Human chorionic gonadotropin (HCG) has a chemical structure
that is very similar to luteinizing hormone (LH), which
triggers ovulation. HCG is also the hormone produced by
pregnancies from the chorionic villi and placenta.
A pregnancy test is essentially a test for the presence of
HCG. Since HCG has a structure like LH but lasts much longer in
circulation than LH, HCG can be used to trigger ovulation at
the appropriate time.
When the monitoring team feels your follicles are at the
appropriate size to trigger ovulation you will be instructed on
a time to take HCG. This is often referred to as
"released".
The type of cycle and day of the procedure (oocyte retrieval
or insemination) will determine what time the HCG injection
will be given.
Once HCG is given there will be no further Lupron or
gonadotropin injections.
Several scenarios are included below,
Timed Intercourse
Timed intercourse can be done with Clomid and controlled
ovarian hyperstimulation (COH) cycles. Patients taking Clomid
may be given 10,000 units HCG whereas patients doing COH
generally get 5,000 units of HCG.These injections are
administered in the clinic at the time of the monitoring visit
since intercourse will need to be planned approximately 37
hours from the time of injection.
As an example, if HCG is given at 9 a.m. then intercourse
should be planned for around 10 p.m. the following night. This
type of timing usually works for most couples that work during
the day. The exact timing is a recommendation and should not be
considered an absolute. Fortunately, nature does not require
such perfect timing.
Intrauterine Inseminations
Inseminations with washed and donor sperm will be scheduled
39 to 42 hours after HCG injection. 5,000 units of HCG is
usually administered at 6 p.m. two days prior to the scheduled
insemination.
For example, a patient with appropriately sized follicles
seen on Monday is directed to stop all injections and take
5,000 units of HCG at 6 p.m. She will then be seen on Wednesday
for an insemination around 9:30 a.m. to 10 a.m. (Semen samples
will be collected at 8 a.m. if applicable.)
In Vitro Fertilization (IVF)
IVF patients now take 5,000 units of HCG at 37 hours prior
to retrieval. There is a margin of several hours before the
release of the oocytes into the abdomen again reinforcing the
above statement that timing is not absolute.
Different IVF centers use different times for their
retrievals and have become comfortable using their own timing.
Be sure to take your medication at the time that was specified
for you. Written directions are provided at the monitoring
visit prior to your retrieval.
Learn More
Learn more about fertility medications below.