH, while hCG acts as an LH analog on the testes. Using them together can create a powerful, combined stimulus for testosterone production.
Actionable advice:
These are best combined only under expert medical supervision to avoid excessive hormone production and side effects.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
selective estrogen receptor modulators stimulate endogenous LH and FSH
Label source:
Primary literature: https://pubmed.ncbi.nlm.nih.gov/26049866/
Action type:
avoid
Target id:
/condition/migraines
Target name:
Migraines
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
hCG-induced changes in testosterone and estrogen levels can trigger or worsen migraine headaches in susceptible individuals.
Actionable advice:
It is worth watching out for increased migraine frequency or severity when starting hCG.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Exact phrase from label:
Use hCG with caution in patients with cardiac or renal disease, hypertension, epilepsy, migraine, or
Label source:
FDA label: Chorionic gonadotropin (Pregnyl)
Action type:
monitor
Target id:
/condition/asthma-copd
Target name:
Asthma
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Fluid retention caused by hCG could theoretically exacerbate asthma symptoms, although this is a rare concern.
Actionable advice:
This is best used with caution, and it is worth monitoring respiratory symptoms in those with asthma.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Since androgens may cause fluid retention, HCG should be used with caution in patients with cardiac or renal disease, epilepsy, migraine or asthma.
Label source:
Action type:
monitor