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What is HCG (Pregnyl)?
Human chorionic gonadotropin (HCG) is a hormone that supports the normal development of an egg in a woman’s ovary, and stimulates the release of the egg during ovulation.
HCG is used to cause ovulation and to treat infertility in women, and to increase sperm count in men. HCG is also used in young boys when their testicles have not dropped down into the scrotum normally. This can be caused by a pituitary gland disorder.
HCG may also be used for other purposes not listed in this medication guide.
Before using Pregnyl:
Some medical conditions may interact with Pregnyl. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:
if you are pregnant, planning to become pregnant or are breast-feeding
if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
if you have allergies to medicines, foods, or other substances
if you have asthma, uterine fibroids, heart or kidney problems, migraine headaches, polycystic ovarian syndrome, or epilepsy
Some MEDICINES MAY INTERACT with Pregnyl. However, no specific interactions with Pregnyl are known at this time.
Ask your health care provider if Pregnyl may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.
Pregnyl by Organon. 1,500 to 20,000 IU (International Units) per 10 cc vials. HCG is not a steroid but it is widely used in athletics today. HCG Prengyl is a natural protein hormone secreted by the human placenta and purified form the urine of pregnant women. This hormone is not a natural male hormone but mimics the natural hormone LH (Luetinising Hormone) almost identically. This LH stimulates the production of testosterone by the testis in males. Thus HCG sends the same message and results in increased testosterone production by the testis due to its effect on the leydig cells of the testis.
In the female
• Since infertile women undergoing assisted reproduction, and particularly IVF, often have tubal abnormalities the incidence of ectopic pregnancies might be increased. Early ultrasound confirmation that a pregnancy is intrauterine is therefore important.
• Prior to treating patients for inadequate endogenous stimulation of the gonads, an examination should be performed to exclude anatomical abnormalities of the genital organs or nongonadal endocrinopathies (e.g. thyroid or adrenal disorders, diabetes). Primary ovarian failure should be excluded by the determination of gonadotrophin levels.
• In the pregnancies occurring after induction of ovulation with gonadotrophic preparations, there is an increased risk of abortion and multiplets. Multiple pregnancy, especially high order, carries an increased risk in adverse maternal and perinatal outcomes. The parents should be advised of the potential risks of multiple births before starting treatment.
• The incidence of congenital malformations after Assisted Reproductive Technologies (ART) may be higher than after spontaneous conceptions. This is thought to be due to differences in parental characteristics (e.g. maternal age, sperm characteristics) and an increased incidence of multiple gestations.
• Women with generally recognised risk factors for thrombosis, such as a personal or family history, severe obesity (Body Mass Index > 30 kg/m2) or thrombophilia, may have an increased risk of venous or arterial thromboembolic events, during or following treatment with gonadotrophins. In these women the benefits of IVF treatment need to be weighed against the risks. It should be noted, however, that pregnancy itself also carries an increased risk of thrombosis.
• There have been reports of ovarian and other reproductive system neoplasms, both benign and malignant, in women who have undergone multiple drug regimens for infertility treatment. It is not yet established whether or not treatment with gonadotrophins increases the baseline risk of these tumours in infertile women.
During treatment of female patients, determinations of oestrogen levels and assessment of ovarian size and if possible, ultrasonography should be performed prior to treatment and at regular intervals during treatment. High dosages may cause oestrogen levels to rise excessively rapidly, e.g. more than doubling on 2 or 3 consecutive days, and possibly reaching excessively high pre-ovulatory values.
The diagnosis of unwanted ovarian hyperstimulation may be confirmed by ultrasound examination.
If unwanted hyperstimulation occurs (i.e. not as part of a treatment preparing for IVF/ET or GIFT or other assisted reproduction techniques), the administration of FSH or HMG should be discontinued immediately. HCG must not be given, because the administration of an hLH – active gonadotrophin at this stage may induce, in addition to multiple ovulations, the ovarian hyperstimulation syndrome. This warning is particularly important with respect to patients with polycystic ovarian disease.
Clinical symptoms of mild ovarian hyperstimulation syndrome include gastro-intestinal problems (pain, nausea, diarrhoea, abdominal discomfort and bloating), painful breasts, and mild to moderate enlargement of ovaries and ovarian cysts. Transient liver function test abnormalities suggestive of hepatic dysfunction, which may be accompanied by morphologic changes on liver biopsy, have been reported in association with ovarian hyperstimulation syndrome.
The severe form of ovarian hyperstimulation syndrome may be life-threatening and is characterised by large ovarian cysts (prone to rupture), acute abdominal pain, ascites, weight gain, very often hydrothrax and occasionally thrombo-embolic phenomena.
Pregnyl should not be used for body weight reduction. HCG has no effect on fat metabolism, fat distribution or appetite.