It gets tricky keeping track of all those meds and acronyms along the fertility path. FSH, AMH, IVF, IUI…and now, add hCG to the getting-pregnant mix. If you’ve been prescribed hCG shots for fertility, there are a few important things you should know.
hCG stands for human chorionic gonadotropin, so you literally will never use its full name in conversation. This is a pregnancy hormone—you may know it as the one that a pregnancy test detects in a woman’s urine.
In fertility treatments, hCG shots are used as a tag team partner with other medications to help a woman ovulate.
The other medications—injections of FSH (follicle stimulating hormone) and/or LH (luteinizing hormone)—stimulate the ovaries to grow the follicles allowing the eggs within them to mature. Then, the hCG shot helps the egg finish maturing and then release, says David Diaz, MD, reproductive endocrinologist at MemorialCare Orange Coast Medical Center in Fountain Valley, California.
hCG may have the brand name Pregnyl, Ovidrel, Novarel or Profasi. You might get prescribed them if you’re not ovulating, if an ovulation drug like Clomid didn’t work for you, or if you’re doing IUI (intrauterine insemination) or IVF (in vitro fertilization).
According to Dr. Diaz, in certain cases of male infertility, hCG may also be used to help increase sperm production.
The basic timeline
Here’s how it works (for women, at least):
The FSH and LH injections usually begin on day three of a woman’s period, to get those follicles going, and continue daily for about 10 to 12 days after that. The doctor will keep tabs on the follicle status with ultrasounds. Once the eggs become mature enough (woo-hoo!), you’ll get the hCG shot, which basically says, “Ovulation? And go!” Most women ovulate 36 to 40 hours after an hCG shot, according to the Society for Assisted Reproductive Technology (SART).
When you’re ovulating, it’s time for fertilization, whether that’s through sex, IUI or IVF.
On pins and needles
You’ll likely give yourself your hCG shot or ask a loved one (who can handle it) to do it for you. A doctor and/or nurse will likely walk you through the injection process. Dosage varies depending on which brand of hCG you’re prescribed.
hCG shots are done subcutaneously (small needle injected just under the skin) OR intramuscularly (larger needle injected into the muscle) depending on your physician’s protocol. If it’s Profasi, Novarel or Pregnyl, the medication will probably be in powder form, and you’ll have to mix it with a specific amount of liquid to dilute it before you inject, says SART. Ovidrel is premixed and thus slightly more convenient. As convenient as a timed injection can be, that is.
There are some side effects to hCG shots that you should look out for. You might have minor pain at the injection site or feel a slight cramping or mild bloating as the mature egg sac releases its fluid and the egg itself.
Not too bad, right? However, there are some more major side effects to watch for. In some cases, women can get ovarian hyperstimulation syndrome (OHSS). In OHSS, the glut of hormones overwhelm the ovaries, causing them to become swollen and painful. Mild OHSS will go away after a week or so if you don’t get pregnant—maybe longer if you do get pregnant. But severe OHSS can cause some pretty scary health problems. Tell your doctor if you have any of these symptoms so they can keep an eye out for OHSS:
- Substantial abdominal pain or tenderness
- Bloating that is increasing daily
- Daily weight gain
- Severe, persistent nausea and vomiting
- Swelling and pain in your legs
- Decreased urination
- Shortness of breath/difficulty breathing
After you get the shot, hCG will be in your urine. Remember, hCG is the same hormone that a pregnancy test picks up, so there’s a chance you could get a false positive on a pregnancy test. In fact, you truly can’t trust the results of a test taken within 10 days after taking the hCG shot, according to SART.
Our advice? Step away from the pregnancy tests. Don’t even pick one up, and skip that aisle at the drugstore. Save those bad boys for later. We’re pretty sure you’re going to need them.