Human Chorionic Gonadotropin hCG

Classification

Chorionic gonadotropin

Brand Names

Profasi® (mfg. Serono), Pregnyl® (mfg. Organon), Novarel® (mfg. Ferring), A.P.L.® (mfg. Wyeth-Ayerst)

Form

Intramuscular injection

Indications

Demonstrated ovulatory dysfunction with:

  • Pre-treatment by human menotropins or follitropins
  • No evidence of primary ovarian failure
  • No prior allergic reaction to hCG

Used for

In women, inducing ovulation by stimulating the release of the egg from the follicle. In men, used to treat hypogonadism.

How does it work?

In women, behaves like luteinizing hormone (LH) to assist the corpus luteum in releasing progesterone, which is crucial to preparation of uterine lining for implantation. In men, stimulates Leydig (interstitial) cells of the testes to produce androgens (testosterone).

Suggested Evaluations

Pre-RX

  • ovarian enlargement or cyst formation
  • uterine fibroid tumors
  • undiagnosed unusual vaginal bleeding
  • estrogen levels
  • primary pituitary or ovarian failure or enlargement
  • evidence of prostate cancer in men

During RX

  • mid-cycle urine LH test (OPK)
  • estrogen levels
  • mid-cycle ultrasound to detect follicle development

Usual Dosage

During a fertility treatment cycle, 5,000 to 10,000 USP units one day after last dose of menotropins or follitropins. For male treatment, 1,000 to 4,000 units two to three times weekly for several weeks.

Instructions

Must be kept refrigerated. Maintain BBT chart or other recommended cycle charting methods throughout treatment cycle. Ovulation usually occurs approx. 36 hours after injection. Women with luteal phase defect may receive additional injections.

Common side effects

  • Injection site pain
  • Lower abdomen tenderness
  • Fluid retention
  • Headache
  • Emotional irritability
  • Breast discomfort
  • Fatigue
  • Multiple births

Side effects to report to your doctor

Severe pain or swelling in lower abdomen

Precautions

  • May result in ovarian hyperstimulation.
  • May result in rupture of existing ovarian cysts.
  • May result in multiple births.
  • May result in arterial thromboembolism.
  • Can cause fluid retention, and thus should be used with caution in patients with cardiac or renal disease, epilepsy, migraine, or asthma.

Drug interactions or incompatibility

No known drug interactions.