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Why Do I Need to Take HCG During Fertility Treatment?

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Updated June 09, 2014

Hormone injection for IVF
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Question: Why Do I Need to Take HCG During Fertility Treatment?
Answer: Human Chorionic Gonadotropin (HCG) is a hormone secreted early in pregnancy by specialized cells called trophoblasts and later by the placenta. It helps maintain high levels of progesterone which is critical for the success of the pregnancy. hCG is also the hormone detected by urine and blood pregnancy tests.

HCG in Fertility Treatments

Because hCG is similar in structure to LH, an injection of hCG when there is a mature egg follicle in the ovary can cause the egg to mature and be released. The medication can be used alone, in an ovulation induction cycle as with intrauterine insemination or during in vitro fertilization. hCG will cause ovulation approximately 36 hours after you take it, allowing your doctor to better time intrauterine insemination or the egg retrieval.

Many brands and forms of hCG are available. Your doctor will prescribe the one most appropriate for you. Injections can be given either subcutaneously or intramuscularly, depending on the brand.

Preparing/Mixing hCG

One form of hCG, Ovidrel, comes in a 250mcg prefilled syringe. Once you open the box, the medicine is already prepared and loaded in the syringe with the needle attached. Simply open the packaging, remove the air bubble by holding the syringe with the needle facing up and slightly depress the plunger until all the air is removed, and inject the medication subcutaneously.

hCG (Human Chorionic Gonadotropin, Pregnyl or Novarel) also comes in a box with a 10,000 unit vial of powder and a vial of diluent (liqiuid) which is used to mix the powder. Your doctor will tell you how many units of the medicine to take and how they prefer you to mix it. For example, if you are taking 10,000 units, you will remove 2mLs of diluent and inject it into the powder. Allow the powder to dissolve and then pull the entire 2mLs back into the syringe. Inject the medication intramuscularly or subcutaneously, according to your doctor’s instructions.

When Do I Take HCG During my Cycle?

This medication is taken once there is a mature egg follicle in the ovary. Your doctor will most likely give you a specific time or time frame to take the medication. It is important to tell your doctor if you do not take the medication on time in case any adjustments need to be made. If you will be having intercourse or intrauterine insemination, ovulation will occur approximately 36 hours later, so the day of the injection and two days following it are your critical days. If you will be having egg retrieval as in an IVF cycle, it will occur close to that 36-hour mark so as to optimize the maturation but avoid ovulation.

Taking a Pregnancy Test

It is really important to remember that hCG is the hormone detected in urine pregnancy tests. When you take hCG as a medication, it may persist in your body (and urine) for up to 2 weeks. Therefore, if you take a pregnancy test during that time, it will turn positive as a result of the medication, not a pregnancy. Make sure to wait at least a full two weeks from the date of administration to ensure that a positive pregnancy test is due to a pregnancy and not residual medication in your system.
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