Chorionic gonadotropin is a unique hormone that allows the embryo to develop and gives a woman the chance to become a mother. It is produced by the tissues of the chorion - the fetal membrane immediately after the fertilized egg descends into the uterine cavity and is fixed there. A special drug with the same name is also a chance to experience the joy of motherhood for those who have problems with conception. How the tool is used and what results it gives, we will tell you in this article.
What is it - a drug and analogues
"Chorionic gonadotropin" is a medicine that is obtained from the urine of pregnant women. The hormone enters the secreted 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 counterparts - "Pregnil", "Profazi", "Khoragon". All drugs containing hCG are prescribed by a doctor for individual indications, unauthorized treatment by them is strictly prohibited, since it can lead to a strong hormonal imbalance in the human body.
As the name suggests, the main active ingredient of the drug is human chorionic gonadotropin. In the body of the expectant mother, it is entrusted with the most important functions - to stimulate the corpus luteum, which is formed after ovulation, to help the production of large amounts of progesterone and estrogen, to preserve the embryo and create the most comfortable conditions for it.
Partially gonadotropic hormone suppresses the aggression of maternal immunity. Without this, the woman's immune defense would simply reject the fetus, which has 50% of the foreign chains inherited from the father in its DNA.
The strong action of the base substance is used for a wide variety of medicinal purposes. The drug in injections is prescribed for women, men and adolescents. However, the drug is most often used in gynecology and obstetrics.
Act
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 its own, anovulatory cycles take place.
After ovulation has occurred, the drug helps to maintain the functions of the corpus luteum - a follicle that produces hormones important for the onset of pregnancy - progesterone and estrogens. Under the influence of gonadotropic hormone, the genitals develop correctly in both men and women, and secondary sexual characteristics are formed normally.
Due to the wide spectrum of action, the drug is highly appreciated by reproductive specialists and obstetricians. It allows not only to get pregnant, but also to support a "problem" pregnancy, which without hormone therapy is likely to end in miscarriage or premature birth.
Who is the drug prescribed to?
HCG injections are recommended for all women and men who visit a doctor with gutters for decreased sexual function. This includes a weak sex drive, 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, insufficient reproductive capabilities, dwarfism, dysfunction of the pituitary gland and hypothalamus, due to which the hormonal background is disturbed. The tool is widely used in adolescence if there is a delay in puberty.
In gynecological practice, the drug is prescribed:
women with dysmenorrhea (severe pain during menstruation, additional unpleasant symptoms of "critical" days - nausea, vomiting, headaches, dizziness, loss of consciousness);
women with ovarian dysfunction;
women with infertility associated with the lack of ovulation in the cycle;
women who cannot get pregnant due to insufficiency of the corpus luteum;
for 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 pronounced signs of threatened termination.
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, "Chorionic Gonadotropin" cannot be used for:
hypersensitivity to this hormone, which can become the beginning of a severe allergic reaction;
with ovarian carcinoma - a cancer of the sex gland in women;
with neoplasms and tumors in the pituitary gland;
with 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;
with an increased level of 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 for women with coronary heart disease, high blood pressure, renal failure, both acute and chronic, suffering from bronchial asthma.
Side effects
Like any hormonal drug, Chorionic Gonadotropin is capable of causing an allergic reaction. Usually it is local in nature, redness, slight swelling and mild itching are observed only at the injection site. Much more often the drug causes headaches. Many women complain that they feel "overwhelmed", constantly tired, some even get depressed.
If the drug is used in combination with other agents 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 excluded.
Sometimes women complain of swelling, mood swings, and uncontrollable bouts 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 of side effects from taking the drug, but everyone should know about the possible consequences.
Instructions for use - dosage
The drug is available in powder form, from which you can prepare a solution for injection. The box also contains an isotonic sodium chloride solution for this. Therefore, the preparation of a ready-to-use tool of labor will not be. The drug is administered exclusively intramuscularly.
The dosage depends on the purpose of using the drug. Women who are going for IVF or to stimulate ovulation are injected with 5000–10000 IU of the drug once. If the treatment is carried out with the use of other means, it is important that at least a day has passed from the last intake of menotropins, and at least five days from the last intake of Clomiphene.
If the patient has insufficient functioning of the corpus luteum, then the optimal dosage for her is 1500 IU. The injection is given every two days until the moment when menstruation either 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, you should not do this in advance. The dosage of the active substance in the packages offered on the pharmacists' shelves is 500 units, 1000 units, 1500 units, 5000 units. The doctor will tell you the most suitable form, since the treatment must necessarily take place under the supervision of an experienced specialist.
Application to stimulate ovulation
Ovulation is the release of a mature and ready egg from a mature follicle. It usually happens in the middle of the cycle. For various reasons, the egg may be weakened, against the background of a lack of female hormones, it may not make a timely release or not mature. This is why fertility treatments often start with the promotion of healthy and normal 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". An important condition is 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 are passable, whether there are adhesions, as well as ovarian cysts.
If these pathologies are not present, then complex therapy is used. After menstruation, a woman is prescribed "Klostilbegit" and she should take it until the 9th day of the cycle.
Then an ultrasound is done, on which the size and number of follicles are established. As soon as one of them reaches the desired size, you can make the hCG angle. The drug is administered at a follicle size of 17 millimeters (preferably 19-22 mm). For this, the imported drug "Pregnyl" is often used, it has proven itself well.
Thus, "Clostilbegit" helps to prepare the egg for release, and the gonadotropin promotes rupture of the follicle and release of the egg. Dosages and treatment regimen are prescribed to each patient individually, because each woman has her own reasons for infertility, her own characteristics of the menstrual cycle. The prescribed course can be adjusted if it turns out on intermediate ultrasound that the therapy is ineffective, that symptoms of superovulation have appeared - cysts on the ovaries. The task of the doctor in this situation is to prevent their rupture; for this, hormonal treatment is canceled.
Many women who are going to have an ovulation stimulation procedure wonder how long after an injection ovulation occurs. The answer to this question is given by the manufacturers of the Russian-made drug. The official instructions for the use of the drug indicate 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 unit. As indicated above, the dosage for one injection is 5,000 to 10,000 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 the desired state of the follicle for conception is achieved. In IVF, ovulation is stimulated with a single dose of 10,000 units. The most effective are injections into the abdomen with a short needle (from an insulin syringe), this intramuscular method of drug administration is most often used.
For more successful planning during the preparation and conduct of ovulation stimulation, a woman is recommended to donate blood for progesterone and estradiol in dynamics, measure basal temperature daily, and also observe the sex life prescribed by the attending doctor.
Post-injection tests
The issue of using various tests after hormonal therapy with hCG drugs deserves special attention. The level of the hormone received by the 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. More often than not, the woman will see the second strip, but the result will be 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 earlier than 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 did not take place.
Pregnancy maintenance
An insufficient level of intrinsic chorionic gonadotropin is primarily manifested by a high probability of early miscarriage. Lack of this hormone leads to insufficient production of progesterone - the hormone "responsible" for maintaining pregnancy. Therefore, a low level of hCG can lead to intrauterine death of the embryo and a frozen pregnancy.
If a woman has already had pregnancies according to this scenario, with a high degree of probability she will be offered hormonal therapy with Chorionic Gonadotropin. If a woman suffers from habitual miscarriage, then she is recommended to identify the fact of pregnancy as early as possible using modern diagnostic methods and to start treatment with this drug or its analog on time.
It is important that the first injections during early pregnancy are given before obstetric week 8 and completed by week 14. This also applies to cases when a woman first develops 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 a successfully passed stage.
If the problem of miscarriage is improper work or dysfunction of the corpus luteum, the dosage can be from 1500 to 5000 units for one injection. If recurrent miscarriage is caused by immune or hormonal reasons, then the first dose will be 10,000 units, and the next 5,000 units. In case of miscarriages of 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.
During 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 a gynecologist more often, more often do an ultrasound scan to monitor the condition of the cervix and cervical canal, as well as to monitor the growth and development of the embryo, donate blood several times for hormones and biochemical analysis. In case of serious threat, a hospital stay is recommended.
If problems with conceiving and carrying a baby are associated with endometriosis, the doctor may prescribe hormonal gonadotropin agonists - releasing hormone.Women should understand that such drugs do not affect the ability to conceive a child, they only help prepare the woman's body for further attempts to conceive a baby, 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 specific cycle. The effect of the drug does not apply to other cycles.
When agreeing to treatment with this hormonal drug, a woman should be aware of such a consequence of gonadotropic therapy as multiple pregnancy. Often, a woman who is stimulated to ovulate with a high dosage of hCG (10,000 units) eventually becomes a happy expectant mother of not one, but two or three babies at once.
Many women complain that the lower abdomen hurts after the injection. This should not be scary, because the hormonal injection is quite painful, gradually these post-traumatic pains will pass.
If you take the drug of human chorionic gonadotropin for too long, then the body can develop antibodies that will prevent the production of this useful and necessary substance in certain situations. This will greatly complicate future pregnancies, making 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 raises a reasonable answer about the inadmissibility of alcohol during the planning period in general, with assisted reproductive techniques in particular.
How to inject?
Considering that the course of treatment is long, and not all future mothers live near a medical institution where you can apply for an injection, the question arises of how to give an injection of hCG yourself. In fact, it is not difficult if you follow the entire algorithm of actions:
Wash your hands well with soap and water. It is better to use an antibacterial soap.
The ampoule with isotonic sodium chloride solution opens first.
A syringe is drawn from it in full.
An isotonic solution is introduced into an ampoule with a powder of the drug and mixed well until uniform distribution without precipitation. You need to stir in a circular motion and in no case shake the ampoule.
The prepared 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.
Cotton wool dipped in alcohol or special pharmaceutical alcohol wipes is used to wipe the injection site.
The drug is administered intramuscularly, not quickly.
After the injection, an alcohol napkin is applied to the injection site and lightly pressed 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 a schedule while maintaining pregnancy, it is better to inject chorionic gonadotropin into the gluteus muscle.
Overdose symptoms
Hormone overdose can manifest itself with ovarian hyperstimulation. The appearance of a cyst on the sex gland can be indicated by a deterioration in a woman's well-being. There may be a sharp pain in the lower abdomen, nausea, vomiting. The pain occasionally "shoots" into the groin area. Many women with acute hyperstimulation syndrome have a feeling of intestinal distention, distention.
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.
In more severe cases, a woman's blood clotting is impaired - the blood becomes thicker, peritonitis and acute pulmonary failure may develop. A woman needs to immediately consult a doctor, temporarily stop taking the drug and undergo symptomatic treatment aimed at reducing and disappearing cysts, restoring water-salt and mineral balance, as well as therapy to normalize blood clotting.
Storage conditions 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 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 used again, 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.
Reviews
Many women in their reviews indicate that it was this drug that helped them get pregnant, gave them a chance to experience the real joy of motherhood. Most of these patients had already been treated with progesterone and other hormonal drugs in previous pregnancies, but to no avail - there were miscarriages or the pregnancy stopped in development.
Many mothers who have become mothers claim that the drug could have worked not from the first, but from the second or third time, but, compared to years of planning, 2-3 months did not seem like a long time to them. Among the shortcomings, women indicate the high cost of the drug, so for December 2017, the following prices for the original remedy are considered relevant:
packaging of the drug in a dosage of 500 U (5 ampoules + solution) - from 500 rubles;
package of "Chorionic gonadotropin" in a dosage of 1000 U (5 ampoules + solution) - from 750 rubles;
packaging of the drug in a dosage of 5000 U (5 ampoules + solution) - from 3200 rubles.
According to women who have left their reviews on this drug on the Internet, such a packaging (5 ampoules) is not very convenient for use, because some do not need more than one or two injections. As a result, the rest of the ampoules remain unclaimed.
The drug is excreted within 2 weeks, pregnancy tests show a reliable result to many after 2-3 days of delay from the day of the expected menstruation, which, fortunately, has not begun.
With regard to another use of the drug - to maintain pregnancy, the reviews are also mostly positive.
