Indications
Human Chorionic Gonadotrophin (hCG) is a hormone injection used in fertility treatment. In women it is used to trigger the final ripening and release of eggs (ovulation) after stimulation of the ovaries, in ovulation induction and assisted reproduction such as IVF, and sometimes to support the early luteal phase. In men it is used for low testosterone and poor sperm production caused by a pituitary problem (hypogonadotropic hypogonadism). In boys it may be used for some cases of undescended testes. It is not for weight loss and has no proven benefit for that.
How It Works
hCG acts like luteinising hormone (LH), the natural signal from the pituitary gland. In women it causes a mature follicle to release its egg about 36 hours later and supports the corpus luteum, which makes progesterone. In men it stimulates the testes to make testosterone, which supports sperm production.
Dosage and Administration
Given as an injection into the muscle or under the skin, as prescribed by a fertility specialist or other doctor. The dose and the exact timing (often in relation to ultrasound scans and the planned egg collection or intercourse) are decided individually, so follow the timing instructions exactly. If you are taught to inject yourself, use the technique shown by the nurse and dispose of needles safely. Powder vials are mixed with the supplied solvent just before use.
Interactions
No important drug interactions are known. hCG can cause a positive pregnancy test for up to about 10 days after an injection, so pregnancy tests should be timed as your doctor advises. It is often used together with other fertility hormones under specialist supervision.
Contraindications
- Allergy to hCG or any ingredient.
- Known or suspected hormone-dependent tumours, such as tumours of the ovary, breast, uterus, testis, prostate, pituitary or hypothalamus.
- Enlarged ovaries or ovarian cysts not caused by polycystic ovary syndrome, and unexplained vaginal bleeding.
- Early menopause or conditions where pregnancy is not possible (such as absent uterus or blocked tubes, unless IVF is planned).
- Active blood clots, and precocious puberty in boys.
Side Effects
Common effects include pain, redness or bruising at the injection site, headache, tiredness, mood changes and mild stomach discomfort. In women, ovarian hyperstimulation syndrome (OHSS) may occur, and multiple pregnancy (twins or more) is more likely. In men, breast enlargement, fluid retention and acne can occur.
Get urgent medical help if you have severe stomach pain or swelling, nausea and vomiting, rapid weight gain, shortness of breath or passing very little urine (possible severe OHSS); pain, swelling or warmth in a leg, chest pain or sudden breathlessness (possible blood clot); or signs of a severe allergic reaction.
Pregnancy and Lactation
hCG is used to help achieve pregnancy; it is not used once a pregnancy is established unless directed by a specialist. It is not used during breastfeeding.
Precautions and Warnings
Treatment needs close monitoring with ultrasound and sometimes blood tests. Tell your doctor about any thyroid, adrenal or pituitary disorders, heart or kidney disease, epilepsy, migraine or asthma, or a personal or family history of blood clots. In boys, treatment can cause early puberty signs and is monitored carefully. Do not use hCG for weight loss.
Overdose
Too much hCG in women increases the risk of ovarian hyperstimulation. Seek medical help if you think you have injected too much or notice OHSS symptoms.
Therapeutic Class
Gonadotrophin, fertility hormone (LH-like activity).
Storage
Store as directed on the pack; many products are kept in a refrigerator at 2 to 8°C and must not be frozen. Protect from light. Use the mixed solution straight away unless the leaflet says otherwise. Keep out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.