Chorionic Gonadotropin Injectable Solution

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

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II. 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)

III. 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

IV. 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)

V. 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

VI. 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

VII. 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

VIII. 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

IX. 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

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Related Studies

Cost: Medications

ovidrel (on 1/25/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
OVIDREL 250 MCG/0.5 ML SYRG $391.45 per ml
pregnyl (on 5/18/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
PREGNYL 10,000 UNIT VIAL $102.95 each
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information. GoodRx is another tool for finding lower drug prices.

Related Topics in Pharmacology

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