Adding hCG to TRT essentially “keeps the factory working”. It counteracts the most of the testicular shutdown that occurs on TRT, and at sufficient doses can even overcome the shutdown from TRT and exceed baseline intratesticular testosterone levels and sperm counts.

So, I’m going to try to simplify the hCG thing as much as possible and skip some of the details, but here is a basic summary; hCG itself was reclassified by the FDA. Under its new classification, compounding pharmacies and drug manufacturers must carry a specific (and extremely expensive and hard to obtain) license in order to manufacture it. Most compounding pharmacies cannot afford this license and/or don’t want to go through all the extra hoops to get it, so they stopped manufacturing it.

Some of the larger compounding pharmacies do have that license, and can continue business as normal (all of AlphaMD’s partner pharmacies have this license and can get hCG to all 50 states).

All of the large drug companies (Eli-Lilly, Pfizer, etc) obviously already also have this license, and you can always have a local pharmacy dispense brand name hCG from a local Walgreens, CVS, etc. all you need is a prescription. However, the cost of hCG in men’s health is already high considering it is classified as off-label use, so insurance does not cover it.

The only potential alternative is a SERM like clomiphene or enclomiphene, however, the TRT/SERM combo is still considered experimental, and you can search Reddit and read the horror stories of men who were placed on this regimen. There are absolutely zero published studies on concurrent TRT/SERM use, and anecdotal reports are not promising.

Hope that helps in your decision