HMG

A retrospective report described induction of spermatogenesis with hCG/hMG or GnRH in men with gonadotropin deficiency. When patients continued hCG alone, sperm counts declined gradually (one of 13 became azoospermic) and testicular volume reached 87% of the volume achieved with combined hCG/hMG; this does not establish a post-AAS recovery protocol. A larger, more recent (2026) cohort in the same disease population found spermatogenesis was induced more often with combined hCG-and-FSH therapy than with hCG alone, though the hCG-alone comparison group was very small.^[1][2]

• Small retrospective disease-specific series; mixed induction treatments and no randomized recovery comparison.
• The 2026 cohort's hCG-monotherapy comparison group was only 3 patients (1 of whom achieved spermatogenesis); this denominator is too small to support a reliable comparison despite the round percentage.
• Both sources describe men with hypogonadotropic hypogonadism (a disease population), not men recovering from anabolic-androgenic steroid use. Abstract-checked for the older report; the 2026 cohort was inspected in full text. No qualified clinical review.

A 2026 Dutch retrospective cohort of 35 men with hypogonadotropic hypogonadism and azoospermia found spermatogenesis induced in 74% overall; 25 of 32 (78%) receiving combined hCG-and-FSH-containing gonadotropin therapy achieved spermatogenesis, compared with 1 of 3 receiving hCG alone, a group too small for a reliable comparison. Most who produced sperm improved their semen category, and most who wanted children achieved pregnancy, mostly through spontaneous conception. This is a disease population (hypogonadotropic hypogonadism), not men recovering from anabolic-androgenic steroid exposure.^[2]

• Retrospective single-center cohort with non-standardized follow-up and semen-sampling timing; potential selection and recall bias.
• The hCG-monotherapy comparison group (n=3) is too small to support a reliable percentage comparison against the 32-patient combination-therapy group.
• Disease population (congenital/acquired hypogonadotropic hypogonadism); does not establish outcomes in men recovering from anabolic-androgenic steroid use. No qualified clinical review.