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Chorionic Gonadotropin Injectable Solution

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Chorionic Gonadotropin Injectable Solution, Recombinant Human Chorionic Gonadotropin, Recombinant HCG, Synthetic HCG, Choriogonadotropin Alfa, Ovidrel, Pregnyl, Novarel

  • See Also
  1. Female Infertility
  2. Human Chorionic Gonadotropin
  3. Recombinant Gonadotropin
  • Indications
  • FDA Approved
  1. Ovulation Induction (Female Infertility due to Anovulation)
    1. Chorionic Gonadotropin (Recombinant HCG, Pregnyl, Novarel)
    2. Choriogonadotropin Alfa (Ovidrel)
  2. Prepubertal Cryptorchidism (age 4 to 9 years, may induce testicular descent)
    1. Chorionic Gonadotropin (HCG, Pregnyl, Novarel)
  3. Hypogonadotropic Hypogonadism in males (pituitary deficiency related)
    1. Chorionic Gonadotropin (HCG, Pregnyl, Novarel)
  • Contraindications
  1. Precocious Puberty
  2. Prostate Cancer (or other androgen dependent cancers)
  3. Primary ovarian failure
  4. Uncontrolled Thyroid or adrenal dysfunction
  5. Pituitary Lesions
  • Mechanism
  1. Human Chorionic Gonadotropin (HCG)
    1. Prevents corpus luteum from involuting during pregnancy
      1. Allows for continued increase of Estrogen and Progesterone
    2. Stimulates Testosterone production in the male fetus Testes
  2. HCG is a GlycoproteinHormone with subunits a and b
    1. Beta subunit (bHCG) is unique to HCG
    2. HCG shares the same alpha subunit with other Hormones
      1. Luteinizing Hormone (LH)
      2. Thyroid Stimulating Hormone (TSH)
  • Medications
  1. Chorionic Gonadotropin (HCG, Pregnyl, Novarel)
    1. Purified HCG extract from the urine of pregnant women
    2. Available in vials of 10,000 USP units of HCG that require reconstitution
    3. Administered IM
  2. Choriogonadotropin Alfa (Recombinant HCG, Ovidrel)
    1. Recombinant HCG product
    2. Available in a preFilled Syringe containing 250 mcg
    3. Administered subcutaneously
  • Dosing
  1. See other references for specific Infertility regimens
  2. Use is typically limited to Infertility specialists
  3. Typically dosed after an initial 9-12 day course of Recombinant Follicle Stimulating Hormone
  • Adverse Effects
  1. Ovarian Hyperstimulation
  2. Fluid third spacing (Ascites, Pleural Effusion, edema)
  3. Ruptured Ovarian Cyst
  4. Ovarian Torsion
  5. Multiple Gestation
  6. Arterial Thromboembolism
  7. Anaphylaxis (urine-derived HCG)
  8. Irritability
  9. Headache
  10. Gynecomastia
  • Safety
  1. Unknown safety in Lactation
  2. Contraindicated in pregnancy
    1. Associated with congenital abnormalities when used AFTER pregnancy is established
    2. No known increased risk of congenital abnormalities when used to induce Ovulation for Infertility
  • Resources
  1. Chorionic Gonadotropin (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=f93b2baa-03ac-4650-b35a-20b818d712d6
  2. Choriogonadotropin Alfa - Ovidrel (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=a683e58a-63ea-44b8-a326-1a99a537bcf2