hCG
Human chorionic gonadotropin (hCG) is a hormone that's naturally made in the body during pregnancy. It's also very similar to luteinizing hormone (LH), a hormone involved in reproduction in males and females. As a medication, HCG (Pregnyl, Novarel) is used for fertility treatments in females. It's also used in certain cases to raise testosterone levels in males and to help the testes descend in males who haven't yet reached puberty (cryptorchidism). HCG is injected into the muscles (or as directed by your provider), typically a few times a week. Some common side effects of HCG can include headache, irritability, and feeling restless.
What is HCG?
What is HCG used for?
- Female infertility
- Low testosterone levels in males (hypogonadism) caused by pituitary gland condition
- Prepubertal cryptorchidism (a condition where the testes haven't descended)
How HCG works
HCG is a hormone naturally produced by body during pregnancy. It's also very similar to luteinizing hormone (LH), a hormone involved in reproduction in males and females.
In female infertility, HCG is used (along with other medications) to promote ovulation. This can help raise the chance of getting pregnant.
In males, HCG causes the production of hormones called androgens (e.g., testosterone). Androgens are responsible for the testes moving into the scrotum, as well as sperm production in males.
Drug facts
Side effects of HCG
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Headache
- Irritability
- Restlessness
- Depression
- Fatigue or tiredness
- Edema (swelling)
- Early puberty
- Growth of breasts in males
- Pain at injection site
Less Common Side Effects
- Skin redness
- Itchy skin
- Rash
HCG serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Serious allergic reaction: trouble breathing, swelling of lips or tongue, rash
- Ovarian hyperstimulation syndrome (OHSS): severe pelvic or stomach pain and swelling along with nausea, vomiting, sudden weight gain, diarrhea, or trouble breathing
- Swollen or ruptured ovarian cysts: dull, sharp, or sudden pain, feeling of heaviness or bloating in your lower belly
- Blood clots: shortness of breath, chest pain, swelling, warmth, or tenderness in the leg or arm, weakness on one side of the body, trouble walking or speaking, vision changes
The following HCG side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Blood clot—pain, swelling, or warmth in the leg, shortness of breath, chest pain
- Ovarian hyperstimulation syndrome—stomach or pelvic pain, bloating, nausea, vomiting, diarrhea, weight gain
- Unexpected hair growth on the face or body, deepening of the voice, acne, mood swings, unexpected breast tissue growth, early onset menstruation, enlarged testicles
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
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Pros and cons of HCG
Pros
Cons
- Need to mix before injection, which can be inconvenient
- Only available as an injection
- Can cause headaches and irritability as side effects
Pharmacist tips for HCG
- Injection instructions will vary from person to person. Make sure you understand how to mix and inject the medication properly before starting home injections. It's important to get the correct amount of medication. Ask your provider if you're not sure how to prepare and use HCG.
- HCG comes in a vial of dry powder that will need to be mixed with the included bacteriostatic water. Always inspect the vial before you prepare your injection. Make sure it's not cloudy, leaky, or containing any particles (solid chunks). If it has particles, is discolored, or foamy, don't use it and contact your provider or pharmacy about getting a replacement vial, since it might not be safe to use.
- Always wash your hands before handling HCG and injecting it. It's also important to clean the injection site with an alcohol swab and let it dry before injecting HCG. This will help prevent contamination, which can lead to infection.
- Use a new needle and syringe each time you give yourself HCG. Throw away your used needles and syringe in a sharps container (a closable container that's puncture-resistant) right after the injection. Don't throw it away in your household trash to lower the risk of needlestick injuries.
- Once you open and mix a vial, you can store the used vial in the refrigerator for up to 30 days for Novarel and up to 60 days for Pregnyl or HCG. You can draw and inject multiple doses from the same vial during this time.
- The medication contains a preservative called benzyl alcohol that prevents contamination (spreading germs) and bacterial growth. After 30 or 60 days of being in the refrigerator (depending on the brand), throw away any leftover medication.
- Store unopened vials at room temperature up to the expiration date on the packaging. Once opened and mixed, store vials in the refrigerator for up to 30 days (for Novarel) and up to 60 days (for Pregnyl or HCG).
Common questions about HCG
Your provider will determine your HCG dose based on your medical condition, age, and body weight. For example, if your child is receiving HCG for prepubertal cryptorchidism, their provider might instruct you to give them 4,000 units injected into a muscle three times a week for 3 weeks. If you're a female receiving HCG for infertility, your provider might instruct you to give yourself a dose of HCG (ranging from 5,000 to 10,000 units) into your muscle one day after your last dose of menotropins, another gonadotropin injectable medication used for female infertility.
You'll likely take your HCG dose one day after your last dose of menotropins, which works to prepare eggs for ovulation. Follow your provider's instructions on when to inject HCG because they'll likely give you a very specific date and time to do so.
HCG can help with infertility problems. This medication is FDA-approved to treat low testosterone levels in males. Having low testosterone levels can cause infertility because it leads to low sperm count. HCG is also FDA-approved to treat infertility in females by triggering ovulation (release of the egg). If you've problems with fertility, talk with your provider to see if HCG is an appropriate option for you.
If you're taking HCG for fertility, you need to wait until after HCG is cleared from your system (at least 2 weeks) before taking a pregnancy test. Otherwise, you'll likely get a false positive result (pregnancy test telling you you're pregnant even if you're not). This is because the pregnancy test tests for the hCG hormone, and you'll have higher hCG levels in the body after the HCG injection. It's best to follow your provider's instructions regarding when to test for pregnancy after a HCG injection.
HCG is FDA-approved for intramuscular (into the muscle, IM) injections. IM injections are often given in the outside of the upper arm or in the hip, buttocks, or thigh. Sometimes, your provider might instruct you to inject HCG differently. Ask your provider if you're not sure how to prepare and use HCG.
If you're a male with hypogonadism, your testosterone levels might return to normal after you take HCG for about 3 months. But you might need to take HCG for about 6 months to a year to see a more noticeably higher sperm count. It's important to be consistent with your injections and follow your treatment plan as recommended by your provider. If your sperm counts don't improve within 4 to 6 months of using HCG, your provider might recommend additional options.
No, HCG isn't approved by the FDA for weight loss, and there is currently no evidence that it helps you lose weight. Many products claim HCG can help you lose weight by changing your eating patterns and affecting your metabolism, but there is no evidence to support these claims. The FDA does not recommend using these products for weight loss. Talk with your provider about a safe and healthy weight loss plan.
Yes, HCG, as well as brands Novarel and Pregnyl, is obtained from the urine of pregnant females. If this concerns you, talk to your provider. There are recombinant hCG medications, such as Ovidrel, that are lab-made versions of hCG.
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Risks and warnings for HCG
HCG can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Severe allergic reactions, including anaphylaxis (closing of the throat)
Serious allergic reactions, including anaphylaxis, have been reported with the use of HCG. If you experience trouble breathing, swelling of your lips or tongue, or rash, get medical attention right away.
Ovarian hyperstimulation syndrome (OHSS)
In females, HCG can cause OHSS, a condition that happens when the ovaries grow too large after you've finished your injection. It can cause stomach pain, stomach bloating, and weight gain. More serious cases include symptoms like severe pain or stomach bloating, trouble breathing, and nausea, vomiting, or diarrhea, or a bursting cyst. Symptoms can occur within days after using HCG, but can also happen even 10 days after the injection. They usually goes away on its own within 2 weeks. People who develop OHSS and then successfully become pregnant tend to have more severe OHSS symptoms. If you feel extreme belly pain, nausea, vomiting, or feel faint after using HCG, tell your provider right away.
Blood clots
- Risk factors: Personal or family history of blood clots | Smoking | Ovarian hyperstimulation syndrome (OHSS) | Overweight
HCG can raise your risk of blood clots, which can lead to life-threatening problems. Smoking, OHSS, or a history of blood clots raise this risk even more. Blood clots can lead to a heart attack, a stroke, or a pulmonary embolism (life-threatening blood clot in the lungs). Be sure to discuss all your past and present medical conditions with your provider before starting HCG. Call 911 or get medical help right away if you have pain in your legs or arms, chest pain, sudden severe headaches, trouble breathing, or sudden changes in your speech or vision.
Getting pregnant with more than one baby
All gonadotropin fertility treatments, including HCG, make you much more likely to conceive and deliver more than one baby (e.g., twins, triplets). This is due to how the medication works to prepare the body to ovulate. Discuss this possibility with your partner before starting HCG.
Early puberty
- Risk factors: Children who haven't gone through puberty
HCG can cause puberty to happen too early in males who are treated for cryptorchidism. If signs of early puberty occur (e.g., changes in voice, hair growth under the arms or near the genitals), stop using HCG and let your child's provider know.
Risk of cancer with use for male infertility caused by hypogonadism
There are reports of tumors in the testes in otherwise healthy, young men using HCG for infertility. Contact your provider right away if you notice lumps or enlargements in either testicle, pain in your stomach, groin, or scrotum, or back pain.
Water retention
- Risk factors: Asthma | Kidney problems | Heart problems | Seizures | Migraines
HCG raises levels of hormones known as androgens, which can lead to water retention (when your body holds onto too much water). This can worsen certain conditions like asthma, kidney problems, heart problems, seizures, and migraines. Make sure to discuss your medical history with your provider before starting HCG.
HCG dosage
Vial| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 10ml of 10000 units | 1 vial | $284.88 | $284.88 |
Typical dosage for HCG
The dose of HCG is measured in USP units.
Female infertility Your provider will determine your dose based on age, body weight, and preference.
- The typical dose ranges from 5,000 USP units to 10,000 USP units injected into the muscles one day after the last dose of Menopur (menotropins).
Lower testosterone levels Your provider will determine your dose based on age, body weight, and preference. Examples of typical dosing include:
- A possible dose ranges from 500 USP units to 1,000 USP units injected into the muscles three times a week for 3 weeks. After that, your provider will continue at the same dose twice a week for 3 weeks.
- A possible dose is 4,000 USP units injected into the muscles three times a week for 6-9 months. After that, your child's provider will lower the dose to 2,000 USP units three times a week for 3 months.
Prepubertal cryptorchidism Your child's provider will determine the dose based on your child's age, body weight, and preference. Examples of typical dosing include:
- A possible dose is 4,000 USP units injected into the muscles three times a week for 3 weeks.
- A possible dose is 500 USP units injected into the muscles three times a week for 4-6 weeks. If needed, your child's provider might continue the treatment a month later by raising the dose to 1,000 USP units per injection.
How much does HCG cost?
HCG contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because HCG will not be safe for you to take.
- Early puberty
- Prostate cancer (or other androgen-dependent cancer)
- Currently pregnant
What are alternatives to HCG?
News about HCG
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