Gonadotropin chorionic for injections (Gonadotrophin chorionic for injections). Instructions for use of chorionic gonadotropin - indications, dosage and side effects Human gonadotropin ten thousand units

Chorionic gonadotropin: instructions for use and reviews

Latin name: Gonadotrophin chorionic

ATX Code: G03GA01

Active substance: chorionic gonadotropin (Chorionic Gonadotropin)

Manufacturer: Moscow Endocrine Plant (Russia)

Description and photo update: 22.10.2018

Chorionic gonadotropin is a drug with gonadotropic, follicle-stimulating and luteinizing effects.

Release form and composition

The dosage form of Chorionic Gonadotropin is a lyophilizate for the preparation of a solution for intramuscular (i / m) administration: lyophilized almost white or white powder (in glass tube vials, in blister packs 5 vials complete with 5 1 ml solvent ampoules, in a carton pack 1 pack).

Composition of 1 vial:

active substance: chorionic gonadotropin - 500, 1000, 1500 or 5000 IU (international units);
auxiliary component: mannitol (mannitol) - 20 mg.

Solvent: 0.9% sodium chloride injection - 1 ml.

Pharmacological properties

Pharmacodynamics

Chorionic gonadotropin has a luteinizing, follicle-stimulating and gonadotropic effect, while luteinizing activity is higher than follicle-stimulating.

The active substance of the drug - human chorionic gonadotropin (hCG), is a gonadotropic hormone produced by the placenta during pregnancy (excreted by the kidneys unchanged). The method of obtaining a substance for the drug is extraction from urine with subsequent purification.

HCG is necessary for women and men for normal growth and maturation of gametes, as well as for the production of sex hormones.

The drug stimulates the development of the genital organs and secondary sexual characteristics. In addition, it promotes ovulation and stimulates the synthesis of estrogens (estradiol) and progesterone in women, and also stimulates spermatogenesis, the production of dihydrotestosterone and testosterone in men.

Pharmacokinetics

After the / m introduction is well absorbed. The half-life is 8 hours.

Achieving the maximum plasma concentration of hCG in the blood is observed after 4-12 hours. The half-life of chorionic gonadotropin is approximately 29-30 hours, with daily use, cumulation of the drug can be observed.

Chorionic gonadotropin is excreted by the kidneys. Approximately 10-20% of the administered dose is found unchanged in the urine, the main part is excreted as fragments of the β-chain.

Indications for use

Chorionic gonadotropin 1500, 1000 and 500 IU

maintenance of the corpus luteum phase;
amenorrhea, anovulatory ovarian dysfunction.

Men and boys:

delayed puberty associated with insufficiency of the gonadotropic function of the pituitary gland;
oligoastenospermia, insufficiency of spermatogenesis, azoospermia;
cryptorchidism, which is not associated with anatomical obstruction;
conducting a Leydig functional test to assess testicular function in hypogonadotropic hypogonadism before prescribing long-term stimulation therapy;
conducting a differential diagnostic test for cryptorchidism / anorchism in boys.

induction of ovulation in infertility, which is caused by anovulation or impaired maturation of follicles;
preparation of follicles for puncture in programs of controlled ovarian hyperstimulation (for additional reproduction techniques);
maintenance of the corpus luteum phase.

hypogonadotropic hypogonadism;
conducting a Leydig functional test to assess testicular function in hypogonadotropic hypogonadism before prescribing long-term stimulant therapy.

Contraindications

Absolute:

hormone-dependent malignant tumors genital and breast (diagnosed or suspected), including ovarian cancer, breast cancer, uterine cancer in women, and prostate cancer, carcinoma mammary gland in men;
organic lesions of the central nervous system (tumors of the hypothalamus, pituitary gland);
thrombophlebitis of deep veins;
hypothyroidism;
adrenal insufficiency;
hyperprolactinemia;
premature puberty in boys (for 500, 1000 and 1500 IU);
infertility that is not associated with hypogonadotropic hypogonadism in men;
children's age up to 3 years (for 500, 1000 and 1500 IU);
individual intolerance to the components of the drug.

Additional absolute contraindications for the use of the drug in women:

bleeding or bloody issues from the vagina of unknown origin;
improper formation of the genital organs, which is incompatible with pregnancy;
primary ovarian failure;
fibrous tumor of the uterus, which is incompatible with pregnancy;
a history of ovarian hyperstimulation syndrome (OHSS) (for 5000 IU);
infertility that is not associated with anovulation (for example, tubal or cervical origin, for 500, 1000 and 1500 IU);
polycystic ovary syndrome (PCOS) (for 5000 IU);
pregnancy and breastfeeding period.

Relative (diseases / conditions in the presence of which the appointment of Chorionic Gonadotropin requires caution):

thrombosis risk factors (aggravated personal/family history, severe obesity with body mass index > 30 kg/m 2 , thrombophilia, etc.);
prepubertal age in boys - for a dose of 500, 1000 and 15000 IU;
latent or overt heart failure, impaired renal function, arterial hypertension, epilepsy, migraine, including indications of these diseases / conditions in history - for men;
bronchial asthma.

Instructions for use Chorionic Gonadotropin: method and dosage

The drug is administered intramuscularly slowly, after the preliminary addition of the solvent to the lyophilisate.

The dosage regimen can be adjusted by the doctor individually.

Chorionic gonadotropin 1000, 500 or 1500 IU

anovulatory cycles: 2-3 times with an interval of 2-3 days for 3000 ME, from 10-12 days menstrual cycle or 6-7 injections - every other day, 1500 IU;

Men and boys:

hypogonadotropic hypogonadism: 2-3 times a week for 1000-2000 ME. In cases of infertility, a drug containing follitropin (follicle-stimulating hormone) may be additionally prescribed. The duration of the course, in which any improvement in spermatogenesis can be expected, is at least 3 months. During the period of use of the drug, testosterone replacement therapy should be suspended. After improvement in order to maintain the result of a sufficiently isolated use of Chorionic Gonadotropin;
delayed puberty due to insufficiency of the gonadotropic function of the pituitary gland: 2-3 times a week for 1500 ME course of at least 6 months;
cryptorchidism not due to anatomical obstruction: 2 times a week, 500-1000 IU for children 3-6 years old or 1500 IU for children over 6 years old; if necessary, repeat the therapy;
insufficiency of spermatogenesis, oligoasthenospermia, azoospermia: 500 IU daily in combination with menotropin (75 IU of follicle-stimulating and luteinizing hormone) or every 5 days, 2000 IU in combination with menotropin (150 IU of follicle-stimulating and luteinizing hormone) 3 times a week for a course of 3 month. In cases of insufficient effect or its absence, the drug is prescribed 2-3 times a week for 2000 IU in combination with menotropin (150 IU of follicle-stimulating and luteinizing hormone) 3 times a week for a course of 3-12 months. After improvement of spermatogenesis, maintenance doses of Chorionic Gonadotropin can be administered in some cases;
differential diagnosis of anorchism / cryptorchidism in boys: a single dose of 100 IU / kg, the serum concentration of testosterone in the blood is determined before the start of the test and 72-96 hours after the injection. With anorchism, the test will be negative, which is evidence of the absence of testicular tissue; with cryptorchidism, in cases where even only one testicle is present, positive (5-10-fold increase in testosterone concentration). If the test is weakly positive, a search for the gonad is required (laparoscopy or ultrasound abdominal cavity), since there is a high risk of malignancy.

Chorionic gonadotropin 5000 IU

induction of ovulation in infertility, which is caused by anovulation or impaired maturation of follicles, preparation of follicles for puncture in programs of controlled ovarian hyperstimulation: once 5000–10,000 IU to complete therapy with follicle-stimulating hormone preparations;
maintenance of the corpus luteum phase: 2-3 injections of 1500-5000 IU for 9 days after ovulation or embryo transfer (for example, 1 time in three days).

hypogonadotropic hypogonadism: 1500-6000 IU once a week. In cases of infertility, hCG can be administered with a preparation containing follitropin, 2-3 times a week. The duration of the course, in which any improvement in spermatogenesis can be expected, is at least 3 months. During this period, testosterone replacement therapy should be suspended. After improvement, in order to maintain the result, in some cases Chorionic Gonadotropin is used in isolation;
Leydig functional test: 5000 IU daily for 3 days (at the same time). After the last injection, the next day, blood is taken and testosterone levels are tested. The sample is evaluated as positive in cases where there is an increase of 30–50% or more from the initial values. It is preferable to combine this test with another spermogram on the same day.

Side effects

immune system: in rare cases - fever, generalized rash;
local reactions at the injection site and general disorders: pain, bruising, redness, itching, swelling; in some cases - allergic reactions (rash / pain at the injection site), increased fatigue.

Chorionic gonadotropin 500, 1000 and 1500 IU

nervous system: dizziness, headache;
metabolism and nutrition: edema.

Men and boys:

subcutaneous tissues and skin: acne;
endocrine system: premature puberty;
sexual organs and breast: gynecomastia, penis enlargement, prostatic hyperplasia, increased sensitivity of the nipples of the mammary glands in men, with cryptorchidism - an increase in the testicles in inguinal canal.

Chorionic gonadotropin 5000 IU

nervous system: headache;
respiratory system: hydrothorax in severe OHSS;
vessels: in rare cases, thromboembolic complications associated with combined therapy of anovulatory infertility (in combination with follicle-stimulating hormone), complicated by severe OHSS;
genitals and breast: breast tenderness, moderate to severe OHSS (ovarian diameter > 5 cm or large ovarian cysts > 12 cm in diameter, prone to rupture). Clinical manifestations of OHSS are bursting pains in the abdomen, hemoperitoneum, diarrhea, a feeling of heaviness in the lower abdomen, tachycardia, decreased hemostasis, blood pressure, increased activity of hepatic transaminases, acute renal failure, oliguria, respiratory failure, shortness of breath;
digestive system: ascites in severe OHSS, abdominal pain and symptoms of dyspepsia, including nausea and diarrhea associated with moderate OHSS;
psyche: anxiety, irritability, depression;
metabolism and nutrition: weight gain (which is a sign of severe OHSS), edema.

subcutaneous tissues and skin: acne;
genital organs and mammary gland: gynecomastia, penis enlargement, prostatic hyperplasia, hypersensitivity of the nipples of the mammary glands.

Prolonged therapy may cause increased side effects.

Overdose

The drug is characterized by very low toxicity.

Against the background of an overdose in women, OHSS may occur. Depending on the severity, several types of this complication are distinguished:

mild: the size of the ovaries usually does not exceed 8 cm; symptoms - abdominal discomfort, minor abdominal pain;
medium: the average size of the ovaries is 8–12 cm; symptoms - moderate / slight enlargement of ovarian cysts, breast tenderness, moderate abdominal pain, diarrhea, vomiting and / or nausea, ultrasound signs of ascites;
severe: the size of the ovaries usually exceeds 12 cm; symptoms - weight gain, clinical signs of ascites (sometimes - hydrothorax), in rare cases - thromboembolism; oliguria, hemoconcentration, hematocrit > 45%, hypoproteinemia, large ovarian cysts prone to rupture.

Basic principles of treatment of OHSS in case of overdose (depending on the severity):

light: bed rest monitoring the patient's condition, plentiful drink mineral water;
medium and heavy (only in stationary conditions): control of hematocrit, respiratory and of cardio-vascular system, kidneys, liver, water / electrolyte balance (diuresis, changes in abdominal circumference, weight dynamics); intravenously drip crystalloid solutions (in order to maintain / restore the volume of circulating blood); intravenous drip colloidal solutions of 1.5-3 liters per day (with persistent oliguria and maintaining hemoconcentration); hemodialysis (in cases of development of renal failure); antihistamine, antiprostaglandin and corticosteroid drugs (to reduce capillary permeability); low molecular weight heparins, including clexane, fraxiparin (for thromboembolism); 1-4 plasmapheresis sessions with an interval of 1-2 days (to improve the rheological properties of blood, reduce the size of the ovaries, normalize the acid-base state and gas composition of the blood); transvaginal puncture of the abdominal cavity and paracentesis (with ascites).

Overdose symptoms in men and boys:

gynecomastia;
degeneration of the gonads (in cases of unreasonably long therapy for cryptorchidism);
changes in behavior in boys, similar to those observed during the first phase of puberty;
a decrease in the number of spermatozoa in the ejaculate in men (in cases of drug abuse);
atrophy of the seminiferous tubules (associated with inhibition of the production of follicle-stimulating hormone due to stimulation of the production of estrogens and androgens).

special instructions

During therapy, the likelihood of arterial / venous thromboembolism increases, and therefore, patients at risk should evaluate the benefits of in vitro fertilization therapy before prescribing the drug. It should also be noted that pregnancy itself is accompanied by an increased risk of thrombosis.

The use of Chorionic Gonadotropin increases the risk of multiple pregnancy. During therapy and for 10 days after stopping treatment, the drug can affect the values of immunological tests, the concentration of hCG in plasma, urine and blood, which can cause a false positive pregnancy test result.

In male patients, chorionic gonadotropin can lead to an increase in androgen production, and therefore patients at risk need strict medical supervision.

Since hCG promotes precocious puberty or premature closure of the epiphyses, it is required regular control skeletal development.

At high content follicle-stimulating hormone treatment in men is not effective.

Long-term therapy may lead to the formation of antibodies to the drug.

Unreasonably long course in cryptorchidism, especially when indicated surgical intervention, can lead to degeneration of the gonads.

Influence on the ability to drive vehicles and complex mechanisms

It is recommended to refuse from driving vehicles during the treatment course.

Use during pregnancy and lactation

According to the instructions, chorionic gonadotropin is contraindicated for use during pregnancy and lactation.

Application in childhood

HCG therapy for children under 3 years of age is not prescribed.

drug interaction

When combined with drugs of human menopausal gonadotropin (MGCh) in cases of infertility treatment, it is possible to increase the symptoms of ovarian hyperstimulation, which occurred due to the use of MCG.

Combination with high doses glucocorticosteroids are not recommended.

No other interactions were noted.

Analogues

Analogues of chorionic gonadotropin are: Horal, Ecostimulin, Horagon, Pregnil.

Terms and conditions of storage

Store in a place protected from light at temperatures up to 20 °C. Keep away from children.

Shelf life (depending on the dose): 500, 1000 and 1500 IU - 4 years; 5000 IU - 3 years.

In the human body, the hCG hormone plays important role. It is responsible for the reproductive function of the female and male genital organs, and also supports the development of the fetus in the womb. The lack of this hormone affects the ability of women to conceive, so gynecologists in such cases prescribe an injection of hCG.

Preparations, which include human chorionic gonadotropin, are used to treat men and women. The active substance can be obtained in several ways. Most manufacturers extract it from the urine of pregnant women, but some synthesize a specific protein using recombinant DNA.

There are many drugs containing hCG or its synthetic analogues, for example, Humegon, Pregnil, Ovitrelle. Doctors sometimes prescribe additional drugs for the treatment of infertility: Diferelin, Luveris, Duphaston, etc.

Release form and composition of chorionic gonadotropin

Chorionic gonadotropin is available in the form of a special powder, from which a solution for intramuscular injection is made. The powder is obtained by lyophilization - vacuum drying of biological material. This allows you to significantly extend its shelf life. The drug is packaged in sealed glass ampoules or vials. They are placed in plastic or cardboard cells of 5 or 10 pieces. The package should also contain ampoules with a solvent - a solution of sodium chloride at a concentration of 0.9%. They need to dilute the powder until completely dissolved. In addition to the main component, the composition of the drug also includes mannitol, which prevents clumping of the dry matter and promotes its uniform dissolution. It is a neutral component.

More often in pharmacies you can find chorionic gonadotropin 1500 IU, but there are other dosage options:

1000;
3000;
5000;
10000.

The concentration of the drug is selected individually based on the diagnosis and prescription of the attending physician. The composition of the drug from different manufacturers may vary slightly, all this is indicated in the package leaflet, the price may also differ. Store the drug in a cool place without direct sunlight.

Gonadotropin shot

Intramuscular injections of the drug are prescribed for various deviations in work reproductive system. Throughout the entire period of therapy, the patient is under observation and passes control tests.

Purpose and indications for hCG injections

The drug is prescribed for the treatment of infertility in women and men, as well as to maintain the natural level of the hormone in the body during pregnancy. Depending on the purpose, the injection scheme varies, as well as the duration of the course.

There are a number of indications for which the administration of gonadotropin is prescribed:

Stimulation of ovulation. In the event that a woman has problems with the development of eggs, injections of the drug help this process to proceed more actively. True, the likelihood of an ectopic pregnancy increases.
Reducing the risk of cyst growth. The hormone prevents the follicle from shrinking and forming a benign tumor inside the ovaries. Normally, the follicle bursts, and the cyst does not develop.
Maintenance of the corpus luteum at the initial stage of pregnancy. Due to hormonal imbalance, it can flake off and provoke a miscarriage.
Conducting artificial insemination and preparing the reproductive system of a woman for the transfer of embryos into the uterine cavity. In the process of such ovulation, not one follicle is obtained, but several at once.
Exclusion of the risk of miscarriage at an early stage, if there was already a negative experience earlier.
Presence of hydatidiform mole during previous pregnancies.

Such injections help not only to conceive a child, but also to endure it. With a correctly calculated dosage, it is possible to treat infertility in women with impaired hormonal background.

Stimulation of ovulation

An injection of hCG when stimulating ovulation is used if it cannot pass naturally. The causes of the problem are different, but the most common are tumor formations, medication that suppresses reproductive function, and polycystic ovaries. Injections are prescribed only on the basis of deciphering the data obtained from the results of tests for the level of hormones in the body.

Ultrasound of the pelvic area, as well as a table of measurements of the patient's basal temperature, plays an equally important role. The drug stimulates the onset of the ovulation period, regardless of what happens next with a mature egg. She will either be fertilized naturally, or will be withdrawn for the IVF cryoprotocol.

Hormone treatment begins from the first day of menstruation, and if the cycle is knocked down, then from the first expected day of menstruation. It is also worth considering the fact that oral contraceptives should be canceled no later than 5-7 days before the start of therapy. During the stimulation of ovulation, you can not drink alcohol, drugs, it is not recommended to smoke. This can negatively affect the reproductive processes in the body. It is worth limiting physical activity, as well as protecting a woman from stress and worries. It is recommended to avoid sex during this period. Sexual intercourse will be effective only 5 days after ovulation.

When is testing done after an hCG injection?

After a woman has been given an injection of gonadotropin to stimulate ovulation, at least 3 days must pass before the release of the egg from the follicle. Sometimes it takes a little over 24 hours. At the same time, increased production of progesterone begins.

Depending on the length of the cycle, ovulation tests after the hCG injection begin to be done:

17 days before the onset of menstruation, if the length of the cycle is known and constant.
15 days before the start of menstruation, if the length of the cycle is not constant. To calculate the day, take the shortest cycle in the last 6 months.

Every day after diagnosing the growth of the follicle using ultrasound. This option is appropriate if there are long delays and breaks in cycles.

There is a huge variety of tests that differ not only in cost, but also in sensitivity. It is better to choose which test to use with your doctor.

Contraindications for HCG injection

Like any hormonal drug, chorionic gonadotropin injections have some contraindications. They are more associated with tumor neoplasms, as well as some individual features organism.

Injections are contraindicated in the presence of any inflammatory processes associated with the reproductive system. This applies to both women and men. You can not inject the drug if there is a pituitary tumor, as well as malignant neoplasms in the ovaries.

Women with early menopause are also not recommended to use gonadotropin for medicinal purposes. The same applies to mothers who breastfeed their children, since the hormone enters the milk through the blood. Because of this, deviations in the development of the genital organs of the child may appear. If there is suspicion or an established diagnosis of obstruction of the fallopian tubes, the doctor does not prescribe hCG injections. Do not use the drug for thrombophlebitis and chronic inflammatory processes in the adrenal glands.

Instructions for use

Regardless of the diagnosis, gonadotropin is prescribed intramuscularly. When planning pregnancy before using the drug, it is recommended to take full examination. When stimulating the ovulation process, one-time injections are used with a dosage of 5000 to 10000 IU. If there is a need to maintain the corpus luteum, then the drug is administered on the 3rd, 6th and 9th day after the onset of ovulation, the dosage is 1500-5000 IU.

Stimulation of superovulation for egg collection for IVF is also carried out using gonadotropin injections. For this, 10,000 IU are administered once. After 34-36 hours, the eggs are removed for their further fertilization. This is done in the case when a woman cannot become pregnant on her own. If there is a possibility of spontaneous abortion, and symptoms appear no later than 8 weeks, the woman is injected with 10,000 IU on the first day and then 2 times a week for 5000 IU. Therapy continues up to 14 weeks. If a woman’s previous pregnancy was interrupted due to a lack of the hCG hormone in the body, then when diagnosing a subsequent one, the same dosage is prescribed as a prevention of miscarriage as in case of a threatened miscarriage.

When diagnosing delayed sexual development, boys are prescribed from 3000 to 5000 IU once every 7 days. The duration of the course is at least 3 months, after which, if necessary, repetition is possible. Men are injected with 500-2000 IU 2 times a week. The duration of therapy is 1.5–2 months. If idiopathic normohormonal oligospermia occurs, then it is treated with a weekly injection of 5000 IU of gonadotropin in combination with menotropin (menopausal gonadotropin). The course lasts 12 weeks. If the disease has developed due to androgen deficiency, 2500 units of the hormone are injected every 5 days for 3 months.

Gonadotropin preparations may cause some side effects. Most often they occur with an overdose. Women may show signs of ovarian hyperstimulation and a significant increase in their size. At this time, the chest and lower abdomen may also hurt. In case of allergic reactions, redness may appear at the injection site, as well as a feeling of itching and pain. The general condition and well-being of the patient may deteriorate significantly. The drug is excreted by the kidneys, so attempts to check for pregnancy using test strips do not give the correct result. An increased concentration in non-pregnant women can be observed for another 36-45 hours after the last injection.

Chorionic gonadotropin for men

Chorionic gonadotropin is used to treat diseases of the reproductive system in men. In addition, the drug is used by athletes. If the functionality of the testicles in boys is assessed in the diagnosis of cryptorchidism or anarchism, an injection of 5000 IU is practiced once. For the treatment of cryptorchidism, gonadotropin is used at a dosage of 500–1000 units if the patient is less than 6 years old. The drug is injected 2 times a week for 1.5 months. For children over 6 years of age and adults, this dosage increases to 1500 IU.

Athletes often use testosterone and its analogues in bodybuilding to obtain high sports results. As a result, testicular atrophy occurs. Gonadotropin is able to prevent this problem.

If you replace injections with a drug in tablets, this will not have the desired effect, although many manufacturers claim otherwise.

Most often, hCG is needed if an athlete starts taking Trenbolone - a very strong steroid for gaining muscle mass. Previously, it was used only in veterinary medicine. PCT (post cycle therapy) in this case is a prerequisite for maintaining the reproductive function of the genital organs.

With an overdose of the drug in men, there is an increase in the sensitivity of the nipples, gynecomastia, as well as an increase in the size of the inguinal testicles. Prolonged excess dosage also has negative consequences. It causes a sharp decrease in the number of active viable spermatozoa in semen.

Hormonal preparations based on gonadotropin have good feedback patients who have been treated for infertility or have used medication to maintain a pregnancy.

HCG injection is designed to compensate for the amount of human chorionic gonadotropin in the body with insufficient natural production. The injection involves the introduction of one of the drugs that have different commercial names. The list of such drugs includes: chorionic gonadotropin (Russia), Profazi (Switzerland), Pregnil (Netherlands or USA), Horagon (Germany), etc. The main purpose of such drugs is to influence the hormonal background of the body and restore the functions of the genital organs. The need to inject hCG for women who want to become pregnant is explained by the normalization of the ovulatory process and the occurrence of subsequent hormonal activity of the corpus luteum after the injection.

Chorionic gonadotropin: general information

HCG or human chorionic gonadotropin has two subunits in its structure: alpha and beta. The alpha subunit is structurally identical to the TSH, FSH, and LH subunits. The beta subunit has no analogues. It is she who is the basis of tests that determine pregnancy.

The production of the beta component of hCG occurs in the first weeks of pregnancy. And by the 11th week, its content grows thousands of times. After that, its level begins to gradually fall. For this reason, it is important to monitor human chorionic gonadotropin during the perinatal period. So the control of the hormone level allows you to timely determine its decrease or increase, which may indicate the development of certain pathologies of pregnancy (threat of interruption, ectopic pregnancy, etc.).

In addition, a woman registered for infertility must undergo an examination to detect antibodies to hCG. These antibodies do not allow the protein to function fully, which leads to a decrease in placental lacogen, estradiol, and progesterone. Due to chorionic gonadotropin, the rejection of the embryo, its death inside the mother's womb, is excluded. This is another argument in favor of monitoring its level. Patients who have antibodies to hCG in the blood are recommended to perform plasmapheresis and take advantage of the possibilities of in vitro fertilization.

Usually, the level of chorionic gonadotropin is monitored during pregnancy, which is normal in such a situation. However, testing for beta-CHG in some cases may be indicated for some non-pregnant women and even men. An analysis that detects chorionic gonadotropin in the blood is prescribed for men and non-pregnant women when it is necessary to confirm hormone-producing tumors.

For injection, chorionic gonadotropin is produced in the form of a solution or in the form of a lyophilisate (a solution is prepared from it). This protein is extracted for the production of hormonal preparations from the urine of pregnant women.

Indications for the use of hCG injections

The effectiveness of drugs with hCG was noted when the following conditions occur in women:

dysmenorrhea;
ovarian dysfunction;
anovulatory infertility;
corpus luteum deficiency;
the threat of spontaneous miscarriage;
inability to bear fruit;
preparation for IVF;
placenta formation.

The drug with hCG can act as an additional tool for assisted reproductive techniques.

Recombinant hCG affects:

on the ovaries and tissues to enhance the production of sex hormones;
when stimulating ovulation.

Instructions for the use of HCG

The drugs are injected intramuscularly. It is permissible for a woman to inject herself with hCG, but only if she knows how to make intramuscular injections. Otherwise, she will have to look for a person from her inner circle who could do it for her. If none of the options is possible, then you can go for injections in treatment room the antenatal clinic that the patient attends at the place of registration. But this option is not entirely convenient, since injections are prescribed for a long time, in whole courses, and the opportunity to visit the treatment room of the clinic is not always possible. Therefore, it is best to still find a person who can come to the house or do it yourself.

When stimulating ovulation, the doctor will recommend an injection of hCG into the stomach. It is much more painless and more convenient than when placing it in the buttock. To do this, measure the distance of about two fingers from the navel to the left and right. Having pinched the fold of the skin, the needle is inserted into it to the end. The needle for these purposes is better to choose a short, insulin. The injection site must be treated with a cotton swab dipped in an alcohol solution.

Permissible doses of drugs with HCG.

The volumes of chorionic gonadotropin may be different. The following dosages of the hormone are found in the pharmacy network: 500 units, 1000 units, 1500 units, 5000 units, 10000 units.

Dosages for various problems obstetrician-gynecologist can prescribe the following.

The dosage of injections of chorionic gonadotropin, which is prescribed to maintain pregnancy, can be from 5000 IU to 10000 IU. Each time it will depend on how much of the hormone was detected in the blood of the pregnant woman. In addition, the size of the follicle is taken into account, since due to the injection of the drug with hCG, ovarian hyperstimulation syndrome may develop.

One of the main indications for the use of hCG injections is infertility. After ovulation stimulation, several procedures are prescribed ultrasound. At ultrasound sessions, follicle growth is monitored (up to 20-25 cm) and then hCG is injected, which triggers the ovulation mechanism. Also, the action of the hormone is directed against the regression of follicles, that is, it prevents the development follicular cyst. In order to stimulate ovulation, chorionic gonadotropin is indicated once at a dose of 5000 or 10000 units. Evaluate the effect of the injected injection after 24-36 hours using ultrasound equipment. Performing injections with hCG increases the possibility of conception many times over.

To stimulate the performance of the corpus luteum for 3-6-9 days, chorionic gonadotropin is indicated at a dose of 1500 units or CG 5000 units.

When performing superovulation as part of reproductive measures, the patient, after stimulating the growth of several follicles, is injected once with about 10,000 units of chorionic gonadotropin. The selection of the egg is carried out after 34-36 hours from the moment of CG injection.

If a threatened miscarriage is suspected, 10,000 units of the drug are first administered, after which the dose is reduced to 5,000 units, which is administered twice a week. Therapy is started before the 8th week of gestation, it can be continued up to the 14th week.

Indications for injection of hCG for pregnant women.

Pregnant women are prescribed injections with hCG with a sharp drop in the level of human chorionic gonadotropin in the blood in order to maintain pregnancy in the future. The low concentration of this complex protein in the blood may be due to early diagnosis. Before prescribing hormone therapy for a pregnant woman, the doctor will once again send for analysis to confirm the lack of gonadotropin.

In situations in which the deviations of the indicator are significant from normal value, always taken into account for the week of pregnancy, and this downward deviation is more than 20%, then a course of hormone therapy is prescribed without fail. Such a deviation in the hormone index may be evidence of anomalies, such as:

ectopic pregnancy;
frozen pregnancy;
chronic placental insufficiency;
risk of miscarriage.

Side effects of hCG shot

Side effects in women: due to the administration of the drug, ovarian hyperstimulation syndrome, hydrothorax, ascites, thromboembolism, and cysts may occur.

Other side effects from HCG are rare. It can be discomfort and a feeling of pulling pain in the abdomen, flatulence (gas formation in the abdomen), mood swings, excessive anxiety and fatigue. After the course of treatment is completed, such symptoms usually disappear.

List of contraindications.

Measures with the artificial administration of a hormone-containing drug are contraindicated:

during lactation;
at the onset of early menopause;
with a tumor process in the pituitary gland and ovaries;
with thrombophlebitis;
when fallopian tubes declared impassable;
with the appearance of allergic reactions to the drug;
with diseases of the adrenal glands;
with hyperthyroidism.

If there are difficulties with conceiving or carrying an embryo, the doctor will first identify the cause of this violation by prescribing an hCG test and a number of other examinations. With all the importance of chorionic gonadotropin for the processes of ovulation and for maintaining the development of the fetus, as well as with its identified shortage and for some other indications, the doctor prescribes hCG injections to artificially restore the lost balance of the amount of the hormone in the woman's body.

At the same time, one should not worry that this hCG injection will be dangerous for the health of the woman herself or for the fetus.

In most situations, it is thanks to this measure that the expectant mother manages to keep and bear a healthy baby. The sooner a medical emergency disorder is identified, the greater the chance of a positive outcome.

Chorionic gonadotropin is a unique hormone that allows the embryo to develop and gives a woman a chance to become a mother. It is produced by chorion tissue - fetal membrane immediately after the fertilized egg descends into the uterine cavity and is fixed there. Special medicinal product with a similar name is also a chance to experience the joy of motherhood for those who have problems conceiving. How the tool is used and what results it gives, we will tell in this article.

What is it - drug and analogues

"Horionic gonadotropin" is a medicine that is obtained from the urine of pregnant women. The hormone enters the excreted fluid from the blood, which in turn is enriched with this substance during pregnancy. The hormonal substance is excreted almost unchanged, which is why it is so easily extracted from the urine of expectant mothers.

In our country, the medicine can be purchased both locally, Russian-made, and its imported analogues- "Pregnil", "Profazi", "Horagon". All drugs containing hCG are prescribed by a doctor according to individual indications, unauthorized treatment by them is strictly prohibited, since it can lead to severe hormonal imbalance in the human body.

As the name implies, the main active ingredient of the drug is human chorionic gonadotropin. In the body of the expectant mother, he is entrusted with essential functions- stimulate the corpus luteum, which is formed after ovulation, help produce large amounts of progesterone and estrogen, preserve the embryo and create the most comfortable conditions for it.

Partially, the gonadotropic hormone suppresses the aggression of maternal immunity. Without this, the woman's immune defense would simply reject the fetus, which has in its DNA 50% of the foreign chains inherited from the father.

strong action the main substance is used for a wide variety of medical purposes. The drug in injections is prescribed for women, men, and adolescents. However, most often the drug is used in gynecology and obstetrics.

Action

Chorionic gonadotropin is directly involved in the synthesis of sex hormones in both men and women. This substance significantly improves the process of production of substances in the testicles of the stronger sex and in the ovaries - in women. It affects the key "event" of the female cycle - it is this hormonal drug that is used to stimulate ovulation, if for some reason it does not occur in a woman on her own, anovulatory cycles take place.

After ovulation has occurred, the drug helps to maintain the functions of the corpus luteum - the follicle that produces hormones - progesterone and estrogens, which are important for the start of pregnancy. Under the influence of gonadotropic hormone, the genital organs develop correctly in both men and women, and secondary sexual characteristics are also normally formed.

because of a wide range the action of the drug is very much appreciated by fertility doctors and obstetricians. It allows not only to get pregnant, but also to support a “problem” pregnancy, which, without hormone therapy, will most likely end in a miscarriage or premature birth.

To whom is the drug prescribed?

HCG injections are recommended for all women and men who go to the doctor with gutters for decreased sexual function. This includes a weak sexual desire, and the inability to get pregnant on their own, and problems with reproductive functions in men.

The drug is indicated for people suffering from underdevelopment of the genital organs, reproductive insufficiency, dwarfism, disorders of the pituitary and hypothalamus, due to which the hormonal background is disturbed. The tool is widely used in adolescence if there is a delay in sexual development.

AT gynecological practice the drug is prescribed:

women with dysmenorrhea severe pain during menstruation, additional unpleasant symptoms"critical" days - nausea, vomiting, headaches, dizziness, loss of consciousness);

women with ovarian dysfunction;

women with infertility associated with the absence of ovulation in the cycle;

women who cannot become pregnant due to insufficiency of the corpus luteum;

to patients to stimulate ovulation before embryo transfer by IVF, as well as after embryo transfer to maintain pregnancy;

patients who have already had several miscarriages, especially in the early stages (recurrent miscarriage);

pregnant women with severe signs of threatened miscarriage.

Indications for the use of the drug are also hereditary problems with reproductive function in women and men.

To whom is the medicine contraindicated?

In some cases, the use of the drug will have to be abandoned, because it has a fairly large list of contraindications. So, "Horionic gonadotropin" can not be used for:

hypersensitivity to this hormone, which can become the beginning of a severe allergic reaction;

with ovarian carcinoma - cancer of the gonad in women;

with neoplasms and tumors in the pituitary gland;

with the so-called hormonal tumors in the body, which are able to respond with rapid growth to the introduction of androgens;

with insufficient work of the thyroid gland;

with dysfunction or insufficiency of the adrenal glands;

at elevated level the hormone prolactin in the patient's blood;

with the onset of menopause, menopause;

with epilepsy;

with obstruction of the fallopian tubes, with a strong adhesive process in them;

during breastfeeding;

with diagnosed thrombophlebitis.

With increased precautions, the drug is prescribed to women with ischemic disease heart, high blood pressure, kidney failure, both acute and chronic, suffering from bronchial asthma.

Side effects

Like any hormonal drug, Chorionic Gonadotropin can cause allergic reaction. Usually it is local in nature, redness, slight swelling and moderate itching are observed only at the injection site. Much more often the drug causes headaches. Many women complain that they feel "broken", constantly tired, some even experience depression.

If the drug is used in combination with other drugs as part of complex therapy for reproductive techniques, for example, with Clomiphene, ovarian hyperstimulation syndrome may develop, when cysts form in the ovaries, which are dangerous from the point of view of the possibility of their sudden rupture. In this case, the appearance of fluid in the abdominal cavity and chest cavity is not ruled out.

Sometimes women complain of swelling, mood swings, uncontrolled attacks of aggression. All this is the result of the effect of the hormone on the brain. It is not necessary that every patient will experience these symptoms. side effects from taking the drug, but be aware of possible consequences each must.

Instructions for use - dosage

The drug is available in the form of a powder, from which a solution for injection can be prepared. The box also contains an isotonic sodium chloride solution for this. Therefore, the preparation of a ready-to-use means of labor will not be. The medicine is administered exclusively intramuscularly.

The dosage depends on what is the purpose of using the drug. Women who are going to IVF or to stimulate ovulation are given a single dose of 5,000–10,000 IU of the drug. If the treatment is carried out with the use of other means, then it is important that last appointment menotropins, at least a day has passed, and from the last dose of Clomiphene - at least five days.

If the patient has insufficient functioning of the corpus luteum, then the optimal dosage for her is 1500 IU. An injection is given every two days until the moment when either menstruation begins or the test confirms the long-awaited pregnancy. The first injection is given on the day of ovulation.

The solution for injection is prepared immediately before the procedure, do not do this in advance. Dosages active ingredient in the packages offered on the shelves of pharmacists - 500 units, 1000 units, 1500 units, 5000 units. Most suitable shape the doctor will tell you, since the treatment must necessarily take place under the supervision of an experienced specialist.

Use to stimulate ovulation

Ovulation is the release of a mature and ready egg from a mature follicle. It usually happens in the middle of a cycle. By different reasons the egg may be weakened, against the background of a lack female hormones it may not make a timely exit or not mature. That is why infertility treatment often begins with the stimulation of healthy and normal ovulation.

Ovulation Calculator

Cycle duration

duration of menstruation

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Enter the first day of your last menstrual period

Ovulation occurs 14 days before the start of the menstrual cycle (with a 28-day cycle - on the 14th day). Deviation from the mean value is frequent, so the calculation is approximate.

Also, along with the calendar method, you can measure basal temperature, examine cervical mucus, use special tests or mini-microscopes, take tests for FSH, LH, estrogen and progesterone.

You can definitely set the day of ovulation through folliculometry (ultrasound).

Sources:

Losos, Jonathan B.; Raven, Peter H.; Johnson, George B.; Singer, Susan R. Biology. New York: McGraw-Hill. pp. 1207-1209.
Campbell N. A., Reece J. B., Urry L. A. e. a. Biology. 9th ed. - Benjamin Cummings, 2011. - p. 1263
Tkachenko B. I., Brin V. B., Zakharov Yu. M., Nedospasov V. O., Pyatin V. F. Human Physiology. Compendium / Ed. B. I. TKACHENKO. - M.: GEOTAR-Media, 2009. - 496 p.
https://en.wikipedia.org/wiki/Ovulation

This method allows you to achieve success in about 70-75% of cases, if everything is done correctly and there are no contraindications for the use of Chorionic Gonadotropin. Important condition- the integrity of the egg. It must not be damaged. This stimulation is preceded by a thorough examination. As part of the diagnosis, doctors check the state of the hormonal background of a woman who dreams of motherhood, examine the health of her reproductive system, finding out whether the fallopian tubes, whether there are adhesions, as well as ovarian cysts.

If these pathologies are not present, then apply complex therapy. After menstruation, a woman is prescribed "Klostilbegit" and she must take it until the 9th day of the cycle.

Then they do an ultrasound, which sets the size and number of follicles. As soon as one of them reaches the desired size, you can make an hCG angle. The drug is administered with a follicle size of 17 millimeters (preferably 19-22 mm). For this, the imported drug Pregnil is often used, it has proven itself well.

Thus, "Klostilbegit" helps to prepare the egg for release, and gonadotropin contributes to the rupture of the follicle and the release of the egg. Dosages and treatment regimen are assigned to each patient on an individual basis, because each woman has her own reasons for infertility, her own characteristics of the menstrual cycle. The prescribed course can be adjusted if the intermediate ultrasound shows that the therapy is ineffective, that there are symptoms of superovulation - cysts on the ovaries. The task of the doctor in this situation is to prevent their rupture, for this hormonal treatment canceled.

Many women who are about to undergo an ovulation stimulation procedure are wondering how long after an injection ovulation occurs. The answer to this question is given by the manufacturers of the Russian-made drug. AT official instructions by application medicinal product it is indicated that the long-awaited moment after the injection occurs after 32-36 hours. For imported manufacturers, the interval is identical.

It is not at all necessary that the angle be single. As indicated above, the dosage for one injection is from 5000 to 10000 units, but the injections themselves can be up to three. It all depends on how the female body reacts to the hormonal attack, and whether it is possible to achieve the desired state of the follicle for conception. In IVF, ovulation is stimulated with a single dose of 10,000 units. Injections into the abdomen with a short needle (from an insulin syringe) are considered the most effective; this intramuscular method of administering the drug is most often used.

For more successful planning during the preparation and stimulation of ovulation, a woman is recommended to donate blood for progesterone and estradiol in dynamics, measure basal temperature daily, and also observe the sexual life regimen prescribed by the attending doctor.

Tests after injection

special attention deserves the question of the use of various tests after hormonal therapy with hCG preparations. The level of the hormone received female body"from the outside" of course affects the results and analyzes that can be carried out later. Therefore, it is recommended to do an ovulation test no earlier than three days later, and a pregnancy test after an injection will not be informative for at least 12 days. Most often, a woman will see a second line, but the result will be a false positive.

The concentration of the hormone obtained during the injection leaves the body in about 12 days. Therefore, doctors do not advise starting to buy pharmacy tests before the fifteenth day after ovulation. The best option is a blood test for hCG. If you do it several times, then the dynamics will be noticeable. Positive if pregnancy has occurred, and negative (the level will decrease) if conception has not taken place.

Application for maintaining pregnancy

Insufficient levels of one's own chorionic gonadotropin are primarily manifested by a high probability of miscarriage in the early stages. Lack of this hormone leads to underproduction progesterone - the hormone "responsible" for maintaining pregnancy. That's why low level HCG can lead to intrauterine death of the embryo and missed pregnancy.

If a woman has already had pregnancies according to this scenario, with a high degree of probability she will be offered hormone therapy with Chorionic Gonadotropin. If a woman suffers from habitual miscarriage, then it is recommended that she detect the fact of pregnancy as early as possible using modern diagnostic methods and start treatment with this drug or its analogue on time.

It is important that the first injections during early pregnancy are given before the 8th obstetric week and completed by the 14th week. This also applies to cases when a woman first has symptoms of an early threat of spontaneous abortion.

The dosage, depending on the type of pathology, ranges from 1000 to 3000 units. Injections are given every two days, after 10 weeks - every 3-4 days up to 14 weeks, when the threat is considered to have already successfully passed the stage.

If the problem of miscarriage is due to malfunction or dysfunction of the corpus luteum, the dosage can be from 1500 to 5000 units for one injection. If habitual miscarriage is caused by immune or hormonal reasons, then the first dose will be 10,000 units, and subsequent 5,000 units. With miscarriages unclear etiology, the causes of which could not be established, any dosage can be prescribed, except for 10,000, this issue is decided by the attending physician, based on the results of a biochemical blood test.

In the course of a long course of treatment, a woman will have to follow other recommendations, without which hormone therapy may be ineffective. She will have to visit the gynecologist more often, do more ultrasound to monitor the condition of the cervix and cervical canal, as well as to monitor the growth and development of the embryo, donate blood for hormones and biochemical analysis several times. In case of a serious threat, a hospital stay is recommended.

If problems with conceiving and bearing a baby are associated with endometriosis, the doctor may prescribe hormonal gonadotropin agonists - hormone releasing hormone. Women should understand that such drugs do not affect the ability to conceive a child, they only help to prepare the woman's body for further attempts to conceive a baby, to help cope with endometriosis.

special instructions

It is a mistake to believe that a single injection of hCG during ovulation stimulation will help cure a woman from anovulation. The drug only stimulates the release of a single egg in a particular cycle. The effect of the drug does not apply to other cycles.

By agreeing to the treatment hormonal drug, a woman should be aware of such a consequence of gonadotropin therapy as a multiple pregnancy. Often a woman who is stimulated to ovulate with a large dosage of hCG (10,000 units) eventually becomes a happy future mother of not one, but two or three babies at once.

Many women complain that their lower abdomen hurts after an injection. This should not be scary, because a hormonal injection is quite painful, these post-traumatic pains will gradually pass.

If you take a human chorionic gonadotropin preparation for too long, then antibodies can be developed in the body that will prevent the production of this useful and necessary substance in certain situations. This will greatly complicate future pregnancies, make the conception and bearing of a child practically impossible.

Both the original drug and its foreign analogues are not recommended to be combined with alcohol and narcotic drugs. The question of the compatibility of the hormone with alcohol, which is often heard in many women's forums, generally causes a reasonable answer about the inadmissibility of alcohol during the planning period in general, with an assisted reproductive technique in particular.

An isotonic solution is introduced into an ampoule with a powder of the drug and mixed well until it is evenly distributed without precipitation. You need to stir in a circular motion and in no case shake the ampoule.
The finished solution is drawn into a syringe, the needle is changed to a regular one if it is decided to inject into the buttock or to a small “insulin” one if it is planned to inject into the stomach.
The injection site is wiped with cotton soaked in alcohol or special pharmacy alcohol wipes.
The drug is administered intramuscularly, not quickly.
After the injection, an alcohol pad is applied to the injection site and pressed lightly for 1-2 minutes.

The method of administration of the drug into the abdomen is most often used to stimulate ovulation. For a systematic intake on schedule while maintaining pregnancy, it is better to inject chorionic gonadotropin into the gluteal muscle.

Overdose symptoms

An overdose of the hormone can manifest itself with ovarian hyperstimulation. The appearance of a cyst on the gonad can be indicated by a deterioration in the well-being of a woman. There may be a sharp pain in the lower abdomen, nausea, vomiting. The pain occasionally "shoots" in the groin area. Many women with acute hyperstimulation syndrome experience a feeling of bloating, fullness.

The appearance of diarrhea is not excluded, but at the same time the number of urination decreases, the woman begins to edema of the lower extremities and hands, breathing becomes more frequent.

Conditions of storage and dispensing from pharmacies

The drug belongs to pharmacological group B, it can be bought in pharmacies only with a doctor's prescription. Store boxes with solution and dry powder for dilution should be at a temperature not exceeding 20 degrees Celsius, so that direct sunlight does not fall on the medicine.

If a diluted solution remains after the injection, it cannot be reused, it is advisable to prepare a new portion of the solution for a new injection, and the remains do not need to be stored at all, either in the first-aid kit or in the refrigerator.

Formula: human chorionic gonadotropin chemical structure is a glycoprotein consisting of two subunits: alpha and beta. The α-subunit of chorionic gonadotropin is completely homologous to the α-subunits of luteinizing, follicle-stimulating and thyroid-stimulating hormones. The β-subunit of hCG is unique to this hormone and distinguishes it from LH, FSH, and TSH. Chorionic gonadotropin consists of 237 amino acids.
Pharmacological group: hormones of the pituitary gland, hypothalamus, gonadotropins and their antagonists / gonadotropic hormone.
Pharmachologic effect: luteinizing, gonadotropic.

Pharmacological properties

Chorionic gonadotropin binds to specific receptors on the membranes of gonadal cells (which are integral glycoproteins with a molecular weight of about 194,000), activates the adenylate cyclase system and reproduces the effects of the luteinizing hormone synthesized in the anterior pituitary gland. In women, it stimulates and induces ovulation, stimulates the rupture of the follicle and its transformation into the corpus luteum, including when performing additional reproductive methods; increases the functional activity of the corpus luteum in the luteal phase of the menstrual cycle, prolongs its existence, inhibits the onset of the menstruation phase, enhances the formation of androgens and progesterone, including in case of corpus luteum insufficiency, helps implantation of the egg and supports the formation of the placenta. Ovulation usually occurs 32 to 36 hours after injection.
In men, it stimulates the testicular Leydig cells, increases the formation and production of testosterone, helps in spermatogenesis, the development of secondary sexual characteristics and the descent of the testicles into the scrotum.
Chorionic gonadotropin is well absorbed into the blood when administered intramuscularly. With systematic use, the content in the blood gradually increases, and by 7–12 days it exceeds the initial level by one and a half times. It has two phases of half-life - 11 and 23 hours. Excreted by the kidneys unchanged during the day, 10-12% of the dose. Has no mutagenic effect. Dose-dependently increases the incidence of congenital external anomalies in mice. May cause adverse effects on the fetus if used in pregnant women.

Indications

Decrease in the functioning of the sex glands in case of disorders in the hypothalamus-pituitary gland system: in women - infertility caused by pituitary-ovarian dysfunction, including after preliminary stimulation of endometrial proliferation and maturation of follicles, menstrual irregularities (including its absence), uterine dysfunction bleeding in childbearing age, insufficient function of the corpus luteum, threatened and habitual miscarriage in the 1st trimester of pregnancy, controlled "superovulation" during artificial insemination; in men, the phenomena of eunuchoidism, hypogonadotropic hypogonadism, testicular hypoplasia, hypogenitalism, adiposogenital syndrome, cryptorchidism, spermatogenesis disorders (azoospermia, oligospermia).

Method of application of chorionic gonadotropin and dose

Chorionic gonadotropin is administered intramuscularly. Women- when using methods of artificial insemination and to stimulate ovulation: 5000-10000 IU one day after the last use of urofollitropin or menotropins, or 5-9 days after the last use of clomiphene; with insufficient function of the corpus luteum - 1500 IU every second day, it is worth starting from the day of ovulation and until the day of the expected menstruation or until confirmation of pregnancy (if pregnancy is confirmed, it is possible to reuse up to 10 weeks of pregnancy).
Men- with hypogonadotropic hypogonadism 2-3 times a week, 1000-4000 IU for several weeks or months or until therapeutic effects are obtained; with infertility to stimulate spermatogenesis for six months or more; if the number of spermatozoa in the ejaculate remains low (less than 5 million / ml), therapy is supplemented with urofollitropin or menotropins and treatment is continued for another 1 year. In prepubertal age, cryptorchidism - 2-3 times a week for 1000-5000 IU until the desired effect is obtained, but not more than 10 doses; to detect hypogonadism in young men - for 3 days, 2000 IU 1 time per day.
If you miss the next dose of the drug, you should immediately consult a doctor.
Solutions must be prepared before use directly on isotonic solution sodium chloride. It is worth considering the possibility false positive results immunological tests for the content of endogenous chorionic gonadotropin and the possibility of increasing the content of 17-ketosteroids and 17-hydroxycorticosteroids in the urine. Therapy should be carried out under the supervision of a qualified physician who has experience in treatment endocrine diseases and violations. When used to stimulate ovulation, an individual choice of doses and regimen of use of the drug and their correction depending on the results are required, ultrasound of the ovaries, regular measurements of the content of progesterone and estradiol in the blood serum, daily monitoring of basal temperature body and compliance with the regimen of sexual activity, which was recommended by the doctor. With the formation of cysts in the ovaries or the development of ovarian hypertrophy, a temporary cessation of therapy is necessary (to avoid rupture of the cyst), a decrease in the dose of the drug for the next course, and abstinence from sexual intercourse. With severe ovarian hypertrophy or a strong increase in the content of estradiol in the blood serum on the last day of therapy with urofollitropin or menotropins, ovulation stimulation is not performed in this cycle.
When treating male infertility, it is worth measuring the content of testosterone in the blood serum before and after using the drug, as well as determining the motility and number of spermatozoa. With premature puberty during the treatment of cryptorchidism, treatment should be canceled, then other methods of therapy are used. If there is no dynamics of testicular descent after using 10 doses of the drug, then it is not recommended to continue therapy. Diagnosis in young men of hypogonadism is carried out under the supervision of the concentration of testosterone in the blood serum before use and one day after the course of therapy. An unreasonable increase in the duration or doses of the drug may be accompanied by a decrease in the number of spermatozoa in the ejaculate in men.

Contraindications for use

Hypersensitivity (including hypersensitivity to other gonadotropins), tumors or hypertrophy of the pituitary gland, inflammatory diseases or hormone-dependent tumors of the genital organs, renal and heart failure, epilepsy, bronchial asthma, migraine; in women, threatened or ovarian hyperstimulation syndrome, uterine fibroids, undiagnosed dysfunctional uterine bleeding, hypertrophy or ovarian cyst, which is not associated with its polycystosis, exacerbation of thrombophlebitis; in men - premature puberty (for the treatment of cryptorchidism), prostate cancer.

Application restrictions

To stimulate ovulation - polycystic ovaries. Age up to 4 years (efficacy and safety not determined).

Use during pregnancy and lactation

During pregnancy, it is necessary to take into account possible adverse effects on the fetus (according to the results obtained when using the drug in pregnant women and experimental animals). Breast-feeding stop during therapy.

Side effects of human chorionic gonadotropin

Nervous system: headache, anxiety, irritability, fatigue, depression, weakness;
allergic reactions: angioedema, rash, dyspnea;
urinary system: in women - the formation of ovarian cysts, ovarian hypertrophy, ovarian hyperstimulation syndrome, peripheral edema, multiple pregnancy;
in men- an increase in the testicles in the inguinal canal, which makes it difficult to further lower the testicles, premature puberty, atrophy of the seminiferous tubules, degeneration of the gonads;
others: breast enlargement, antibody formation (with prolonged use), pain at the injection site.

Interaction of chorionic gonadotropin with other substances

Joint use with urofollitropin and menotropins increases the severity of ovarian hyperstimulation syndrome, the possibility of pregnancy and premature birth.

Overdose

In women with stimulation of ovulation at the beginning of menstruation, acute ovarian hyperstimulation syndrome may spontaneously develop. Symptoms: nausea, sharp pain in the abdominal cavity (in inguinal region), vomiting, bloating, diarrhea, decreased diuresis, swelling of the lower extremities, rapid breathing, in severe cases - blood clotting, hypovolemia, ascites, electrolyte imbalance, peritonitis, acute pulmonary insufficiency, hydrothorax, thromboembolism phenomena. Necessary: temporary withdrawal of the drug, hospitalization (if necessary), symptomatic treatment(correction of blood coagulation, water-salt balance and other disorders).