My husband has a low but healthy sperm count. What is involved with the hCG hormone treatment? How many shots does it take? How often? How long does it normally take to show effects?

-- Sherri

The hCG treatment is of benefit for low sperm counts (oligozoospermia) only if the cause for the low counts is abnormal hormonal stimulation of the testicle -- that is, low levels of FSH and LH. If the man's testosterone levels are normal, and the testicles are normal size and consistency, the medication will not make a difference.

When a man has not spontaneously entered puberty due to absent testosterone production, the hCG shots are given three times each week. After a few months, the testosterone level climbs to normal. At that point, injections switch from hCG to FSH, which directly supports sperm production.

This treatment is often very costly. Using existing sperm for IVF with sperm injection (ICSI) would more likely be successful and probably cost less in the long run.